top of page

Rejection Sensitive Dysphoria

Most people want to be accepted and liked by those around them. Many wish they didn’t care about what others think of them, which rarely happens. In many circumstances, we might find ourselves getting rejected by people. No one likes getting rejected, although; often, people can manage the feelings arising from rejection in a fair manner. Certain factors involve social support, resilience, coping mechanisms, and self-esteem, influence how one handles oneself in the face of rejection. From the evolutionary side, though, one can understand the benefits of being averse to rejection. During cave dweller days, one needed the tribe to survive. Being on the verge of getting ousted by the tribe puts an individual in mortal peril. Hence as a species, humans developed physical and psychological reactions to rejection. These usually support the feelings of belongingness and made one more obstructed towards rejection.

Even though averse to it, all humans face rejection in some form or another during their lifetime. For some people, these feelings of rejection are easier to manage, for others not so much. Specific individuals who experience rejection sensitive dysphoria (RSD) have a severe emotional reaction following rejection. In real or perceived rejection cases, a person with RSD can exhibit episodes of panic, rage, hopelessness, or despair. They may also feel intense feelings of guilt, shame or inadequacy. Those experiencing RSD perceive a strong sense of disappointment in their loved ones while feeling that they have failed those around them. Some individuals who chronically go through this, feel an insurmountable amount of distress and struggle to maintain control.

In the face of rejection, RSD makes it difficult for the person to move forward and deal with the feelings. There is a heavy preoccupation involved with the thought of being rejected to the point that these thoughts become intrusive leading to mental discomfort spilling to physical uneasiness too.

RSD usually follows two patterns: high-anger RSD and high-anxiety RSD. For individuals with high-anger RSD, there are more episodes of lashing out on others. They seek revenge on those who criticize or reject; outbursts of hostility or anger directed at those rejecting or in intense feelings, an aggressive stance towards self or others. On the other hand, with high-anxiety RSD, there is a high avoidance of situations where one may be rejected. They may also withdraw from most people and situations to avoid rejection or ruminate over being rejected repeatedly. It can be caused by being exposed to overly perfectionist standards, experiencing an extremely upsetting rejection at a young age. This may lead to being shamed for normal behaviour or being made to feel overly guilty for the same. It also involves a dysfunctional attachment with caregivers or any possible trauma, abuse, or neglect can also make one sensitive to rejection.

Quality of life deteriorates for these people. They avoid situations where there is a possibility of getting rejected, such as applying for new jobs or trying to date new people. Over time due to an inability to express oneself to their full potential, they start to feel dissatisfied and frustrated with their lives and themselves. Some may also develop resentment and anger towards self. Whilst the impairment of this condition causes is very real, there is still no official diagnosis present for the same. Despite not being recognized as a condition on its own, it is associated with other mental health concerns. Individuals with RSD have a vulnerability for developing depression as they find themselves unable to express this pain through anger and direct it inwards.

Any negative incident with rejection affects the person’s self-esteem, causing them to evaluate any event in the same light. For example, a person with RSD facing light-hearted teasing at their friends’ hands may believe their friends don’t like them. Sometimes this can be confused with social anxiety. However, social anxiety begins before one enters a social situation compared to a person with RSD who feels no anxiety while interacting with others. Although, unless the interaction involves a possible hint of rejection or criticism. Another important distinction between the two may be how a person experiencing social anxiety would feel embarrassment while facing strangers. On the contrary, a person with RSD will feel more embarrassment and despair when rejected by a loved one. In some instances, RSD may also overlap with social anxiety within the same individual and contribute to one another.

Research also shows that RSD is linked to people who have ADHD and autism. This does not necessarily mean that all individuals with ADHD and autism have RSD but that these conditions increase the likelihood of being more sensitive to rejection. This may be because these mental health conditions make regulation and management of emotions difficult. Such individuals experience all the emotions more intensely than the average population, thereby adding to troubles they face. ADHD and autism symptoms may make one miss social cues and cause seeming social friction between them and others in an interaction. Thus, they may hear more people complain about them or criticize them on a greater frequency. For example, a child who cannot wait for his turn to talk or may not be able to help soothe someone in distress is more likely to be criticized. Constant criticism may invariably feel like rejection by others on most fronts and trigger their rejection sensitivity leading to feelings of shame and embarrassment.

This meme is a simple representation of how a slight form of criticism may feel like an intense rejection for an individual who has ADHD

RSD may also cause dysfunction in relationships. The person with rejection sensitivity would be highly focused on any perceived or real, even slight criticism or rejection. Simple events like their partner replying late to their texts may make them anxious with thoughts like “Why are they not texting me back?” “Why are they taking so long” “Have I done something wrong?” This rumination may lead to feelings of sadness and anger directed at self, which can encourage the individual to isolate themselves. Once the individual isolates themselves, they will begin to push away the person in relation by seeming disinterest from their side. A person with RSD may also seek constant reassurance from their partner on trivial topics to avoid rejection. Individuals may also start to suppress their own emotions. They may feel that these feelings may not be accepted by the other. An individual with RSD may also become very controlling towards their partner because of their anxiety. To avoid getting rejected by their partner, they may keep a tighter leash around them.

For individuals experiencing RSD, it is essential to understand the emotional reactions to situations with perceived rejection. Challenging the dysfunctional thoughts and examining the accuracy of rejection can help one manage the feelings arising from it. Secondly, creating a dialogue with the other person, about the perceived rejection. For example, suppose Kate’s friend didn’t respond to her text, rather than spiralling into thoughts of being rejected. In that case, Kate can begin an inquiry into the same. She can do so by asking her friend why she didn’t answer her phone, to which she will get a response. This response is likely to reduce the anxiety that Kate experiences. It reinforces her to break the cycle of assuming rejection on others’ behalf.


Bonior, A. (2019, July 25). What Is Rejection Sensitive Dysphoria? | Psychology Today

Raypole, C. (2019, November 30). More Than ‘Thin-Skinned’: Rejection Sensitive Dysphoria. Good Therapy.

151 views0 comments


bottom of page