Rejection-sensitive dysphoria (RSD) happens when you feel severe emotional pain in reaction to perceived rejection. RSD is strongly associated with attention-deficit/hyperactivity disorder (ADHD). Most ADHD individuals report extreme emotional dysregulation when they’re criticized, left out, rejected, or have any other experience that could be seen as “falling short.”
ADHD puts individuals at a higher risk of developing an eating disorder. The overlap between eating disorders and ADHD could be a result of various factors unique to the individual, such as struggles with proprioception or the stress of being neurodivergent in a world built for neurotypical people. But in this post we’ll focus on why the emotional dysregulation resulting from RSD could overlap with the development of an eating disorder.
What Is Rejection-Sensitive Dysphoria?
Rejection is an unpleasant experience for almost everyone, but for those with RSD, any perceived rejection can cause a painful and intense emotional reaction. RSD is a more intense version of rejection sensitivity—an experience that has long been recognized in clinical psychology and psychiatry.
People who have rejection sensitivity tend to anxiously expect, readily perceive, and intensely react to rejection. Rejection sensitivity is proven to develop from low self-esteem, social anxiety, insecure attachment, or past experiences with rejection. The difference between rejection sensitivity and RSD is how intensely the person reacts to any perceived rejection.
The word dysphoria stems from a Greek word meaning “difficult to bear.” Those with RSD experience a significant level of emotional dysregulation when faced with rejection, criticism, or the feeling of falling short. Emotional dysregulation happens when you can’t properly regulate your reaction to your emotions. It can lead you to feel unable to control your response to intense feelings, such as shame, anxiety, disappointment, or, in the case of RSD, rejection.
Rejection-Sensitive Dysphoria and ADHD
RSD is not a diagnosis in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, but it is an experience that is strongly linked with ADHD. The brain chemistry associated with ADHD makes rejection, criticism, and failure more unbearable and severe than for neurotypical individuals.
Also, being a neurodivergent individual in a world built for neurotypical brains often results in more experiences of social rejection. These past experiences, alongside the intense emotional dysregulation that accompanies failure or criticism, can lead people with ADHD to turn to people-pleasing or avoid specific experiences or tasks that could open them up to further rejection.
Common Ways People Cope With RSD
- People pleasing. People pleasing is the tendency to put others’ needs before your own. Those with RSD will constantly be trying to anticipate the wants and needs of those around them so that they can behave in a way that ensures praise or admiration. People pleasing can leave individuals emotionally exhausted and confused about their identity. When you constantly put someone else’s desires before your own, you can lose sight of your opinions, hopes, or wants.
- Avoidance. If facing rejection becomes too overwhelming, individuals with RSD will begin to avoid situations where there is any possibility of falling short or being criticized. Individuals with RSD may stop trying new things, refuse to take on a new project, or find they cannot get themselves to start an assignment for fear of messing it up. In this sense, RSD can become paralyzing, leaving those struggling unable to participate in activities that could move them forward in life.
Rejection Sensitive Dysphoria or Mood Disorder?
The emotional response to RSD oftentimes gets internalized by people who are struggling. People with RSD may internalize their emotions around rejection due to their heightened sensitivity to opening themselves up to criticism from others. When RSD’s reactions are internalized, they can mirror mood disorders. However, mood shifts from RSD are distinct from mood disorders in the following ways:
- The mood changes have an identifiable trigger.
- The mood shifts in an instant.
- The mood episode ends quickly and rarely lasts more than a few hours.
When RSD Gets Internalized
Signs of internalized RSD can include:
- Withdrawal from others
- Negative self-talk
- Low self-esteem
- Negative self-perception
- Rumination and perseveration on the situation that caused pain
When RSD Gets Externalized
Externalized RSD can manifest in different ways, such as:
- Sudden emotional outbursts
- Rage at the person or situation causing the emotional pain
- Abruptly leaving the area or space
- Slamming doors
- Yelling or bursting into tears
- Self-injury
Eating Disorders, ADHD, and Rejection-Sensitive Dsyphoria
Research has shown that individuals with ADHD are at a higher risk of developing an eating disorder. The link between ADHD and eating disorders is thought to be due to multiple factors, including the following:
- Increased sensory sensitivities that can lead to a gravitation toward or avoidance of certain foods.
- Struggles with proprioception, or an inability to get in touch with hunger or fullness.
- Time blindness, or difficulties with perceiving the passing of time, which can lead to missed meals.
- Impulsivity, which can cause people with ADHD to struggle to regulate how much or what they eat.
- Added stress or trauma of living as a neurodivergent individual in a world built for neurotypical people.
- Emotional dysregulation, or the inability to properly regulate reactions to feelings.
RSD leads to emotional dysregulation when faced with rejection. Eating disorders can develop as a way to cope with the big emotions that arise as a result of RSD. Eating disorder behaviors can mute or distract a person from their feelings, giving them a sense of control over the situation.
Disordered eating behaviors could also develop as a way to try to gain the approval or praise of people. As mentioned earlier, one of the ways that people with RSD cope is through people pleasing. Since we exist in a society that glorifies thinness, an eating disorder could develop as a way to cope with feelings of rejection by trying to be accepted by pursuing a thin body.
Getting Support
If you are struggling with RSD or disordered eating, know that support is out there. In therapy, you can build insight into your experience, learn more about your unique neuro complexities, and explore new ways of coping with your emotions. Therapy can also be a place where you can begin to explore your reaction to rejection and rewrite your relationship with food.
To find a therapist, visit the Psychology Today Therapy Directory.