What is the treatment for Rejection Sensitive Dysphoria in ADHD?

A Quick Guide

People with Attention Deficit Hyperactivity Disorder ADHD frequently experience RSD, also known as Rejection Sensitive Dysphoria. They may become more sensitive to rejection and begin to expect it. Someone may experience an RSD episode and an abrupt change in mood due to an emotional reaction to perceived or actual rejection. Although it is difficult to describe, many who have RSD describe it as “intense, horrific, terrible, and overwhelming.” There are certain treatment options for Rejection Sensitive Dysphoria in ADHD which include medications etc.

What is Rejection Sensitive Dysphoria?

Rejection Sensitive Dysphoria RSD is a psychological concept that describes an extreme sensitivity to perceived criticism or rejection from others. Although not officially recognized as a diagnosable condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), RSD has been discussed and studied within the context of attention-deficit/hyperactivity disorder ADHD, and other mental health conditions.

People with RSD often experience intense emotional reactions to situations involving potential rejection or criticism. They may interpret even mild criticism as a personal attack, leading to feelings of shame, humiliation, or worthlessness. These emotional responses can be immediate, overwhelming, and disproportionate to the situation at hand. Individuals with RSD may also engage in avoidance behaviors to prevent perceived rejection or criticism.

Common Signs

People with RSD may have a variety of symptoms, such as the ones listed below:

• A poor sense of self
• Becoming enraged when they are rejected or hurt
• Being easily embarrassed
• Establishing high expectations for themselves
• Experiencing social anxiety
• Feeling like a failure
• Social withdrawal

Other mental health issues with similar symptoms

Other mental health issues also share some of these characteristics. RSD may commonly look like:

• Bipolar disorder
• Borderline personality disorder
• Depression
• Obsessive-compulsive disorder OCD
• Post-traumatic stress disorder PTSD
• Social anxiety Disorder

Episodes of RSD are intense but brief, which is one difference. It’s critical to receive the proper diagnosis because RSD might resemble other mental health illnesses. Seek assistance from a psychologist, counselor, or another mental health professional if you have ADHD and any of these symptoms.

What are the causes of Rejection Sensitive Dysphoria?

Experts are unsure of the exact cause of RSD. But they believe it has to do with the brain’s structure and that it develops for similar reasons to ADHD. Researchers are aware that social rejection triggers similar brain activity to pain, even when it is ambiguous or uncertain. They are also aware that the way the brains of people with ADHD and those without it regulate internal communication differently. There is less activity in the parts of the brain that filter and control impulses. This implies that the filter on brain activity is lessened.

Due to their inability to regulate internal communication, people with ADHD frequently struggle to obtain insights from their senses. Additionally, it makes individuals more susceptible to feeling disoriented by loud sounds, glaring lights, or abrupt changes in their environment. It may be difficult for someone with ADHD to control pain-like behavior, which would account for why rejection is so much more upsetting and unpleasant for someone with RSD.

Genetic links

Due to the genetic component of the disorder, ADHD frequently runs in families. Similarly, RSD, which has strong ties to ADHD, is more likely to have a hereditary component.

How is RSD diagnosed?

Determining whether you have RSD might be difficult. Your doctor must first rule out the possibility that it is a sign of a deeper mental health issue. It might not always be possible to get a professional diagnosis because Rejection Sensitive Dysphoria is not listed as a disease in the Diagnostic and Statistical Manual of Mental Disorders DSM-5. You must consult a counselor, psychologist, or another mental health expert to evaluate your symptoms.

Your doctor could question you about your symptoms and family history. You’ll probably be asked a number of questions about your responses and emotions in various circumstances. Some possible questions could be:

• Do others describe you as being overly sensitive?
• Do you believe that nobody likes you?
• Do you experience rage or anger after being rejected or criticized?
• Do you try to please everyone?
• When someone offends your feelings, do you get a strong sense of rage or aggression?

Additionally, your physician might inquire as to any prior ADHD or autism spectrum disorder diagnoses. Your doctor can suggest screening to better understand the underlying reason for your emotional reactions if you don’t yet have a diagnosis for these diseases but are experiencing symptoms.

What are the treatment options for Rejection Sensitive Dysphoria?

While there is still much that scientists don’t know about Rejection Sensitive Dysphoria in ADHD, there are treatment options available. In addition to having a variety of forms, treatment approaches can also be used in conjunction with one another frequently. Your doctor could advise taking care of any underlying conditions first since this is linked to autism and ADHD.

Medications are mostly used in the treatment of Rejection Sensitive Dysphoria. These medications are used to treat ADHD and other diseases of a similar nature. This is due to the fact that treating one illness affects both of these conditions because they both have an impact on the same brain regions that create RSD symptoms. Treatments for those disorders can frequently be helpful because they have very comparable effects on the same brain regions as RSD.

Medications

There are no medicines specifically licensed to treat RSD because it isn’t a recognized medical condition. Instead, medical professionals adopt a procedure called “off-label prescribing.” When a doctor prescribes a drug for a condition other than the one it was specifically approved to treat, this practice is known as an off-label prescription. When data indicates a drug has a minimal chance of producing negative side effects and is beneficial when used outside of its prescribed usage, this type of prescribing is lawful, medically acceptable, and warranted. RSD can be treated with the following types of medication:

Alpha-2 receptor agonists

A specific kind of chemical receptor that is present in neurons (brain cells) in particular brain regions is activated by this kind of drug. These regions become more active after taking drugs like clonidine and guanfacine that stimulate those receptors. By engaging those brain regions, you can lessen the impact of RSD by helping your brain better control internal communication. 

Stimulant medications

These drugs raise the concentrations of specific neurotransmitters in your brain. Your brain uses neurotransmitters, which are chemical messenger molecules, to interact and activate or deactivate specific processes. Increases in some neurotransmitter types can boost activity in particular brain regions. That is how stimulant drugs like methylphenidate (better known as Ritalin) and amphetamine/dextroamphetamine (commonly known as Adderall) activate brain regions that control communication.

Monoamine oxidase inhibitor (MAOI) medications 

This family of drugs addresses depression, although specialists are aware that drugs like tranylcypromine can also aid with RSD. These drugs cannot be taken along with other popular ADHD treatments, though. Additionally, you need to watch what you consume because some foods (such as old or strong cheeses, aged meats, etc.) can interact with MAOIs and raise blood pressure to excessive levels.

The potential side effects and consequences of various treatments are determined by a variety of factors, most notably the treatments themselves. Because of this, your healthcare provider is the best person to advise you on any potential or likely side effects or complications, as well as what you may do to minimize their impact. 

Cognitive behavioral therapy

A way to lessen hypersensitivity is through behavioral intervention. This can make it simpler to handle and get over rejection and criticism. As a result, your doctor probably will advise psychotherapy. This is a typical approach to assisting patients with Rejection Sensitive Dysphoria. Cognitive behavioral therapy is one form of efficient psychotherapy (CBT). In this form of talk therapy, coping mechanisms are taught. You’ll discover how to deal with challenging circumstances, mend broken relationships, enhance communication, and get past emotional abuse or trauma.

Outlook

Rejection Sensitive dysphoria is an additional aspect of ADHD that you must accept and learn to handle. Nearly all people with ADHD are somewhat sensitive to rejection. Managing your stress is one method to cope with RSD. When you’re stressed out, you face the risk of experiencing an emotional meltdown. To keep your mind at ease, maintain a healthy diet, get enough sleep, and practice yoga or meditation.

We hope you found this article helpful in learning more about the treatment options to deal with Rejection Sensitive Dysphoria in ADHD.