Symptoms of Rejection Sensitive Dysphoria (RSD) 

Written by:Cynthia V. Catchings, LCSW-S

Published On: August 30, 2022

Medically reviewed by: Dr. Karmen Smith, LCSW, DD

Reviewed On: August 30, 2022

Updated On: July 14, 2023


Do you struggle with your self-image? Are you convinced that bad news and rejection are lurking around every corner? Does criticism trigger an unusually severe and emotional response even when it’s friendly or intended to be constructive? Have you been diagnosed with ADHD?

If you answered “yes” to any of these questions, especially the one about receiving an ADHD diagnosis, you may have a condition known as rejection sensitive dysphoria (RSD). While nobody truly enjoys criticism or rejection, RSD is a condition characterized by extreme emotional sensitivity to feelings of perceived rejection.

Although RSD isn’t a mental health condition formally recognized by the American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), it’s still a real thing that can make life extremely challenging. A psychiatrist or psychologist can help you evaluate what you’re experiencing to see if you have rejection sensitive dysphoria symptoms that interfere with your ability to live a healthy, productive life.

Keep reading to discover signs that you might be dealing with RSD along with tips for managing symptoms.

Signs of Rejection Sensitive Dysphoria

As noted, if you have attention deficit hyperactivity disorder (ADHD), there’s a good chance you might also have RSD. Some signs of rejection sensitive dysphoria to look for include:

  • You avoid new growth opportunities, both in your work and personal life, because you fear being rejected. It can be tempting and easy to simply not try for the things you want, since if you don’t try, you can’t be rejected. The truth is, though, this will ultimately just hold you back from reaching any sort of goals or growth in life.
  • You replay embarrassing moments from your life repeatedly in your mind. Everyone makes mistakes, and when you can’t give yourself grace and forgiveness, it can be detrimental in more ways than one. Becoming consumed with a misstep means you will be closed off to future relationships and possibilities.
  • You dread checking your email (or texts or messages) because you’re convinced there’s bad news waiting for you there. This can be especially prominent after you send a message or email and are waiting for a response.
  • You don’t just take criticism personally; you let it ruin your day. What’s important to remember here is that criticism is not just a normal part of life; it can be healthy when it’s constructive. You can work on how you handle and accept criticism by focusing on the times you receive it from people you trust in your life. When you know they’re coming from a good place, you can use the feedback or advice they’re giving you as an opportunity for growth.
  • You obsessively think about negative things that have happened to you in the past. Life can be hard sometimes, but focusing on things in your past, especially if they were challenging, can prevent you from experiencing great things in the present or future.
  • You are constantly worried your partner is mad at you or your relationship. All relationships have the occasional ups and downs, and nobody’s going to be in a good mood all of the time. However, becoming convinced that your partner is always mad at you is unhealthy for your relationship and for your own mental health.
  • You’re often accused of being too sensitive or of taking things too personally. If you find that your genuine reaction to things leads people to accuse you of being too sensitive, you might be dealing with RSD. It can be common for people to seem overly emotionally reactive when they’re dealing with rejection sensitive dysphoria.

“Some RSD signs resemble other mental health disorders, making it somewhat difficult to identify. That’s why it’s vital to consult with a mental health professional before diagnosing yourself.”

Licensed Clinical Social Worker-Supervisor (LCSW-S), CIMHP, EMDR Cynthia Catchings

Symptoms of Rejection Sensitive Dysphoria

Rejection sensitive dysphoria symptoms can be difficult to spot in some cases because symptoms do such a good job of mimicking other conditions like bipolar disorder and chronic depression. RSD also might look strikingly like:


Major and common symptoms of RSD can include:

  • Fear of failure
  • Feeling hopeless
  • Avoidance of social situations
  • Unreasonably high expectations for oneself
  • Low self-esteem
  • Frequently experiencing emotional outbursts
  • Intense anxiety
  • Anger or rage
  • Aggressive tendencies
  • Being a people-pleaser
  • Being a perfectionist

While RSD can look like other things, unlike most other mental health conditions and disorders, rejection sensitive dysphoria symptoms are generally brief and are rarely triggered by actual events. Rather, they’re typically brought on by an emotional cycle.

Managing Symptoms of Rejection Sensitive Disorder

While what causes rejection sensitivity is not yet fully understood, treatment is available, which focuses mainly on managing symptoms. Reducing your stress level can help in moderating RSD symptoms. Also helpful is taking good care of yourself by making lifestyle changes like:

  • Getting at least 7 hours of sleep each night
  • Eating a healthy diet
  • Exercising at least 5 days a week
  • Practicing self-care and stress-relieving techniques such as meditation and deep breathing exercises

“Learning to manage RSD symptoms is not complicated, but you need to seek professional help. Changing your lifestyle, talking to a therapist, and sometimes taking medication can help you reduce the symptoms, making it easier to work on the condition itself.”

Licensed Clinical Social Worker-Supervisor (LCSW-S), CIMHP, EMDR Cynthia Catchings


Therapy can be really beneficial in addressing things like fear of rejection, inability to accept or navigate criticism, and the tendency to be hypersensitive. Specifically, a form of talk therapy known as cognitive behavioral therapy (CBT) can be effective in treating symptoms of RSD.

CBT teaches people how to identify unhealthy or unhelpful thought processes and behaviors and then change them into more positive ways of thinking and doing things. Successful CBT sessions can teach you how to manage conflict in relationships, deal with stressful situations, and improve your communication skills…all things that can be challenging for people trying to navigate RSD.

When to Seek Help for Rejection Sensitive Disorder

While some people can learn to cope with RSD symptoms on their own, if symptoms impact your relationships and/or your ability to enjoy life, it’s time to seek professional help. Therapy with a good psychiatrist, therapist, or psychologist (especially cognitive behavioral therapy) can help you learn to recognize your symptoms and neutralize them while learning new coping skills.

Get Professional Help with Talkspace

If you’ve decided you need professional help with your RSD symptoms, reaching out to your primary care physician is a good place to start. They can recommend a psychiatrist or therapist in your area who has experience treating RSD. The National Alliance for Mental Illness website is another valuable resource. You can also find a mental health professional through an online therapy platform like Talkspace.

If you recognize signs of rejection sensitive dysphoria in your own behavior or relationships, it’s time to stop being so hard on yourself. The fact that you feel emotions intensely also makes you a good and caring person as well as a loyal friend. Realizing that what you’ve been experiencing is actually just symptoms of a treatable mental health condition can go a long way in helping you come to terms with things.

Now, you’re ready to start looking for the positive in your situation. Seeking professional help can be the first step you take in overcoming the limitations RSD is presenting in your life.

See References

Cynthia V. Catchings, LCSW-S

Cynthia Catchings is a trilingual licensed clinical social worker-supervisor, mental health consultant, professor, and trainer for federal law enforcement agencies. Cynthia has over 15 years of experience in the mental health profession. She is passionate about women’s mental health, life transitions, and stress management. Her clinical work, advocacy, and volunteer service have focused on working with domestic violence survivors and conducting mental health research in over 30 countries.

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