Have you ever felt confused about a situation that ended with a seemingly odd response from someone else?
Maybe you think, “Did I mess up?” or “I’m such a burden.”
If this happens to you regularly and you’ve been diagnosed with autism, you could be experiencing RSD. But what is RSD, and what are some signs you may be experiencing it instead of emotional dysregulation alone?
Let’s start by defining what RSD is and some signs of it in autistic adults.
Have you ever felt confused about a situation that ended with a seemingly odd response from someone else?
Maybe you think, “Did I mess up?” or “I’m such a burden.”
If this happens to you regularly and you’ve been diagnosed with autism, you could be experiencing RSD. But what is RSD, and what are some signs you may be experiencing it instead of emotional dysregulation alone?
Let’s start by defining what RSD is and some signs of it in autistic adults.
What is RSD?
Rejection Sensitive Dysphoria (RSD) is an intense emotional reaction to perceived rejection. It is not a formally recognized diagnosis in the DSM, which means there aren’t specific treatments for the condition.
The term was coined by Dr. William Dodson, a well-known ADHD clinician and the first person to use it in the setting we are now discussing.
RSD is often associated with ADHD and is characterized by extreme discomfort due to perceived or real rejection. To be clear, RSD is not simply being overly sensitive. It is a real condition experienced by many people.
Signs of RSD
Other signs and symptoms of RSD include:
- Sudden emotional pain
- Intense shame or panic
- Spiraling thoughts
- Difficulty regulating after a trigger
- Low self-esteem
- Extreme anxiety
Is RSD More Common In ADHD & AuDHD?
Yes, some research indicates that people who are neurodivergent or have ADHD experience RSD at a higher rate than non-ADHD individuals.
H2:
How RSD Shows Up in ADHD and Autism
RSD is characterized by an impulse to react to any feeling of rejection, criticism, or even feedback. However, how it shows up in ADHD and autistic individuals varies.
In ADHD:
- Faster emotional activation
- Difficulty with emotional regulation
- Urgency, impulsivity, or shutdown
In Autism/AuDHD
Some 50-70% of autistic adults also have ADHD, which may indicate a closer link between autism and RSD than we may yet understand. Here’s how it can show up in autistic adults.
- Heightened sensitivity to social nuance
- Masking amplifying pain when rejection is perceived
- Rumination + nervous system overwhelm
H2:
Core Signs You Might Be Experiencing RSD
Extreme emotional reactions to minor feedback
When faced with minor criticism or even feedback, many people with RSD experience a feeling of devastation, shame, and panic. This often comes from over-reading tone or facial expressions that may not match intention.
Fear of letting others down
This manifests as people-pleasing, over-correcting, or even masking your autism. An extreme need to avoid the discomfort of letting others down often dictates behaviour and even life choices for people with RSD.
Conflict avoidance and shutdown
Ghosting, withdrawing from social relationships, freezing in the moment, and fawning all can occur with RSD.
Anger outbursts or inward spirals
Depending on your unique makeup, you may experience anger outbursts or spirals of self-doubt when facing criticism or feedback. Burning need to fix or apologize immediately after the outburst is also typical.
Relationship struggles
Interpreting neutral interactions as rejection is difficult for relationships. RSD often makes trusting others challenging as well.
Persistent shame
RSD makes it hard to avoid replaying criticism (whether it is healthy or not). It also leads to harsh self-talk and emotional exhaustion once the loop stops.
What Triggers RSD in Adults?
Many things can lead to an RSD spiral. The most common triggers for RSD symptoms include:
- Constructive feedback
- Being ignored, misunderstood, or not responded to soon enough.
- Relationship uncertainty
- Work deadlines, performance reviews
- Social interactions where nuance and social cues are unclear
- Internal triggers (self-disappointment, unmet expectations)
How Living with RSD Affects Your Day-To-Day
RSD affects much of what we experience on a day-to-day basis. This can include our social interactions and how we replay social situations over and over in our heads to figure out what we “did” wrong, even though the other person may not be thinking about it at all.
You may also avoid getting close to people altogether. This affects your social life.
Some people also experience a fear of failure that makes trying new things a real challenge.
Living with RSD can feel exhausting, and like you’re constantly avoiding rejection, when in reality, the rejection exists within.
How to Begin Managing RSD (Approaches Proven to Help)
Because it’s not a formal diagnosis, there isn’t a formal treatment plan for RSD. However, there are things you can do to avoid being triggered and manage your triggers.
Step 1. Recognize your triggers.
Study your pattern. Are you triggered when you make a mistake at work? Or when someone comments on what you’re wearing that day? Tracking your triggers helps you identify and more quickly apply coping strategies before RSD spirals.
Step 2. Ask clarifying questions.
When you feel rejected, it may be helpful to ask clarifying questions. What you may think the intention was may not be quite right.
Step 3. Don’t self-abandon.
RSD is commonly coupled with people-pleasing, but that may feed the RSD cycle. Don’t forget that you matter, too, and that your needs are important. It cannot be easy, but with time, you can strengthen your resolve to embody who you really are.
Other therapeutic resources and strategies that may help include:
- Nervous system regulation—naming the trigger, grounding, and slowing the moment down)
- Cognitive reframing techniques for perceived rejection.
- Building distress tolerance
- Reducing masking behaviours that lead to emotional overwhelm.
- Practical self-compassion exercises (particularly as it relates to Tall Poppy Syndrome)
How Therapy Helps—Especially for Late-Diagnosis Adults
Late diagnosed ADHD and autism can also come with comorbid conditions like RSD. However, there is a way to move through the fog and come out the other side feeling stronger than ever.
Therapy is a great resource to help you understand your emotional patterns, reduce shame, rebuild self-trust, integrate ADHD/autistic identity, and lower your mask.
You’re Not Too Sensitive. You’re Wired for Emotional Depth.
RSD is a real, neurodivergent experience. It happens frequently in ADHD and autistic adults. And it is nothing to be ashamed of.
There is hope: you can cultivate calm within and learn to regulate your emotional reactions before you feel ashamed.
Ready to take the next step toward balance within?
ADHD, emotional dysregulation, and RSD with an autistic diagnosis don’t have to be the end. Explore how neurodivergent therapy can support you on your journey to recovery by booking a meet n greet with me.
Or stick around the blog and learn more about autism and ADHD from an informed therapist.
Blog Disclaimer
This blog includes occasional personal anecdotes used to illustrate therapeutic ideas and foster connection. All identifying details have been altered or omitted to protect confidentiality. These reflections are intended as examples only; every individual’s experience is unique, and what resonates for one person may not apply to another.
The information provided here is for educational and informational purposes and should not be considered a substitute for professional medical or mental health advice, diagnosis, or treatment. If you have concerns about your health or well-being, please consult a qualified healthcare provider or licensed mental health professional.
Psychotherapy services described on this site are available to residents of Ontario. If you are interested in support or would like to schedule a complimentary 20-minute consultation, you are welcome to contact me through my practice.
These resources are offered to support your learning and self-understanding as you move toward a more grounded, authentic, and meaningful life.
