Those with ADHD are also more likely to be rejected by peers while also exhibiting a far more pessimistic view of the quality of their social relationships, which later carries over into romantic attachments. Relational dysfunction continues later in life, as individuals with ADHD show higher rates of potentially risky sexual behavior yet are still unable to establish close relationships with ease . Instead, they often portray impulsivity in partner choice, perpetuation of self-protective measures to manage feelings of rejection, and depression. Many develop a sense of mistrust in others that leads to engagement in deactivation strategies. As a result, the automatic response to distress becomes shutting down and denying needs, as an individual learned that this can further their relational alienation. Thus, relying on ineffective problem-solving is adapted to avoid conflict and favor internalizing behaviors. 

RSD and Romantic Relations

-rejection (the real or perceived withdrawal of love, approval, or respect)

-teasing

-criticism, even if constructive

-persistent self-criticism, or negative self-talk prompted by real or perceived failure

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A common and disruptive type of emotional dysregulation (ED) that is thought to be innate to ADHD and not caused by trauma. It is also sometimes called hysteroid dysphoria in Europe and is characterized by intense but brief mood shifts triggered by real or perceived rejection or criticism. 

Rejection Sensitivity Dysphoria (RSD)

Dodson, W. (2022, July 11). New insights into rejection sensitive dysphoria. ADDitude. Retrieved March 12, 2023, from https://www.additudemag.com/rejection-sensitive-dysphoria-adhd-emotional-dysregulation/ 

New insights into rejection sensitivity dysphoria

Triggers for RSD

-sudden emotional outbursts after perceived criticism/rejection

-social withdrawal/self-isolation

-negative self-talk

-thoughts of self harm

-avoidance of social situations where they could fail or be criticized

-low self-esteem

-rumination and perseveration 

-relationship issues, especially feeling constantly attacked and responding defensively 

Outward Behavioral Signs of RSD

"Dysphoria" means "unbearable" in Greek; the emotional pain experienced during an episode of RSD is often described as "unbearable", "terrible", "catastrophic", or "devastating". The feeling is also often compared to being punched or stabbed in the chest and the specific emotional quality is hard to verbalize according to those who experience RSD.

Emotional Impact of RSD

Qualities of Mood Disorders:

-mood shifts have no clear trigger

-mood is independent of current life events

-mood shift is gradual, happens over course of a couple of weeks

-duration of episode must be 2+ weeks

Qualities of RSD:

-mood shifts have trigger

-mood is reflective of current life events

-mood shift is immediate

-duration of episode is a few hours at most before returning to baseline


RSD vs Mood Disorders

-RSD/ED not constantly present, only appears in triggered episodes

-there's no way to measure it at this point in time, so its presence cannot be published in research

-many people hide their RSD/ED due to shame and stigma, and do not want to be labeled as mentally unstable or over-reactive so it often goes unnoticed or unaddressed 

*note that research into RSD is very new, about 5 years old; though RSD is not diagnostic material there have been an overwhelming amount of subjects in ADHD studies and others with ADHD who identify strongly with this experience and so research is ongoing*

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