Rejection Sensitive Dysphoria: An Extreme Reaction to Rejection

No one enjoys feeling rejected. However, not all people are capable of finding a way out and they find themselves trapped. What can be done in these cases?
Rejection Sensitive Dysphoria: An Extreme Reaction to Rejection

Last update: 13 December, 2021

Rejection sensitive dysphoria (RSD) is an extreme emotional reaction to the actual or imagined perception of rejection. The person experiencing it feels overwhelmed when judged, excluded, or criticized.

Therefore, if you suffer from this disorder, you may feel like a failure in the face of the judgment of others and think that the whole world is against you. In fact, generally, you experience a whirlwind of disproportionate emotions. Furthermore, the feeling can be so intense that you remain anchored in the event and you’re unable to properly continue with the rest of your daily life. Mental rumination  takes over and you find it extremely difficult to let go of your negative thoughts.

Rejection sensitive dysphoria isn’t classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but it’s no less real for that. It’s currently considered a disorder that’s formed by a set of symptoms that are often associated with other conditions, as you’ll see below.

We don’t really know why some people are so overwhelmed by rejection. In general, it’s thought that there’s no one specific reason but a set of factors that promote this reaction. Let’s take a closer look at some of its features.

Why are feelings of rejection so common?

Experiencing uncomfortable emotions, such as sadness or anger when you feel rejected is normal. It’s part of being human. In fact, it works in favor of our ability to adapt, as a species.

Thousands of years ago, when we lived in nomadic tribes and depended on hunting and gathering, people needed to be in groups to survive. Failure to do so diminished our chances of survival due to all the dangers that threatened us.

For that reason, we developed a series of strategies to stay within the group. From these, we learned that our behavior should be adjusted to the tribe. If not, we ran the risk of being expelled. In other words, being far more unprotected in the face of environmental threats.

However, today things are very different, and our survival doesn’t depend on belonging to a tribe. Nevertheless, we continue to be social beings. For this reason, we can experience emotional pain when we carry out a behavioral pattern that’s not approved by others.

Sad woman

Symptoms of rejection sensitive dysphoria

Each person who experiences rejection feels it in different ways. However, some of the most common symptoms are:

  • Approval-seeking behavior.
  • High self-demand.
  • Feelings of extreme shame.
  • Low self-esteem.
  • Anger.
  • Irritability.
  • Aggressiveness.
  • Anxiety.
  • Fear of rejection
  • Sadness.
  • Despair.
  • Need to control the feared situation.
  • Avoidance of social contact.
  • Somatic manifestations such as digestive upsets or headaches.

These symptoms may be experienced at the same time as the interaction or later when the interaction has ended. In addition, they don’t have to manifest all at the same time. Indeed, they’re dependent on each individual and their specific situation.

Susceptibility to rejection sensitive dysphoria

There are several personality profiles that are more susceptible to experiencing rejection sensitive dysphoria. For example, people who’ve been subjected at an early age to strong rejection, especially parental. Another group would be people with social anxiety, since they tend to feel bad when they feel like they’re being judged.

Hypersensitive people are also exceptionally susceptible to this disorder. Hypersensitivity doesn’t always have to be associated with highly sensitive people. For example, an individual may be going through a difficult time and feeling much more emotionally vulnerable. This makes them experience more pain in the face of rejection. This kind of hypersensitivity can end up severely limiting their life, especially if they don’t learn to manage their emotions properly.

In addition, people who suffer from autism spectrum disorder (ASD) are also prone to suffer from rejection sensitive dysphoria. This is because their emotionality is usually high. Therefore, if they perceive that they’re rejected or criticized, they tend to feel significantly more upset than most people.

Finally, people who suffer from attention deficit hyperactivity disorder (ADHD) are more likely to suffer from this condition. This is due to the difficulty of adequately managing their executive skills like self-control or cognitive flexibility. Somehow, people with ADHD find it more difficult to relativize, distance themselves, and escape from their current way of thinking.

Boy from back with a blanket

Treatment for rejection sensitive dysphoria

There’s no pre-established treatment to treat rejection sensitive dysphoria. However, many tools can be learned to help sufferers experience their emotions less intensely. Here are some of them:

  • Applying cognitive restructuring. Being more aware of thoughts, detecting the most irrational ones and replacing them with less harmful ones is an excellent way to start fighting rejection sensitive dysphoria.
  • Learning to relativize. Putting everything that happens in perspective helps make the experience of rejection less intense.
  • Increasing resilience. Building a discourse based on improvement and strength concerning negative experiences is an excellent strategy for leaving victimization behind.
  • Hearing success stories. Knowing that other people have managed to improve their lives despite obstacles can be inspirational for sufferers of this disorder.
  • Improving communication skills. Knowing how to express emotions more appropriately reinforces feelings of security and reduces the fear of not knowing how to act.
  • Strengthening self-esteem. Gaining self-confidence is a great way to reduce the importance of other people’s opinions.
  • Leading a healthy lifestyle. Getting enough sleep, eating real food, and exercising regularly helps in the managing of emotions.
  • Reducing stress levels. High stress levels can further exacerbate rejection sensitive dysphoria, so incorporating activities such as meditation or mindfulness can be helpful.

Seeking help

It’s important to keep in mind that feeling upset when someone judges or criticizes you is normal. After all, we all prefer to be praised than rejected. However, as a rule, the uncomfortable emotions that rejection generates tend to disappear in a short time.

However, if you find that these annoying emotions last for days or that they overwhelm you and really affect your day-to-day life, it may be a good time to consult with an expert emotional management therapist. In fact, although rejection sensitive dysphoria has no pre-set treatment, there are many strategies you can learn to minimize its negative impact on your life.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • American Psychiatric Association (2018). Manual Diagnóstico y Estadístico de los Trastornos Mentales(DSM-5), 5ª Ed. Madrid: Editorial Médica Panamericana.
  • Bondü, R., Esser, G. (2015). Justice and rejection sensitivity in children and adolescents with ADHD symptoms. European Child & Adolescent Psychiatry, Vol. 24, 185–198. [fecha de consulta 30 de noviembre de 2021]. doi:
  • Rojas, E. (2014). Cómo superar la ansiedad. La obra definitiva para vencer el estrés, las fobias y las obsesiones. Barcelona: Planeta.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.