Rejection Sensitivity Dysphoria (RSD)

Rejection Sensitivity Dysphoria (RSD) = an internal emotional crash after real or perceived rejection, criticism, or exclusion. It isn’t “being dramatic.” It’s a neurologic overload that can drop you for 12–48 hours (sometimes longer). It often rides with adult ADHD and gets mislabeled as PTSD, depression, BPD, or “moodiness.”

RSD

RSD is a pattern, not a personality flaw. It’s most often part of adult ADHD, and it’s why PTSD-only care stalls for some vets.

What it actually looks like

Instant collapse: one comment → shame, worthlessness, urge to hide.
Long tail: hours to days of withdrawal; can’t function or “snap out of it.”
Freeze, not rage: outside looks quiet; inside is brutal.
Obsessive replay: you relive words, texts, facial expressions.
Identity hit: “I’m too much,” “I ruined it,” “they’ll leave.”
Next-day fragility: extra sensitive; small jabs feel lethal.

Why it’s missed or misdiagnosed

No big scene. Many shut down, not blow up—clinicians miss it.
PTSD overlap. Sleep loss, hyperarousal, and avoidance muddy the picture.
Bipolar/BPD confusion. People often misjudge the intensity of emotions and apply the wrong label.
Screeners ignore it. Most ADHD tools skip emotions entirely.

The cost of untreated RSD

Work churn: quitting or ghosting after embarrassment.
Relationship damage: pre-emptive push-aways to avoid rejection.
Isolation: hiding to “not be too much.”
Suicidal ideation: silent, shame-driven (especially with ADHD + OS).

Quick self-check (if ≥6 are “often/always,” RSD is likely part of your picture)

One critical comment ruins my day.
I replay conversations for hours/days.
I hide after embarrassment (work, friends, online).
I think “I’m too much” around people I love.
I pull away first so they can’t reject me.
I can’t think straight during these crashes—function drops.
The feeling lasts 12–48 hours (not minutes).
The next day I’m extra fragile and need low-conflict space.