Part of ADHD for many of us is rejection sensitivity dysphoria. Many people minimize the experience, but recent research has highlighted the link between RSD and physical sensations. They varied from person to person, but all participants experienced this physical manifestation (Rowney-Smith et al., 2026). I myself have experienced this. For me, RSD is the worst part of ADHD. I recently had an episode that lasted a week. A week of being in a shame spiral that I could not get myself out of.

The research also discussed how people coped with RSD, and many use withdrawal as a technique. If you avoid situations where you could be potentially rejected, then you won’t be rejected, correct? I often have parts that want to avoid certain social situations because of this fear. If it gets triggered, I know I will suffer for days. The participants also discussed how the expectation of rejection is often as bad as, or worse than, actually being rejected (Rowney-Smith et al., 2026).

When it happens, participants reported masking it because they are often perceived or told they are oversensitive, and they want to avoid that (Rowney-Smith et al., 2026).

Dr. Megan Anna Neff describes rejection sensitivity as a “normative human experience) but dysphoria as  “an extreme and often distressing emotional response to perceived rejection or criticism, which goes beyond the typical range of reactions. This pain can significantly disrupt a person’s capacity to engage in relationships, work, and various aspects of life” (Neff, October 4, 2023, para 20).

It is so important not to invalidate the experience of someone with RSD by minimizing the experience because that just perpetuates neurodivergent stereotypes and beliefs about being too much or not fitting in. I have a friend that we can call out and name RSD when we see it in each other, and that, to me, is helpful. Support around the shame and related feelings also works well for me. In the research, people reported that reassurance was also helpful to them, though they did not usually ask for it, because….. RSD (Rowney-Smith et al, 2026).

RSD is just beginning to be researched. It has long been part of a female ADHD profile, but since that is something that is just being studied and acknowledged, little is known right now. It also often shows up in autistic women. And men can also experience it.
This is one of the places I recommend for consultation and resources from people with lived experience. Dr. Megan Anna Neff has many resources on her Neurodivergent Insights Blog. Since people with RSD do not experience these challenging emotions, it can be hard for them to understand them. Often, they just feel the person is overreacting. If you want to be supportive, reassure and name the pain without invalidating it.

References

Neff, D. M. A. (2023, October 4). The pain of Rejection Sensitive Dysphoria (RSD) [Blog]. Https://Neurodivergentinsights.Com/. https://neurodivergentinsights.com/rejection-sensitive-dysphoria/

Rowney-Smith A, Sutton B, Quadt L, Eccles JA. The lived experience of rejection sensitivity in ADHD – A qualitative exploration. PLoS One. 2026 Jan 21;21(1):e0314669. doi: 10.1371/journal.pone.0314669. Erratum in: PLoS One. 2026 Mar 13;21(3):e0345112. doi: 10.1371/journal.pone.0345112. PMID: 41564005; PMCID: PMC12822938.