Rejection Sensitive Dysphoria Test

Guide to RSD;  Rejection Sensitive Dysphoria Test
By: NeuroSpark Health

Note: While Rejection Sensitive Dysphoria is not a medically-recognized term or condition, it is often used by the ADHD community who realized that many of us share this unique set of challenges and began sharing about this common phenomenon on social media and other platforms. Many ADHDers find that they identify with RSD and its many emotional challenges. This blog aims to reflect these lived experiences, and is not to be mistaken for diagnostic or therapeutic advice. The Rejection Sensitive Dysphoria test is an informal checklist and is also not to be interpreted or used as diagnostic or therapeutic advice.
 

About Rejection Sensitive Dysphoria 

Rejection Sensitive Dysphoria, or RSD, is a commonly used term to describe the collection of lived experiences shared by many adults with ADHD. RSD involves intense emotional responses to real or perceived criticism and rejection. While it is true that most people － neurodivergent or not－ would get upset by rejection, it seems that individuals with ADHD have a much more pronounced and intense response to it that significantly affects their lives, relationships, self-esteem, and emotional regulation. Dysphoria is the emotional experience of being upset, unhappy, uncomfortable, uneasy, and dissatisfied. For people with ADHD, even a small comment or action by another person may send them into this deeply upsetting headspace if it activates their rejection sensitive dysphoria. Furthermore, ADHDers report that their threshold for coping with rejection seems to be lower, or significantly more sensitive, than neurotypical people. This could be due to a variety of factors. 
 

What’s the connection between RSD and ADHD? 

Many studies show that neurobiological features of the ADHD brain include differences in dopamine, including less dopamine availability, disruptions in dopamine reward pathways, and differences in reward-seeking. In plain language, we have a complex relationship with “feeling good” due to our challenges with dopamine regulation. Thinking about how emotional regulation can be such a challenge with ADHD, it begins to make sense why many people with ADHD can be more sensitive to social stimuli. This may be one reason behind why rejection sensitive dysphoria is common with ADHDers. 

Another important point about rejection sensitive dysphoria is our often long histories of challenges, criticisms, judgment, and ableism that we have lived with as neurodivergent people navigating a neuronormative society.  Many of us have been exposed to a litany of criticism and negative narratives about our “deficits'' since childhood, which impacts self-esteem. Our heightened sensitivity to rejection may have been born out of a long history of being rejected for our differences. 

Additional possible contributors to rejection sensitive dysphoria include heightened emotional intensity, difficulties with regulation, and decreased frustration tolerance, which are all aspects of the neurodivergent emotional experience that may explain the heightened sensitivity.
 

How is Rejection Sensitive Dysphoria experienced?

When RSD is triggered, it can drastically impact their mood and cause people to feel deeply upset, sad, dysregulated, and/or anxious. Many describe an occurrence of RSD as a negative “spiral” that is difficult to manage or control. Whether the rejection was real or perceived, the individual may also exacerbate or expand on the initial trigger through negative self-talk which can further reinforce the feelings of rejection. In other words, if someone makes a statement that is critical or rejecting in nature, this can unfortunately be worsened by the neurodivergent person’s own negative beliefs.

Responses to rejection may be externalized, such as crying, screaming, confronting the person who rejected them, or explaining to the person why they are hurt. People can have a fight, flight, freeze, or fawn response to rejection. Fawning could look like overapologizing, people-pleasing, and trying very hard to rapidly regain the rejecting party’s “acceptance” or “approval.” Conversely, when RSD is triggered, a person may retreat and shut down when they feel rejected and move through these emotions independently.  An RSD episode may even manifest physically, including headaches, stomach aches, rapid heartbeat, and muscle tension.
 

Recognizing rejection sensitive dysphoria

Being able to recognize whether you experience rejection sensitive dysphoria, and how it shows up for you, is a powerful aspect of self-awareness that could be helpful for you to better manage it.

Because rejection sensitive dysphoria is not a medically recognized term, an official rejection sensitive dysphoria test does not exist. You can feel free to explore this topic with a neurodiversity-affirming therapist who has knowledge of RSD. 

We have created an unofficial, informal  "Rejection Sensitive Dysphoria Test," designed as a checklist to help neurodivergent people identify whether RSD is something that they experience. Please note: this Rejection Sensitive Dysphoria Test is not therapeutic or diagnostic information or advice, it’s an informal checklist that aims to capture and categorize lived experiences.

Rejection Sensitive Dysphoria Test

Instructions:

Rate each statement on a scale of 1 to 5. 

1- "Not at all true for me" 

2- “Somewhat or sometimes true for me” 

3- “Moderately true for me”

4- “Very true for me”

5 is "Extremely true for me."

• I often have intense emotional responses to real or perceived criticism or rejection 

• Receiving criticism, even if constructive, makes me feel deeply hurt and demoralized.

• I avoid social situations or new experiences due to fear of rejection.

• My mood can drastically shift based on how I perceive others' opinions of me.

• I go to great lengths to avoid conflict or disagreement to prevent feeling rejected.

• I often replay social interactions in my mind, analyzing and overthinking them.

• The fear of being rejected has influenced my life choices and decisions.

• My personal relationships have been affected by my intense reactions to rejection or criticism.

Scoring:

• 7-14: Low likelihood of Rejection Sensitive Dysphoria.

• 15-28: Moderate likelihood; consider seeking support if these feelings impact your daily life.

• 29-35: High likelihood; it is recommended to explore these concerns with a professional.
   

Understanding the Rejection Sensitive Dysphoria Test scores

If the above Rejection Sensitive Dysphoria Test indicates likelihood of RSD, please know that you are not alone. These feelings are valid and not a sign of personal weakness or being “overdramatic.” RSD can be a very difficult experience to live with. You deserve to feel secure and safe in yourself and your relationships.Seeking support from others who can relate with your struggles or consulting with a neurodiversity-affirming therapist or coach can provide valuable insights and strategies that can be helpful for your specific situation.

Coping Strategies for Rejection Sensitive Dysphoria

Coping strategies for rejection sensitive dysphoria depends on the person’s experience and should be specifically designed around what works or does not work for that individual. Some people may benefit from cognitive reframing techniques of CBT, but CBT has been discussed as being potentially unhelpful or problematic for autistics or AuDHDers. Others may benefit from some self-empowerment and self-affirmations when they are feeling rejected! Having a comforting, encouraging person to support you when your RSD is triggered can make a big difference. For a list of a few treatment and coping strategies that may be helpful for RSD, visit our blog “How to Deal with Rejection Sensitive Dysphoria.”
 

NeuroSpark supports neurodivergent individuals who experience RSD

Our rejection sensitive dysphoria test was created as a basic starting point for you to begin having conversations around RSD and your experience of it. We’d be happy to have these conversations. We know how profoundly RSD can impact the emotional well-being of neurodivergents, and we want to help you feel safe and supported to move through these feelings. While there is no official rejection sensitive dysphoria test or assessment, please let us know if you’d like to explore your RSD experience with us and we’ll meet you exactly where you’re at.