Welcome my lovely 💙

Wherever you are on your ADHD journey, whether you’re an adult with ADHD, a teen, or a parent supporting a child or teenager, my hope is that this newsletter brings a few aha moments. I also hope it becomes something you can return to when you are experiencing RSD (more on that below), or when someone close to you, a colleague, friend, parent, or child is showing signs of it.

Sometimes simply having language and understanding can make these moments feel a little less confusing and a lot less lonely.

Let’s get into it. Have you have you heard of RSD?

RSD stands for Rejection Sensitive Dysphoria, and for many children, teens, and adults, it describes the intense emotional pain that can show up around rejection, criticism, or feeling misunderstood. For many ADHDers, this is one of the hardest, and most isolating parts of their lived experience.

I took a moment to look more closely at the meaning of the three words that make up RSD, and here’s what they mean on their own:

• Rejection (noun): being dismissed, excluded, criticised, or not accepted

• Sensitivity (noun): a heightened responsiveness or reactivity to something

• Dysphoria (noun): a state of intense emotional distress or discomfort, more than sadness; it describes deep unease, pain, or suffering

When you put these together, it helps explain why RSD can feel so overwhelming. It isn’t about being 'too sensitive' or overreacting, it’s about a nervous system that experiences perceived rejection as deeply distressing.

Rejection Sensitivity describes a fast and intense emotional reaction to anything that feels like rejection - being criticised, corrected, getting something wrong, failing, or even imagining that someone might be disappointed. For the people who experience it, the emotional pain can arrive suddenly and feel overwhelming and deeply personal, often creating a strong sense of feeling 'not good enough,” even when that isn’t what was intended.

And the key word here is feels.

Because this response happens in the nervous system, not the logical thinking brain, the emotional pain can feel overwhelming, unbearable, and catastrophic. It’s not 'a bit of hurt' or 'taking things personally.' It can feel like an emotional punch to the chest.

When this happens, the nervous system reads the moment as threat. Once the brain shifts into threat mode, everything changes. Access to learning, reflection, problem-solving, and self-regulation goes offline.

The body is then driven into protective survival responses: fight, flight, freeze, or shutdown. Avoidance, withdrawal, anger, or refusal aren’t choices in that moment; they’re protective reactions.

It’s important to know that RSD isn’t an official diagnostic criterion for ADHD. While it’s very closely associated with ADHD, it doesn’t appear in the DSM-5, which is the diagnostic manual used by clinicians.

That said, many clinicians, researchers, and people with lived experience recognise RSD as a real and significant emotional experience, particularly for those with ADHD, especially when emotional regulation and sensitivity are already part of the picture.

Often, a casual comment from a parent, friend, or partner is taken as deep criticism, even when none was intended. It might be a throwaway comment, but it lands hard, and once it’s there, the hurt can’t simply be switched off. The person may overthink it, replay it, and take it incredibly personally, often because it reinforces an old belief they already hold about themselves.

Just checking in - how is this landing for you? Are you noticing this in yourself, or recognising it in your partner, child, or someone close to you?

When we open up a coaching session about rejection sensitivity, I often see a huge sense of relief wash over my clients. They already know what it is. What feels relieving is talking to someone who gets it, someone who understands without minimising, fixing, or explaining it away. It’s like they’ve been holding something tightly for a long time, something confusing, painful, and isolating, and for the first time, they don’t have to justify it or carry it alone.

There’s often a big sigh.

And then they become more open. More honest. More themselves.

They describe everyday situations where someone says something fairly benign, to them or about them, and yet there’s an immediate sinking feeling. It’s a felt sense. Something that can’t simply be shaken off. Often their inner critic shows up and starts the same old story… or invents a new one entirely. They know the comment probably wasn’t meant the way it landed, but their body doesn’t get the memo.

The emotional pain arrives fast and loud. It hurts. It really hurts. It’s as though the comment is saying something much bigger:

I’ve failed.
I’m not enough.
I’ve disappointed someone.

Many tell me they replay conversations on a loop, trying to work out what they did wrong or how they should have responded. Shame can move in quickly, bringing harsh self-talk and a strong urge to either fix it immediately, or disappear altogether.

For some, this shows up as tears, anger, or snapping defensively. For others, it’s a quiet shutdown, pulling away, going silent, or avoiding situations altogether, just in case rejection might happen again.

When someone has rejection sensitivity, their nervous system stays on high alert around other people.
They’re not choosing to overanalyse, their brain is constantly checking:

Am I okay with you?
Did I do something wrong?
Are you upset with me?

So they watch closely for changes in tone, facial expression, energy, or mood. A pause, a sigh, a flat reply, or a slightly different look can register as possible disapproval, even if nothing has actually changed.

And even when reassurance is given, “It’s fine,” “I’m not annoyed,” “You didn’t do anything wrong," the nervous system doesn’t always settle straight away. The words might be heard, but the body is still bracing.

And perhaps the hardest part?

Even when someone says, “You’re okay. I’m not upset,” the nervous system doesn’t always believe it immediately. Many people need time for their brain to come back online. In the meantime, their reactions may not look how they wish they would.

They’re not choosing this. They really want to respond differently, but in that moment, they can’t think it off or shake it off straight away. And this becomes another layer. Some may pick fights, raise their voice, or withdraw completely. These reactions aren’t what they want, and afterwards they’re often left with shame, embarrassment, guilt, and even more overthinking.

They Describe Rejection Sensitivity as…

• Intense emotional pain after feedback or correction
  Even gentle feedback can feel overwhelming or crushing.

• Reading rejection into tone, facial expressions, or neutral comments
  The brain quickly interprets disapproval, even when none was intended.

• Replaying conversations again and again
  Overthinking is common, with a strong pull to work out what went wrong.

• Sliding quickly into shame or harsh self-talk
  Thoughts like “I’m not good enough,” “I’ve messed everything up,” or “They must be disappointed in me” can appear fast.

• Emotional reactions that feel sudden or bigger than expected
  Tears, anger, withdrawal, freeze, or shutdown can happen quickly.

• Avoiding situations where rejection might occur
  This can look like procrastinating, people-pleasing, pulling away from others, or not trying at all, all attempts to stay emotionally safe.

• Difficulty separating feedback from self-worth
  A comment about behaviour or performance can feel like a judgement of who they are as a person.

• Defensiveness or emotional shutdown in the moment
  Some react outwardly (arguing, snapping), while others go inward (silence, sulking, withdrawing).

• Being highly attuned to other people’s moods or reactions
  Constantly scanning for signs of disappointment, annoyance, or disapproval.

• Wanting reassurance, but struggling to believe it straight away
  Even when reassured, the nervous system may take time to settle.

These are internal experiences commonly reported by people with ADHD who experience Rejection Sensitivity. They often happen beneath the surface and may not be visible to others.

• Intense shame responses after perceived criticism or rejection

• Rapid negative self-talk (“I’m useless,” “I’ve failed again,” “They hate me”)

• Catastrophic thinking about small interactions or feedback

• Hyper-vigilance to others’ reactions (tone, facial expression, silence)

• Emotional overwhelm that feels sudden and uncontrollable

• Difficulty separating feedback from self-worth

• Persistent rumination (replaying conversations repeatedly)

• Fear of disappointing others that feels deeply distressing

• Strong need for reassurance, paired with difficulty believing it

• Emotional pain that lingers, even when logic says “it wasn’t a big deal”

These patterns are repeatedly described by clinicians who specialise in ADHD and emotional regulation, including:

Dr William Dodson (psychiatrist): One of the earliest clinicians to formally name and describe Rejection Sensitive Dysphoria, based on decades of clinical observation with ADHD patients.

Dr Russell Barkley (clinical psychologist, ADHD researcher): While Barkley doesn’t use the term RSD as a diagnosis, his work on emotional dysregulation, threat sensitivity, and rapid emotional reactivity in ADHD strongly aligns with these observed behaviours.

• Withdrawal or shutdown after feedback or conflict

• Defensiveness or emotional outbursts (snapping, arguing, crying)

• People-pleasing or over-apologising to avoid rejection

• Avoidance of tasks or situations where failure or judgement feels possible

• Procrastination linked to fear, not laziness

• Sulkiness or mood shifts that seem disproportionate to the trigger

• Perfectionism or over-preparing to prevent criticism

• Refusal to try again after a perceived failure

• Seeking reassurance repeatedly, then still feeling unsettled

• Relationship strain, caused by misread intentions and emotional reactions

Here’s an example from one of my coaching clients (name has been changed). Jess describes what it can feel like for her when Rejection Sensitive Dysphoria shows up:

“Sometimes it’s something really small. The other day my partner said, ‘Did you mean to leave that there?’

I know they probably didn’t mean anything by it, but it hit me straight away. It’s like a dark fog gets released in my head, and I can feel it physically, often in my throat and chest.

My brain doesn’t let it go. I replay the comment again and again, trying to work out what I did wrong. Did I do anything wrong? How I should have done it differently.

Within seconds, anger shows up and I start ranting at my partner, telling him he doesn’t accept me, that his standards are too high and that I can’t meet them. I tell him he’s behaving like my mother. Who even cares if I left something out?

That just adds another layer of shame on top of everything else. All of this can spiral from one small comment, even though I wish it wouldn’t.

Somewhere, I logically know it was probably just a throwaway question, that it didn’t have any mean intent. But it derailed me, and what was meant to be a nice morning with my partner, just hanging out together, suddenly felt off.

After a few minutes, the anger passes and the sulky part turns up. I can’t really help it, I just shut down and sulk, and that’s not what I want to be doing. What I actually need is time to process what’s come up for me. But from the outside, I probably just look moody. And then I start thinking, ‘Who wants to be around someone who looks moody and is such hard work? My partner will want to leave me. Something must be wrong with me.’”

Matt, whose wife has ADHD, describes what it’s like living with someone who experiences RSD:

Sometimes it feels like I’m walking on eggshells. A comment that feels completely casual to me can land as deep criticism for her, even when that’s not what I meant at all!

I find myself replaying conversations in my head before I even have them, checking my words, my tone, even my facial expression. There are times I don’t say what I’m thinking or needing, because I’m worried it will cause hurt or tension.

It’s not that I don’t want to be honest, I just don’t want to upset her. Over time, that can feel really hard in a relationship. And to be honest, it’s exhausting. I love her. I want her to feel better about herself and to trust that the things I say don’t come from a place of ill intent. I often wish I knew how to help her in those moments.

It’s also really hard for me not to get upset myself. I have to work hard to stay calm and regulated, because if I don’t, my wife feels worse and our time together can quickly get derailed.”

“We’ve both had coaching sessions with Trudy, separately, and those sessions have helped us both so much. Something really shifted for me. I started to understand what was actually happening in those moments and why they felt so intense for both of us.

It didn’t magically make things easy, but it gave me a different way of seeing and responding. These are the three learnings that have genuinely changed things for me.”

The three key learnings I keep close with me every day are these:

1. It’s not about me, and it’s not about her being ‘too sensitive’.
One of the biggest shifts for me was understanding that when RSD shows up, it’s not a sign that I’ve done something wrong or that she’s overreacting. It’s a nervous system response. That understanding alone has helped me take things less personally and respond with more steadiness instead of defensiveness.

2. My calm matters more than my words in those moments.
I’ve learned that when she’s triggered, logic and reassurance don’t always land straight away. What helps most is my tone, my body language, and staying regulated myself. I don’t have to fix it or convince her she’s okay. Staying calm, kind, and present gives her system the space it needs to settle.

3. Pausing doesn’t mean avoiding - it means protecting the relationship.
I used to worry that stepping back or taking a pause meant we weren’t dealing with things properly. Now I understand that sometimes space is exactly what helps prevent things from escalating. We can come back to the conversation later, when we’re both more grounded. That pause has actually helped us feel safer and more connected over time.

A Crucial Reframe

RSD is not a character flaw or a behavioural problem. It’s a nervous system response to perceived threat, often shaped by years of correction, misunderstanding, or feeling 'not enough.'

Understanding this distinction helps move responses from judgement → compassion → support.

This reframe is supported by ADHD psychiatrist Dr William Dodson and ADHD researcher Russell Barkley, whose work highlights the neurological and regulatory nature of emotional responses in ADHD.

Until Next Time...

If you take one thing from this, let it be this: experiencing rejection sensitivity, whether it’s something you live with yourself or notice in someone you care about, is a response, not a defect.

What you’re seeing is a nervous system responding to perceived threat, doing its best to protect in the only way it knows how. You can begin by simply noticing what’s happening. And if you can, offering a moment of kindness, to yourself or to the person in front of you, truly matters.

Some people do have to navigate this on their own, and that can feel heavy. If that’s you, please know this: learning your patterns and responding with compassion still makes a difference. Understanding creates more choice. Compassion helps the nervous system feel safer. And even small moments of kindness towards yourself can make this feel a little more bearable.

Warmly,