"Sorry, I can’t make it today. Next week?" It was just a text — a friend cancelling on me for plans we had later that day. But I kept reading and re-reading it; continually dismantling the message and putting it back together again, analysing every letter, comma, and emoji for the things left unsaid. Why did they suggest ‘next week,’ but not give a specific date? Was I being brushed off? Did they find a better offer for how to spend the day? Of course they did — they clearly couldn’t stand me. Is it because I didn’t laugh enough at their meme last night? Had I been too self-absorbed when talking about my day? 

Maybe it was because I arrived late last time we hung out. Or perhaps I was too loud. Or too quiet. Or too boring. In my mind, I was simultaneously ‘too’ everything and yet not enough at the same time. Each and every scenario burrowed its way under my skin, biting down, and sucking my blood until every pore and nerve ending stung. The tears started and they wouldn’t stop coming. Everything hurt. And it was just a stupid text.

What is rejection sensitive dysphoria?

Once I found out what rejection sensitive dysphoria (RSD) was, I realized that my reaction, in hindsight, wasn’t stupid and actually made a lot of sense. Rejection sensitive dysphoriais a little-known symptom of Attention Deficit Hyperactivity Disorder(ADHD) wherein we struggle to regulate our emotions when faced with real or perceived rejection. This results in a heightened emotional response that, to neurotypical people, might seem disproportionate. At the time of receiving the 'brush off' text, I thought I was losing my mind. I knew that reacting like this over a cancelled plan wasn’t "normal," that it truly was no deeper than the seven-word text I received, but a mild disappointment was all my brain needed to convince me of a catastrophe. If straw was all it took to break the proverbial camel’s back, I was constantly one piece of straw away from my legs buckling under the weight of self-loathing and the feeling that I was unlovable and unworthy of anything good. 

I actually found out what RSD was by accident. I saw others respond to mild rejections like I did — and none of them experienced days-long spirals of depression, hysterical crying, and even thoughts of self-harm because they didn’t know what to do with all the feelings inside of them. For a while, I actually thought I had borderline personality disorder (a common misdiagnosisin women who actually have ADHD), but I didn’t relate to other parts of it — just the rejection part. So I then figured that it was just a strange character flaw I had, a glitch in the system, until one day, while researching another aspect of ADHD, a small footnote referring to RSD and how it impacted people with ADHD was mentioned. Although approximately a third of peoplewith ADHD experience RSD, it’s often overlooked and not discussed as much as other aspects of ADHD on social media, meaning that those of us who experience it aren’t given the resources, tools, or even the basic reassurance of ‘this is what’s going, you’re not insane’ to help us navigate RSD.

Even when I was diagnosed with ADHDlast year, I had no idea that it had anything to do with how I handled rejection. I mean, the name ADHD itself doesn’t appear to account for any emotional problems — just inattentiveness and a brain that goes 100 miles an hour — but as more and moreadults get diagnosed with ADHD, we’re learning that the disorder is a lot more complex than we once thought.

ADHD's impact on emotions

At the heart of ADHD is a lack of regulation. ADHD is a form of executive dysfunction— which means my brain lacks the ability to organise and prioritise not just the thoughts inside my head, but pretty much everything on the outside. Think: my tasks, time, and possessions — you name it. What I didn’t realise is that this lack of regulation also applies to feelings.

Psychiatrist Dr. William Dodson writesin a paper entitled "Emotional Regulation and Rejection Sensitivity" that the "hyperarousal" of ADHD means we never get a single moment where our minds are just… quiet. "Their minds are always going 100 MPH until they are totally exhausted," he wrote. When I try to describe to other people what ADHD is like I usually use the metaphor of an overheated laptop with about ten tabs open simultaneously, all with vastly different topics and one of them playing music.

Although more than 30 percentof people with ADHD say "emotional instability" is the most debilitating part of their condition, it’s something that none of us really talk about. For me, it’s something I shied away from opening up about because we all know the tropes around "hysterical women" and "crazy ex girlfriends." If I were to tell someone that a fleeting situationship left me crushed under my duvet for two weeks, or that I had to take three sick days from my internship after hearing that I wouldn’t be hired permanently, they’d think I was unhinged. They’d find me off-putting. And then the cycle of rejection would continue.

Dr. Lindsay Popilskis is a practising psychologists who has treated several people with ADHD in the past. In a statement to Mashable, she said that "when an individual experiences RSD, they can respond with extreme embarrassment, anger, avoidance, constant second guessing of themself, or even completely shutting down emotionally."

"The interpretation of criticism from others activates the sympathetic nervous system which evokes a physiological fight-or-flight response in an effort to protect the individual's emotional well-being," she explained. "This leads to triggering the areas of their brain associated with blood pressure, emotions and decision-making. This can impact a person mentally as well as even physically with some individuals truly feeling as if they're being punched in the gut."

"Consequently," she explained, "the individual may respond by flight, (as an example of how this may manifest, this can cause an individual to isolate themself), or on the flipside, fight, (which can manifest itself as rage towards others)."

"Because perceived criticism brings on such an intense physiological and neurological response, individuals with ADHD may find themselves ruminating over future socialization scenarios, feeling highly sensitive towards rejection, withdrawing from social opportunities altogether, feeling shameful about themselves, or turning to extreme perfectionism," she added. "Emotional dysregulation is typically a paramount demarcation of ADHD, which presents itself in someone with ADHD as becoming overly excited, focusing more on negatives than positives, developing anxiety, and experiencing relationship obstacles.”

RSD's impact on relationships

Heartbreak is a universal human experience: that dull pain in your chest; the inability to eat, and the sadness gnawing away at you. But I realised that my heart was getting broken at least once a week, if not more, and it wasn’t even anything to do with dating or crushes most of the time. It was about the way a friend looked at me when I made a joke, that mocking read receipt on WhatsApp coupled with no reply, or getting that polite-but-curt email from an editor saying: "Not for me thanks, but please keep pitching!" These are all simple things that, to a neurotypical person, would barely warrant the bat of an eyelid. But because my brain is unable to properly filter and process these rejections as being not a big deal, anything that can even be perceived as negative ends up causing me to spiral into a void of anxiety and self-loathing. As Dodson points out in his paper, the term 'dysphoria' literally comes from the Greek word for 'unbearable' — and while it might seem like I’m being dramatic, there’s no term more fitting to describe rejection sensitive dysphoria. 

The emotional pain that comes with rejection sensitivity can very easily overpower and debilitate me, and the difference is, while I can take medication or undertake treatment for things like my depression and anxiety, I can’t do that with RSD because it is literally a result of how my brain is wired. You can’t change a neurodivergent brain to become neurotypical, and I wouldn’t want to anyway, but because RSD is part of the inherent structure of my brain, I’m limited in what I can do to stop myself from experiencing it to the intensity that I do. I can supplement dopamine with medication to improve my concentration and decrease my inattentiveness, make the cogs turn a little slower, but I can’t stop those cogs in their tracks altogether.

RSD is especially complicated because my ADHD also impacts my relationships in other ways, making it a near-relentless, sometimes toxic cycle where various aspects of my ADHD feed off one another. My executive dysfunction, fatigue, and inattentiveness can, to the untrained eye, make me look like a terrible friend or partner. On the one hand, I’m often late to things, I end up cancelling at the last minute, I can’t maintain my attention during important conversations, and I have a tendency to forget important dates like birthdays and anniversaries. On the other hand, I’m hyper-aware of how these traits can be perceived as carelessness and how they affect other people, so I often end up stuck in a loop of constant apologies, desperately seeking reassurance and forgiveness, and being unable to stop the apologies tumbling out my mouth no matter how many times they tell me it’s okay. I get so far into my own head about the implications of my actions that I fail to see how, in trying to mitigate their impact, I just end up digging myself a hole. 

• 'Can I have your meds?' and other questions you shouldn't ask someone with ADHD
• Privilege plays a huge role in getting an ADHD diagnosis
• How to navigate dating when you have borderline personality disorder (BPD)
• How to separate romantic rejection from your self-worth

The same goes for my professional relationships — I can end up hyper-focusing on a task so much that I end up missing deadlines and meetings, leading to me bombarding my boss with messages asking them if I’m getting sacked because I don’t understand why on Earth they would evenwantan employee who seems incapable of performing the very basic tenets of a job. At a previous job, I ended up becoming so worried that a simple miscommunication made my manager angry that I ended up overcompensating, writing them a novella of a Slack message trying to explain my point of view in much detail as humanly possible in order to solve the misunderstanding which, unsurprisingly, came off as overly intense to them. Of course, learning that I had concerned this manager with my Slack message made my rejection sensitivity worse, and so the cycle continued. Note to certain employers: not all workers are neurotypical, so maybe don't call us "intense."

As one would expect, RSD naturally makes dating really difficult for me. Between September 2015 and January 2021, I was never actually ‘single’ — I was a serial monogamist, having back-to-back, often emotionally volatile relationships. When the relationships would end, I would become inconsolable for a couple weeks or so (my brothers love to bring up me crying face down on the carpet when my first relationship ended), but once I accepted a relationship was over, I’d very quickly find myself involved with another person because not only did I want to prove to myself that Iwas loveable, but I also didn’t want to deal with the feelings of rejection and heartbreak from the last relationship. This meant that when the new relationship inevitably ended, I’d find myself dealing with compounded heartbreak accumulated from other relationships that I never actually got over. It was when I found myself bed-bound and unable to eat because of  a situationship I started mere months after splitting up with anotherlong-term boyfriend that I realised that this cycle needed to end, or else I’d end up wearing myself down until there was nothing left.

So, for the first time in my life, I’m trying to stay single. I saytry because, of course, I find myself dabbling on dating apps or developing crushes on people. At first, it was difficult because I subconsciously found myself trying to continue my habit of simply transferring my feelings onto another person through crushes on friends or short-term attachments on dating apps. I thought being in a relationship (or, at least, being involved with someone romantically) was the only way to keep a lid on this Pandora's Box of cumulative rejection and heartbreak. But over time, I got better at checking myself and noticing when I was blowing little crushes or Hinge matches out of proportion. I realised that running away from my RSD and using other people to keep it at bay ultimately didn’t serve me because, while people come and go, I’m the one who sits with my own feelings and thus I’m the one who should be responsible for them. This is still a work in progress, so I try to remind myself often that being single doesn’t mean I’m perpetually unwanted — I just want to make sure that when I’m ready to try relationships again, I’m at a stage where I can handle them in a healthy way.

I can’t expect everyone in my life to fully understand what it’s like to have RSD and to be neurodivergent — but surrounding myself with people who are empathetic, patient, and at the very least try to understand has made navigating life with RSD a lot easier. What also helped was learning what RSD actually was. I could never find the words to express exactly why I was trapped under this extreme, often wordless pain and anxiety, but once I found that it had a name and explanation, I was set free. I wasn’t losing my mind — or worse than that, wasn’t a fundamentally bad or toxic person — there was an explanation in why I reacted to things the way I did, which allowed me to let go of the guilt and shame I had about responding how I do to things.

And finally, I stopped taking it as an insult when people described me as an "intense" person, because while that may be true, intensity doesn’t have to be a bad thing. While the intense emotions I feel around rejection can be difficult, I feel lucky to have the capacity to love things and experience life with as much vibrancy as I do. Warts and all. 

Ultimately, neurotypical people need to learn about neurodivergence and RSD because they need to understand that reacting a certain way to rejection and confrontation not because they're “intense” or "crazy" — they just have different needs because of how they're wired. As adult ADHD becomes more normalised in society, maybe we all need a little bit more compassion.