Everyone feels hurt when they’re rejected or criticized, but for some people, that emotional pain can feel almost unbearable. This intense response is known as rejection sensitive dysphoria (RSD), a common experience among neurodivergent individuals, especially those with ADHD or autism.
So, what is rejection sensitive dysphoria, and what can be done about it? Understanding what RSD is and how it works can help people develop self-compassion, set boundaries, and find tools to manage emotional sensitivity in a healthy way.
What Is Rejection Sensitive Dysphoria?
Rejection sensitive dysphoria refers to an extreme emotional reaction to real or perceived rejection, criticism, or failure. The word dysphoria refers to a state of unease or discomfort, and that’s exactly what RSD feels like: an emotional pain that’s often disproportionate to the situation.
People experiencing RSD might describe it as a sudden wave of shame, embarrassment, or anger that comes on when they think they’ve disappointed someone or been left out. Sometimes, the fear of rejection is so strong that it causes individuals to avoid social situations or new opportunities altogether.
While RSD isn’t an official medical diagnosis, many mental health professionals recognize it as a pattern linked to brain differences seen in ADHD and autism. These brain differences affect emotional regulation—making rejection, even imagined, feel like a threat.
Rejection Sensitive Dysphoria & Autism
RSD and autism often go hand in hand. Autistic people may already experience heightened emotional and sensory sensitivity, which can make perceived rejection feel especially intense.
Communication challenges, social misunderstandings, and a lifelong experience of being “different” can all amplify rejection sensitivity. For instance, an autistic person might interpret a neutral facial expression as disapproval, or replay a social interaction for hours afterward, convinced they said something wrong.
Over time, this can lead to social anxiety, masking, and burnout—as individuals try to avoid rejection by constantly monitoring or suppressing their authentic selves.
What Does RSD Feel Like? Rejection Sensitive Dysphoria Symptoms
Rejection sensitive dysphoria can look different for everyone, but some common signs and symptoms include:
- Extreme emotional pain after perceived criticism, rejection, or failure
- Avoiding relationships or opportunities to protect against possible rejection
- Anger or rage in response to feeling dismissed or misunderstood
- People-pleasing or perfectionism as a way to prevent disappointment
- Overanalyzing interactions, replaying conversations, or feeling deep regret afterward
- Low self-esteem that fluctuates based on others’ approval
- Physical sensations like chest tightness or a “drop” in the stomach after rejection
Because RSD reactions are so intense, they can sometimes be mistaken for mood disorders. However, the key difference lies in what triggers them—emotional pain that’s directly tied to rejection or criticism.
Why Rejection Sensitivity Happens
It’s believed that rejection sensitivity stems from differences in how the brain processes emotional stimuli and social feedback. In people with ADHD and autism, certain neural networks may respond more strongly to emotional pain and social stressors.
Additionally, many neurodivergent people grow up facing misunderstanding or exclusion, which reinforces the belief that rejection is inevitable. Over time, the brain becomes conditioned to expect rejection, even when it’s not actually happening.
How to Cope with Rejection Sensitive Dysphoria
While RSD can be painful, it’s also manageable. Understanding the cause is the first step; from there, individuals can explore strategies to build resilience and self-compassion. Here are a few approaches that can help.
1. Name and Normalize It
Simply learning that RSD is a recognized pattern can be empowering. When you identify what’s happening, you can respond with understanding rather than shame.
2. Build Awareness of Triggers
Keep track of moments when you feel especially reactive or hurt. Recognizing patterns—such as feedback from a boss or social rejection—can help you plan ahead for emotional regulation.
3. Practice Self-Soothing and Emotional Regulation
Mindfulness, deep breathing, or sensory grounding techniques can help calm the body’s stress response. Some people find that stimming, journaling, or movement helps release emotional intensity.
4. Reframe Rejection
Try to separate your sense of self-worth from others’ opinions. Cognitive reframing—asking “What else could this mean?”—can turn automatic negative thoughts into more balanced interpretations.
5. Seek Support
Working with a therapist who understands autism, ADHD, and RSD can provide strategies tailored to neurodivergent needs. Peer support groups can also be valuable spaces for connection and validation.
Learn More About Life with Autism, ADHD, & Other Neurodevelopmental Disabilities
At NeuroNav, we help autistic and neurodivergent individuals and families navigate services, goals, and self-determination. Whether you’re learning about your diagnosis, developing emotional regulation skills, or planning for independent living, our team can help guide the way.
Schedule a consultation today to learn how NeuroNav’s independent facilitation services can support your goals.
