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Evening Standard
Evening Standard
Health
Nuray Bulbul

What is RSD and how can it be managed? The ailment linked to ADHD

No one enjoys rejection. It stings whether you are excluded from a social gathering, passed over for a promotion, or ghosted by a romantic partner.

While these emotions may be felt heavily for a few minutes for most people. For some, rejection hurts just as much as getting hit or hurt physically and can last a very long time.

People with Rejection Sensitive Dysphoria (RSD) may imagine that others reject them or are disappointed in them, even when that’s not the case. And this rejection sensation may have negative implications in other parts of their life.

But what exactly is RSD? Here’s a full breakdown.

What is RSD?

Rejection Sensitive Dysphoria, or RSD, is a term used to characterise a severe emotional discomfort or sensitivity to criticism or rejection that is frequently linked to ADHD.

Currently, it's not an official medical diagnosis, but it describes a typical experience when even little criticism can cause overwhelming feelings of despair, anger, or worry.

Social connections, academic or professional performance, and general mental health are just a few of the areas of life that RSD can profoundly affect. It may result in social scenario avoidance, relationship management issues, and possibly exacerbate anxiety and depression.

The cause is still not entirely understood by experts. However, some think that your brain's structure may have a role.

Why is it linked with ADHD?

According to Eugene Arnold, a behavioural health specialist and psychiatrist at Ohio State University, individuals with ADHD are more likely to have RSD symptoms because of structural changes in their brains, as written on WebMD.

“For people with ADHD, the frontal lobe of the brain, which controls your ability to pay attention, language, social skills, impulse control, judgment, and problem-solving, works slightly differently. This might cause you to miss or not pay attention to certain social cues or details, or not collaborate well within a team. “

“You might lack insight” into how this might affect others around you and interpret unclear conversations as a form of rejection, being teased, or as criticism.”

All of this combined may cause intense emotions of betrayal, uncertainty, grief, and sadness. In addition, those with RSD may struggle to control emotions as rapidly as people without ADHD.

Emotional dysregulation, or the inability to control and recover from intense emotional reactions, is a significant (and frequently disregarded) aspect of ADHD that is frequently linked to attention or impulsivity.

The prefrontal cortex, which controls emotions and impulses, and the amygdala, the brain's emotional alarm system, tend to function differently in individuals with ADHD, according to brain imaging research.

How is RSD diagnosed?

Diagnosis for RSD is difficult as it’s currently not a medical diagnosis. Additionally, your GP, counsellor, or professional therapist may still be unaware of RSD.

They may identify the pattern of behaviour related to rejection sensitivity and link it to other problems you have if you have already been diagnosed with ADHD or another mental health condition.

How to manage symptoms

RSD does not have a specific cure or treatment. However, certain medications and therapies for ADHD and other mental health conditions may help control strong emotional reactions.

Psychotherapies, including talk therapy and cognitive behavioural therapy, typically assist in addressing rejection sensitivity. Patients may benefit from this type of therapy by being more conscious of and insightful about their emotional reactions.

Instead of having a violent emotional outburst, it can help you develop positive habits like listening to the other person, asking for clarification, or waiting or taking some time to consider your reaction. Additionally, it may help you better regulate your impulses.

Psychotherapy can assist you in developing coping mechanisms or methods to manage your emotions and control them in a variety of social contexts.

Consult your GP, who will advise you on the best course of action.

If you or anyone you know is struggling, contact the NHS urgent mental health helpline by calling 111. You can also contact Samaritans by calling 116 123, or text “SHOUT” to 85258 for 24/7 crisis text support.

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