Rejection Sensitive Dysphoria

No one likes rejection – it doesn’t matter if it comes from friends, family, coworkers, or a crush. While some people can move on from rejection easily, others find the feeling excruciating, so much so that it triggers an overwhelming emotional response of emotional pain and anxiety. While it is completely normal to be a sensitive person, someone with high rejection sensitivity will experience deep emotional pain from their mood disorder. Those who have a more painful reaction to rejection may be experiencing rejection sensitive dysphoria (RSD), characterized by extreme emotional sensitivity to being criticized or rejected (it can occur even when no rejection has taken place).

For those who experience rejection sensitive dysphoria, normal life experiences such as rejection, criticism, or failure simply become too much to bear. Their responses are much more severe than would be typically expected, and can be restricting, difficult to manage, and affect quality of life. Sometimes, this complete dread of rejection will fuel a person to work hard to be universally liked, or they may avoid situations where they could be hurt emotionally. This mental health condition can also negatively impact relationships – the belief that you are being, or will be, rejected becomes a self-fulfilling prophecy.

While no one enjoys rejection or failure, those with rejection sensitive dysphoria may exhibit symptoms such as:

• Being easily embarrassed or ashamed
• Having an emotional outburst and getting angry when they feel rejected
• Setting impossibly high standards for themselves
• Experiencing low self-esteem
• Feeling anxious, especially in social settings
• Having issues with relationships
• Avoiding social situations and other people
• Feeling like a failure because they haven’t lived up to others’ expectations
• Thinking about hurting themselves after experiencing rejection

 

It is important to note, some of these symptoms are also common in other mental health conditions, such as:

• Bipolar disorder
• Borderline personality disorder
• Posttraumatic stress disorder
• Obsessive-compulsive disorder
• Depression
• Social phobia

 

This mental health condition can look like other mental health conditions, so it is important to get the right diagnosis from a licensed psychologist, psychotherapist, counselor, doctor, or other mental health provider. There is  a causal link between having adult ADHD and experiencing any of these symptoms, so consider seeking a more immediate diagnosis.

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Those who have RSD are extremely sensitive to perceived rejection and triggered by certain situations – but the exact reason for this is not yet fully understood. Like many mental health issues, there is not one single factor that causes this rejection sensitivity, but rather, it is often a history of trauma – rejection and neglect early in life – as well as genetics that play a role.

Some people are genetically predisposed to RSD, and it can be passed down in families. In other instances, someone with RSD may have experienced a parent or caretaker who is overly critical or neglectful. In these situations, it’s likely that trauma may have contributed to the sufferer’s low self-esteem, intense fear of rejection, anxiety, and of abandonment in their relationships. Other situations can also cause an extreme sensitivity to rejection, including being bullied by peers or a romantic partner.

A doctor must first rule out if the rejection sensitive dysphoria is connected to an underlying mental health issue when determining if a person has the condition. This is because its symptoms are also common in other mental health issues. To assess symptoms, be sure to seek a professional diagnosis from a licensed counselor, psychologist, psychotherapist, or other mental health professional.

During the initial consultation, a doctor may ask about family history and symptoms. A person will likely answer questions about how they react and feel in certain situations. There are also online self-tests to help determine if a person’s symptoms match those of RSD.

Some of the screening questions may include:

• Do you experience sudden, intense feelings of rage when your feelings are hurt?
• Do you experience sudden depression when you feel rejected or criticized?
• Are you your harshest critic?
• Do you feel anxious in social situations because you assume no one likes you?
• Are you a “people pleaser” who goes above and beyond to get on someone’s good side?
• Do you think that you cannot go on feeling this way?