ADHD, Emotional Dysregulation, and Rejection Sensitivity Dysphoria (RSD)

I’m not a dramatic person but I am a very sensitive person and to outsiders, sometimes that can look dramatic.

So many times throughout my life, I’ve felt like “too much” like a “burden” like I just feel emotions more strongly than others. Little comments that others might be able to brush off or not even register at all, can bother me a hours and sometimes even days. I’ll think I’ve processed it enough because surely replaying it over and over for an hour should be long enough to process it, right? But then I’ll be taking a shower or zoning out while watching T.V. and there it is again, playing through my head on a loop...

Did I really say that? What did they think of me when I said it? How did they interpret it? Was it okay? Should I follow up with them and try to clarify? No, it’s probably fine. Over and over again.

It’s mentally exhausting to be constantly checking myself and yet, it’s automatic for me.

This is really common for people with ADHD (and anxiety!). It can be caused by a combination of Emotional Dysregulation and Rejection Sensitivity Dysphoria (RSD). If you can relate to my story, you're not alone. 70%-80% of adults with ADHD report difficulties with emotional regulation. I work with adults who are just now discovering how ADHD may be shaping their lives and I’d be honored to support you on your journey. Schedule a free 15 minute consultation to find out more.

To learn more about emotional dysregulation and RSD, keep reading!

What is Emotional Dysregulation?

Emotional dysregulation is when a person struggles to manage, control, or respond to emotional experiences in a flexible and appropriate way. It’s like your emotions hit too hard, last too long, or completely take over your ability to think clearly or act in alignment with your values. It’s not a character flaw. Emotional dysregulation is linked to differences in brain regions that handle impulse control and emotion regulation, like the prefrontal cortex and amygdala.

What it looks like:

• Strong emotional reactions to everyday events (e.g., crying, anger, panic).

• Difficulty calming down once triggered—emotions linger or escalate.

• Feeling out of control or overwhelmed by emotional waves.

• Shame spirals or emotional shutdown after a conflict or mistake.

• Overreactions to minor stress, criticism, or rejection.

• Feelings emotions more intensely and immediately

• Struggling to pause, process, or respond calmly.

  
  

What is Rejection Sensitivity Dysphoria?

Rejection Sensitive Dysphoria (RSD) is an intense emotional response to perceived rejection, criticism, or failure, often experienced by people with ADHD. Even small slights or neutral feedback can feel deeply painful, triggering shame, anger, or anxiety.

RSD isn’t a formal diagnosis, but it’s a common and overwhelming part of the ADHD experience. It often leads to emotional outbursts, people-pleasing, or complete withdrawal. It can make relationships and therapy feel unsafe, but learning to recognize and regulate these responses can bring powerful relief and healing.

What it looks like:

• Many with ADHD describe RSD as “emotional evisceration”—a near-instantaneous spiral into shame, hurt, or rage after a perceived slight.

• RSD can cause someone to replay a small interaction for days, ruminating and catastrophizing.

• Even a neutral “we need to talk” text can feel like proof that someone is mad, disappointed, or abandoning them.

• People with RSD may edit themselves constantly to avoid conflict, fearing they’ll be “too much” or “not enough.” This can lead to masking or emotional exhaustion, especially in work, friendships, or romantic relationships.

• Emotional outbursts may look like anger or crying but underneath is often deep hurt or shame. Others may go the opposite direction and shut down, withdraw, or dissociate after rejection.

• Chronic RSD can lead to extreme people-pleasing to avoid any risk of disapproval. For some, it’s safer to say yes to everything than to face the pain of someone being disappointed or upset.

How does this impact therapy and relationships?

• RSD can make vulnerability feel dangerous, especially when past experiences of criticism still sting.

• Some clients with ADHD struggle to open up in therapy—not because they don’t want to—but because even gentle feedback feels like a threat.

• It may look like perfectionism, guardedness, or even “noncompliance,” when in reality, it’s protective behavior.

• RSD can make rupture in relationships feel catastrophic. This sometimes leads to ghosting, cut-offs, or intense grief.

• Working through RSD means rewiring how we perceive and respond to feedback and disconnection.

RSD doesn’t mean you’re broken. It means you’re wired for deep connection, and your brain just needs new tools to feel safe again.

I’ve been there, so I get it! Together we can use the right tools to cut through the mental noise and help you find peace within your own mind.

You don’t have to struggle alone and unseen, I work with adults who are just now discovering how ADHD may be shaping their lives and I’d be honored to support you on your journey. Schedule a free 15 minute consultation to find out more.

Want to learn more about how ADHD shows up in everyday life?

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