Unmasking the Emotional Depth of ADHD: Exploring Rejection Sensitivity Dysphoria (RSD)

ADHD is a neurodevelopmental condition that affects millions of individuals around the world. While ADHD is often associated with symptoms like impulsivity, hyperactivity, and inattention, it encompasses a range of emotional and cognitive challenges that can be just as impactful. One of these challenges is Rejection Sensitivity Dysphoria (RSD), a concept pioneered by renowned clinical psychologist Russell A. Barkley. In this blog I will try to shed some light on this often-overlooked aspect of ADHD.

ADHD – More than meets the eye.

Females of all ages have since long known what research and clinic is starting to catch up with: that ADHD is more than distractibility and restlessness. Indeed, ADHD is a multifaceted condition that extends well beyond these well recognized symptoms. Letterlife is very much inspired by the theories displayed by Russell A. Barkley, who argue that ADHD is better understood through a framework of executive functioning deficits such as self-organizational skills, self-regulation, and emotional self-control.

Since ADHD can manifest so differently in everyone, a spectrum of symptoms can be the outcome of the same underlying disorder. For some, ADHD is manifested predominantly as inattention, causing difficulties in sustaining focus and completing tasks. For others, hyperactivity and impulsivity take the forefront, leading to difficulties in risk-taking behaviors and problems in social interactions.

Rejection Sensitivity Dysphoria (RSD)

Among the many challenges associated with ADHD, Rejection Sensitivity Dysphoria (RSD) stands out among girls and women. The term RSD, coined by Barkley several years ago, describes how children and adults with ADHD experience intense emotional reactions when feeling criticized, get negative attention or feel left out in social situations. It’s not a formal diagnosis but rather a concept very accurately describing the heightened emotional responses displayed by many children and adults with ADHD when they feel questioned or rejected by their peers.

Of course, RSD is not unique to ADHD, but according to Dr Barkley it seems to be particularly common in neurodivergent people of all ages. Individuals suffering from RSD often find themselves overwhelmed or almost “kidnapped” by emotions of loneliness, hurt, sadness, frustration, or anger in response to perceived criticism or rejection, even if it’s totally and honestly unintentional or perceived as a “silly thing” by others. Others may feel that these strong emotional reactions are quite disproportionate to the situations. Thus, extremely unfortunate for neurodivergent people with RSD, they distance themselves or withdraw from the person with RSD, making the self-full fulfilling prophesy a fact.

How is ADHD and RSD associated?

So, how does Dr Barkley explain the connection between ADHD and RSD? Well, much of Dr Barkley’s work emphasize that individuals with ADHD often have deficits in emotional self-regulation. These deficits can result in heightened emotional responses to criticism or rejection, leading to RSD. Moreover, the challenges in executive functioning can also contribute to misunderstandings, impulsive reactions, and difficulties in social interactions, further fueling the emotional turmoil. Adding female hormonal fluctuation to the mix usually doesn’t help.  Rather naturally cycling girls and women with ADHD and RSD, daily life can be a rollercoaster of intense emotions, misunderstandings, strained relationships and sinking self-esteem.

Is there anything to be done?

Yes of course, and just as with so much around ADHD and mental health it starts with self-awareness and understanding that RSD is a real and valid aspect of ADHD. And, importantly, that you are absolutely not alone having these experiences. Also, Cognitive Behavioral Therapy (CBT) can offer valuable tool for addressing RSD by identifying and reframing irrational thoughts about what others may think and how to interpret others’ behaviors. By questioning what you perceive as criticism or rejection, you can take control over your emotional responses and reduce the intensity of your emotional reactions. Many girls and women find support networks like our Letterlife Community crucial to gain control over their RSD. By sharing your experiences with others that truly understand what you are experiencing. Many of our users say how much the testimonies of community members have helped them gain a deeper self-awareness and articulating feelings and experiences in words that makes sense for their friends and family members. The beauty of the LL Community is that it’s there for you 24:7 offering understanding, empathy, and guidance during challenging times.

So, to conclude, it’s essential to remember that ADHD so much more than inattention and hyperactivity. Females with ADHD face complex challenges affecting emotional, mental, and physical well-being. By embracing the important work by Dr Russell Barkley, we can all be part of the movement towards a more inclusive and empathetic society, ensuring that females with ADHD and RSD receive the understanding and support they deserve.

Do you want to be part of a more compassionate and supportive environment for girls and women facing the same challenges as you? 

Do you want to raise awareness about RSD, reduce stigma and help others find the resources and support they need? 

Then you should join our new avenues for research and support by co-creating Letterlife Community with us!