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Rejection Sensitivity Dysphoria (RSD) and Neurodiversity

Mar 11, 2024

4-minute read


Dealing with rejection is a common human experience at work and in our personal lives. However, for individuals dealing with Rejection Sensitivity Dysphoria (RSD), it can be debilitating and significantly impact the quality of life, relationships, and careers.

RSD explained

Rejection Sensitive Dysphoria (RSD) is where a person feels extreme emotional sensitivity and pain due to a perceived or actual rejection, often leading to diminished mood and self-esteem (Medical News Today, 2021). It is important to note that RSD is not a matter of being overly sensitive but rather a legitimate emotional response. This can seriously impact various aspects of life, including relationships, work, and overall well-being. It often coexists with neurodiversity, due to an already heightened sensitivity and difficulties with social interactions, which makes neurodivergent individuals more susceptible to RSD. Dr. Dodson’s (2024) extensive research and his clinical experience estimate that 99% of individuals with ADHD encounter RSD at some point in their lives. This can trigger intense emotional reactions such as anger, sadness, or despair which are difficult to manage and lead to impulsive and reckless behaviour.

The signs of RSD

Although RSD is beginning to be more recognised and accepted, it isn’t an official category in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Creating awareness and recognition is extremely important as when a person internalises the emotional response of RSD, it can look like a sudden development of a mood disorder. Some common signs include:

  1. Intense emotional reactions: people with RSD often experience overwhelming emotions in response to perceived criticism or rejection, such as sadness, stress, anxiety, and feelings of worthlessness.
  2. Hypersensitivity: even seemingly small comments or gestures that may seem insignificant to others can trigger profound emotional responses in individuals with RSD. For example, not receiving a response to an email can lead to the individual thinking that their colleague dislikes them or they have said something to which they have taken offense.
  3. Avoidance behaviors: to shield and protect themselves from potential rejection or criticism, those with RSD might avoid social situations, new challenges, or even relationships altogether. Finding it easier to distance themselves, before they get rejected.
  4. Perfectionism: people with RSD often set impossibly high standards for themselves to avoid criticism, which can lead to chronic stress and burnout.
  5. Low self-esteem: chronic exposure to perceived rejection can erode self-esteem, making individuals with RSD feel inherently flawed or unlovable. This is especially true if they are diagnosed as Autistic or with ADHD later in life.

How to manage RSD

Learning to manage RSD can be difficult, especially as there aren’t defined diagnostic criteria, which means it can be challenging to identify the symptoms of RSD or a symptom of a mental health condition. It can be particularly challenging for neurodivergent individuals to recognise the patterns in behaviours, due to their already heightened emotional response. However, once the initial grasp of RSD comprehension is achieved, individuals can embrace several strategies to navigate their personal lives effectively.

  • Seek support: Workplace Strategy Coaching sessions are incredibly helpful to learn strategies and utilise tools to help manage RSD in the workplace.
  • Take breaks: Stepping away from your desk or taking short breaks can help with avoiding feeling overwhelmed.
  • Effective communication: if possible, try to openly communicate with colleagues and managers regarding the difficulties faced with criticism or rejection. In addition, consider discussing accommodations in the workplace that can help with RSD-related challenges.

Supporting employees with RSD

Leaders must do their best to create a psychologically safe environment to ensure everyone can reach their full potential and feel valued. RSD can be particularly invasive and prevalent in times of layoffs, high targets, and economic downturns. As well as accommodating practical neurodiversity needs, it is equally as important to create an understanding of RDS as managers may not fully understand it themselves. In addition, employees who experience it may decide not to disclose it or may face difficulties in explaining it.  

  1. Be explicit, not implicit: be clear with communication as ambiguity can be an RSD trigger.
  2. Feedback: everyone has unique preferences when it comes to receiving feedback, but it is important to be mindful when offering criticism. Giving concrete examples, factual language, and balanced feedback can give employees the ability to be actionable. In addition, following it up in writing will allow for the information to be fully understood and processed, and help negate the impact of RSD.
  3. Workplace Neurodiversity training: can be hugely beneficial in helping to understand how to support their colleagues who may suffer with RSD and recommend strategies or tools that can be implemented in the workplace.
  4. No surprise meetings: this applies to scheduling meetings and providing context, as people with RSD may assume the worst-case scenario and assume it is a performance review or they are getting fired.


RSD can have a profound effect on an individual’s emotional, social, academic, and professional functioning, but it is possible to manage its impact. The first step is raising awareness and understanding RSD. Individuals who themselves are impacted can explore their triggers and develop coping strategies accordingly. If needed seek professional help who will be able to offer valuable guidance. It is important to cultivate a supportive work environment by communicating needs to colleagues and superiors. Equally, it is as important for co-workers to implement strategies to support employees in reducing the impact of RSD.

Thriiver offers a multifaceted approach to supporting employees with RSD in the workplace. This includes providing Awareness Training sessions for HR teams and bespoke one-to-one Coaching sessions to equip individuals with effective strategies for managing RSD-related challenges.

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