ADHD: Living with Rejection Sensitivity Dysphoria

Does your child seem to have intense emotional responses?

ADHD is mostly defined by behavioral criteria and what the therapist can visually see. The behavioral criteria help define who and what will be studied and/or diagnosed.

Why should you focus on your child’s diagnosis?

ADHD affects their self-esteem and self-definition. They may often find themselves asking “Who am I?”, “Why do I behave this way?”, “Do people like me?”. This can be hard on their little minds and we want to help them feel accepted in every way possible. Your child may have different ways of thinking and processing the world and that’s okay! Cognitive capabilities are different in each individual and that’s what makes us unique!

Children who have ADHD have nervous systems that work in a different way. They may tend to lead intense, passionate lives. When they experience low moods, it will be very low moods. Also, when they experience high joyful moods, they will be very high. This is not to be confused with bipolar or mood disorders. Majority of their mood shifts are associated with a trigger, which sets it apart from those other disorders. It is hard for them to find a happy medium. They tend to feel more with every emotion. This can lead to them feeling more overwhelmed from within. This is called emotional dysregulation. Emotional dysregulation is a symptom of having ADHD.

Why does this happen?

ADHD is primarily a problem with insufficient inhibition in the brain. The Corpus Striatum is the area of the brain that inhibits all of the neurological inputs. When the Corpus Striatum is not ‘working appropriately’, children are unable to regulate the experience or expression of their emotions. This causes all of the emotions to be received by the brain as “raw” and becomes overwhelming to the child from too much input. Children with ADHD also notice a lot more input than those without. In fact, their brain is frequently recognized as moving 3 times faster than a brain without ADHD!

If your child seems to experience a sensitivity to rejection and/or teasing that is much more intense than usual, Rejection Sensitivity Dysphoria (RSD) may be what they are experiencing. Many researchers have acknowledged the concept of RSD, but they have yet to formally introduce it to the list of symptoms associated with ADHD. Many therapists and mental health professionals believe that they can see this as a symptom in their clients. RSD gives no warning to when or how emotions and feelings are received and outwardly expressed. The emotions usually happen all at once and instantaneously. They last as little as a few minutes or it could last for a few months and they are uncontrollable once they start. When the emotions are internalized, they may look a lot like symptoms of major depression (even possibly with suicidal thinking). When the emotions are externalized, it presents as rage and anger directed at the person and/or situation that “wounded” or offended them. We find RSD as one of the number one reasons our parents call us for a first time appointment.

How to help your child through it?

The best way to help your child is to let the emotion run its course. The emotion will eventually die down or your child may find something to distract themselves on their own. As a parent, you may want to evaluate the situation to make sure it is not manipulative. If the emotion disappears immediately after they have received what they wanted, then they could be using outburst to get what they want in the moment. You may want to talk to a psychiatrist for possible options for medication to help regulate moods. You may want to seek options for behavioral management. Your child may want to work on mindfulness and acceptance aspects of therapy. Mindfulness helps them focus their thoughts and attention on the present moment (here-and-now). Ultimately, it is used to increase awareness and focus.

Click here to learn more about our treatment plan for ADHD and Anger

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