Symptoms of Rejection Sensitive Dysphoria
- Being easily embarrassed or ashamed
- Emotional outbursts or intense anger when feeling rejected
- Setting impossibly high standards for themselves
- Low self-esteem
- Anxiety, especially in social settings
- Relationship difficulties
- Avoiding social situations and other people
- Feeling like a failure for not living up to others’ expectations
- Thinking about hurting themselves after experiencing rejection
Some RSD symptoms are also common in other conditions, including:
Because RSD can look like other conditions, accurate diagnosis by a licensed professional is essential. There is also a causal link between adult ADHD and RSD — consider seeking evaluation for both if symptoms suggest it.
Causes of Rejection Sensitive Dysphoria
The exact cause is not fully understood. A history of early trauma and genetics both play a role — RSD can be passed down in families. Other contributing factors include an overly critical or neglectful parent or caretaker (which can contribute to low self-esteem, fear of rejection, anxiety, and fear of abandonment), and experiences of bullying by peers or romantic partners.
Diagnosing Rejection Sensitive Dysphoria
Because RSD symptoms overlap with other conditions, a doctor must first rule out underlying mental health issues. Seek a professional diagnosis from a licensed counselor, psychologist, psychotherapist, or other mental health professional. During the consultation, a doctor may ask about family history and how you react to certain situations. Online self-tests can also be a helpful starting point.
Screening questions may include:
- Do you experience sudden, intense feelings of rage when your feelings are hurt?
- Do you experience sudden depression when you feel rejected or criticized?
- Are you your harshest critic?
- Do you feel anxious in social situations because you assume no one likes you?
- Are you a “people pleaser” who goes above and beyond to get on someone’s good side?
- Do you think that you cannot go on feeling this way?
Treatment for Rejection Sensitive Dysphoria
There is no cure for RSD, but treatment options are available. The best approach depends on symptom severity and whether there is overlap with other conditions. Awareness is the first step.
- CBT: Cognitive behavioral therapy can reduce hypersensitivity and build coping skills for rejection and criticism. Works in a structured, goal-oriented way to address dysfunctional emotions, behaviors, and thought patterns. Available online.
- Medication: Can help calm physiological reactions to rejection and relieve associated symptoms such as hyperactivity and depression.
- Stress management: Emotional reactions to rejection are more likely when stressed. Eating well, getting enough sleep, and regular exercise all help promote a calmer emotional baseline.
