Rejection Sensitive Dysphoria (RSD)

Rejection Sensitive Dysphoria (RSD) is an intense emotional hypersensitivity to real or perceived criticism, rejection, failure, or humiliation, described by Dr. William Dodson as one of the most prevalent and impactful features of ADHD in adult life. The emotional pain during an RSD episode is genuine, intense, and hard to control.

RSD isn't part of the official diagnostic criteria for ADHD, but it's reported by a large proportion of adults with the condition. It shapes behavior significantly: avoiding situations involving evaluation, paralyzing perfectionism, intense masking of difficulties to avoid being 'found out,' and abandoning relationships or projects at the first sign of criticism.

RSD can be especially hard to distinguish from mood episodes in bipolar disorder — the difference is that RSD episodes are triggered by a specific perceived rejection, tend to be briefer, and don't occur without that identifiable trigger.