Does your ADHD child seem overly sensitive or overreact to perceived rejection? Your child might have RSD, or rejection sensitivity dysphoria. RSD is an emotional response to being rejected or criticized. Feeling rejected or criticized by those we value and love doesn’t feel very good, but it can feel a lot worse for someone who has RSD. While ADHD is discussed quite a bit, RSD is not discussed much and yet it can be a big proponent of ADHD. Let’s dive more into what RSD is, how the brain experiences RSD, and what to do if you suspect that your child does have RSD.
Characteristics of RSD:
- Low self-esteem
- Feeling embarrassed or self-conscious easily
- Setting unrealistically high standards
- An excessive need to please adults and peers
- Difficulty believing that they can do something
- Outward emotional response that may look like an outburst of anger or tearfulness
- Inward emotional response that may look like a sudden shift in mood or a depressive state
- Going out of the way to please others to avoid their disapproval
- Avoiding things that may spark that feeling of failure
- A theme of perfectionism – this may look like erasing and starting over, or not being able to stop until something is the way they want
RSD in the Brain:
Research hasn’t given a clear answer as to why RSD happens, but there is research on how it shows in the brain. There are different parts of the brain that are responsible for things like speech, hearing, vision, emotions, and pain. The thalamus is the part of the brain responsible for pain, and research has shown that it lights up for individuals with RSD when they feel rejection. So, individuals with RSD quite literally feel pain when they feel rejection!
At the moment, RSD isn’t a recognized medical condition. As a result, there is limited research available and therefore no conclusive way to diagnose someone with RSD aside from looking at the characteristics. It is also not well-known medically, so there is a chance medical providers will be unfamiliar with RSD.
What can you do?
Currently the treatment for RSD is a combination of medication (medications that are already commonly used for ADHD, such as guanfacine) and therapy. Aside from these options, here are some things that you can do at home:
- If your child shows signs of RSD, this means that the slightest change in your facial expression, tone of voice, and the words you use, can all be taken as signs of rejection to your child. It can be overwhelming when certain things you do as a parent can cause your child to feel rejection. However, it will help if you become more aware of the words you use, how you speak and the body language you use in communication with your child, especially when you are trying to teach or give consequences as these are usually the moments that increase feelings of rejection. And don’t take it personally!
- If you are aware that something you did or said created a rejection response in your child, acknowledge, apologize and repair the relationship. How you respond after the fact is a critical piece in preventing a continued and prolonged rejection response.
- Try to boost your child’s self-esteem by shifting to more positive language that praises effort rather than the finished product. Instead of saying “Good job!” or “I like this,” try to recognize the time and energy spent, or ask what your child likes about the process.
- Focus on the good things your child does as well. Sometimes it can be easy to only focus on the negative things when you are correcting your child or giving consequences. However, it is vital to communicate the positive things your child does too.
- Finally, teach and model coping skills so your child will learn what to do when faced with feelings of rejection. Think about how you handle rejection: How have you learned not take things personally? What inner dialogue do you have that helps? Skill-building takes time, but these are skills you can teach your child so have some patience in this process!
Rejection Can Be More Painful with ADHD – CHADD
How ADHD Ignites Rejection Sensitive Dysphoria (additudemag.com)
Rejection Sensitive Dysphoria (RSD): Symptoms & Treatment (clevelandclinic.org)