Rejection Sensitivity Dysphoria, or RSD, is a characteristic of ADHD that I only recently became aware of. In fact, it was whilst listening to my recently diagnosed daughter explaining her struggles that I looked further into it and discovered that it is often considered one of the most debilitating aspects of having ADHD. RSD is when you experience severe emotional pain due to being rejected, teased, criticised or feeling like a failure and it often results in persistent self-criticism or negative self-talk.
In the last few years, as more research is done into ADHD, it has become apparent that RSD is a significant burden and has huge implications on the self esteem of ADHDers. It affects their ability to make and keep friends because it affects social skills. This is because RSD makes a person very sensitive to what other people think or say about them. Whilst RSD is not a medical diagnosis, it is due to differences in brain structure and it describes some of the symptoms of ADHD.
The term ‘Dysphoria’ comes from a Greek word which means ‘difficult to bear’. Because of this, many ADHDers do not handle rejection very well. The perception that another person is leaving them out or being critical of them is extremely difficult for them. ADHDers can be so sensitive to rejection that they might even get upset thinking that they are being talked about or excluded when it is not necessarily even the case. Further, people with RSD have a tendency to focus on their distress without taking steps to alleviate it.
Studies have determined that up to 99% of people with ADHD are more sensitive than usual to being rejected. Additionally, about one third of those living with ADHD describe RSD as being the hardest part of their ADHD.
ADHDers with RSD may get embarrassed easily, anger very quickly, or have emotional outbursts when they feel like they have been rejected or when someone hurts them. They can often set high standards for themselves which are impossible to meet and they may have low self esteem and poor self-perception. Social settings can make them feel very anxious. They can experience problems in relationships with others and they often feel like a failure because they believe they have let other people down. Sometimes they even consider harming themselves because it can all feel too hard. Additionally, because they feel like they are constantly under attack, they can become defensive.
So, how does it feel to suffer from RSD?
It is a real burden!
Imagine always having to work hard to make other people like you. Or, choosing to stay away from any social setting or situation that might hurt you. It can lead to social phobia because they might be so scared of being embarrassed in front of others.
RSD has significant implications for the ADHDers in our classrooms! School is already difficult for them due to their weak executive functioning skills which include: difficulty organising thoughts, planning, prioritising, and performing complex tasks, managing time efficiently, and making decisions. For a student with ADHD, the realisation that others can do their class work more easily than they can is devastating and heightens their RSD. Imagine constantly watching other students being able to concentrate easily, listen attentively and get their work finished. It must be extremely frustrating and, constantly being reminded or nagged at to focus, stop talking and to get on with their work can confirm to them that they are letting other people down, especially their friends, teachers and family.
Teachers can really help their students with ADHD by understanding how RSD might impact their self esteem and ensuring that they are providing them with lots of positive reinforcement by way of praise, thumbs up, smiles, green ticks on their work, smiley faces, stickers or anything else to outweigh the number of times you remind them to stay on task, stop talking, stop moving etc.
Another thing to be aware of is that, every time a teacher glares at an ADHDer when they are doing the wrong thing, even when no words are spoken, communicates volumes and increases their belief that they are letting others down. The same is true for smiles and positive gestures such as giving them a thumbs up; it gives them a boost and actually helps them to demonstrate positive behaviour and increases their self esteem.
I encourage teachers to give it a try. Especially for primary school ADHDers, give them lots of smiles, claps, high fives and thumbs up, and watch their faces beam as they start to believe that they are valued and enjoyed. This is definitely one of the easiest tools in the ‘Flicking the Switch’ toolkit. 😊
I’d love to hear your thoughts about RSD and the strategies you have found which help your students. What works in your classroom?
Blessings,
Fiona xx
