Dealing with Rejection Sensitive Dysphoria (RSD)

Many children with ADHD have a sense that they’re somehow different from their peers, even if they don’t have a diagnosis. These children are right; they are different — and that can be both a great thing and a source of challenges. Some children have a harder time bouncing back from failures, criticism, and rejections than others. Children with rejection sensitive dysphoria (RSD) may start to fear that others are harboring resentment for them or just plain dislike them. These children need some extra support and positive reinforcement to develop emotional resilience and a positive self-image.

Rejection-sensitive dysphoria is severe emotional pain caused by perceived failures or the feeling of rejection. A lot of people with ADHD experience it, and researchers suspect it may happen because of differences in their brain structure. People with RSD have a harder time regulating rejection-related emotions and behaviors. This only makes these feelings feel more intense.

RSD goes beyond typical rejection sensitivity in a few significant ways. People with RSD may develop anxiety or feel other negative emotions while anticipating a rejection. If an encounter is neutral or vague, they’re likely to see it as a rejection and react accordingly. People with RSD struggle to regulate their emotions in situations when they expect they might fail. This can look like overreacting, taking things personally, perfectionism, people pleasing or extreme negative feelings.

Parents, teachers, and mentors can help children with RSD learn healthy coping skills to regulate their emotions. They can also support them in developing the social skills and resilience to engage with others in ways that aren’t so painful. The following are our top tips for helping a child with rejection-sensitive dysphoria.

1. Be kind. This point may sound simplistic, but children with RSD are likely to encounter others who don’t have the patience or consideration to meet their intense feelings with kindness. This includes both peers and adults in their lives. Speak to them with an even and gentle tone, and if you’ve said something harsh, apologize. Recognize that these children are more vulnerable to feeling embarrassed or ashamed. “Tough love” isn’t going to work for children with RSD.

2. Help them learn self-compassion. Some children internalize negative messages they hear about themselves because of RSD. This can lead to a poor self-image or low self-esteem and perfectionism. You can model self-compassion by admitting your mistakes. When you hear the child use negative self-talk, encourage them to give themselves some grace. Talk about the important function of self-compassion in a positive relationship with oneself. You can set up this conversation by asking what they would say to a friend in a similar situation.

3. Help them learn emotional regulation skills. We all need emotion regulation skills to get through the day. Children with RSD may need more help noticing when their emotions are running high and redirecting them to a healthy outlet. Practice things like deep breathing and self-soothing with comforting sensations when the child is feeling good. That way, these skills will be accessible when intense emotions come up.

4. Help them come up with positive affirmations. Affirmations are another proactive tool that can help build defenses against negative self-talk. You can help the child take some of the negative things they’ve said about themselves and flip them to create positive affirmations. For example, “Nobody likes me because I’m always crying” could turn into, “My emotions are powerful messages and I have good friends who don’t judge me.”

5. Help them focus on what’s true. In moments when RSD is causing a lot of anxiety, gently challenging and reframing negative thoughts can help a child curb their worries. After all, worrying about things we can’t control drains energy we could be using in more interesting and positive ways. When a child expresses that they’re expecting negative feedback, ask how they know that will be the outcome. Getting consistent negative feedback from someone might say more about the person giving feedback than the person receiving it. This can be very hard to understand at a young age.

Allison Green
Boston Tutoring Services