What Is 'Rejection Sensitive Dysphoria' And Do I Have It?

If you've ever been called "too sensitive" or if you fear rejection, this TikTok diagnosis may seem familiar.
Here's what "rejection sensitive dysphoria" entails, according to experts.
Luis Alvarez via Getty Images
Here's what "rejection sensitive dysphoria" entails, according to experts.

Emma O’Toole’s father left her family not once, but twice.

“We reconciled and then [he] dropped me for a girlfriend,” O’Toole says. She grew up without a father figure, with a fear of rejection taking his place. This fear continued into adulthood. “I am a freelance yoga teacher, so getting clients, and when clients don’t renew, I will take it personally,” she said.

Thomas Slatin, a 42-year-old intersex woman, recalls her earliest memories of not fitting in. “For the majority of my life, I have felt like an outsider, even when surrounded by friends or family members,” she says.

And Zurlia Servellon, a 28-year-old digital entrepreneur, struggles with both rejection and feeling proud of herself. She believes this is because of previous trauma. “No matter my big achievements, I always felt like a failure. Nothing was ever enough,” she said. “I always wanted to impress others and was terrified of public embarrassment.”

All three women are explaining their experiences with “rejection sensitive dysphoria,” a term you may have heard on TikTok.

While Dodson said it’s often an overlooked part of ADHD, you don’t need to have ADHD to struggle with it. On TikTok, the hashtag has over 25 million views.

But is RSD a real diagnosis? What does it entail? Here’s some information about what it is and how you can cope with similar feelings:

What is ‘rejection sensitive dysphoria’ and what are the signs your sensitivity is affecting your mental health?

First, it’s important to note that RSD isn’t a mental illness or diagnosis. It’s a nonclinical term that helps to describe ”a myriad of symptoms related to an extreme fear of rejection that causes distress and harm to the beholder and, subsequently, their relations,” explains Angela Karanja, a psychologist and expert on parenting teens who founded Raising Remarkable Teenagers.

Signs of RSD include a tendency to get easily embarrassed, overworking yourself to please others, pulling out of a task to avoid embarrassment, having an emotional outburst when you feel rejected, experiencing anxiety around family, having low self-esteem, and feeling like a failure even after setting lofty standards, Karanja says.

But rejection is hard on all of us. So what’s the difference? Or how is this phenomenon separate from social anxiety?

“Most people do not like feeling disliked or rejected; however, people with RSD have a much harder time bouncing back from rejection and have overwhelming emotional reactions as a result,” explains Rachel Cavallaro, a licensed psychologist with Thriveworks in Boston who specialises in mood disorders, trauma, depression and anxiety.

The difference is that with social anxiety, the emotional reaction is more so in anticipation of the social interaction, whereas RSD is in the aftermath of the interaction,” Cavallaro continues.

Karanja says social anxiety disorder is an actual diagnosis, and RSD isn’t. However, both can be maladaptive when they hinder your life and self-development.

How to cope with ‘rejection sensitive dysphoria’

If you think you’re experiencing RSD, Karanja first recommends seeing a psychologist. Professionals can determine if you have a co-occurring, diagnosable condition and help you work through the effects of the phenomenon.

On your own, you can also challenge your negative self-talk by practising “the four Cs,” according to Karanja:

Catching it: Being aware of self-destructive thoughts.

Coining it: Separating those thoughts from your own and calling them out.

Challenging it: Realising those thoughts won’t make you feel better or help you.

Calibrating it: Thinking about how you want to think and respond next time.

Cavallaro recommends trying an emotion regulation technique to help you manage negative emotions and increase positive experiences. It’s about understanding your emotions, reducing your vulnerability and decreasing your suffering. A major part of emotion regulation is self-soothing. Some examples of activities you can try are aromatherapy, looking at nature, listening to music, drinking tea and using a weighted blanket.

Cavallaro also suggests mindfulness. Consider doing a breathing exercise (such as inhaling and exhaling for four seconds while noticing how your body feels) or progressive muscle relaxation (tensing and releasing your muscles one group at a time). “In fact, progressive muscle relaxation helps to train the body to relax … and turn off the fight or flight response,” Cavallaro says.

A cognitive behavioural therapy skill, like reappraisal, can help, too. “Replace a negative thought such as ‘My supervisor doesn’t like me,’ to something more accurate after evaluating the facts of the situation, such as ‘I’m a good worker and I haven’t had any negative performance reviews. If my supervisor is upset, it’s likely due to something else and not anything I did,’” Cavallaro says.

O’Toole has worked on changing her perspective and can confirm how helpful it is. She realised she can’t please or be compatible with everyone, and that’s OK. “Be aware of what the negative thoughts can do to the body and change it,” she says. “This has been my saving grace.”

Slatin reaches out to loved ones for support. “I have one really close friend who I can call or text literally anytime, named Chris,” Slatin says. “My wife, Amelia, is my main source of support, and her unconditional love has a way of grounding me and helping me focus.”

Servellon turned to helpful books, a job in sales to help her build a strong character, and healing practices for her mental health.

At first, it was extremely hard to be rejected every day by people, but slowly, I started building confidence to the point of becoming [the] number one salesperson in the company I worked for,” Servellon says. “I started my business once I felt confident enough and started looking at rejection as feedback and redirection that will help me grow.”