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“RSD Has Blessed Me with an Immense Capacity for Feeling — and I’m Grateful.”

“Just as a force of nature can be powerful and destructive, RSD can also bring me to my knees in awe and wonder. It feels amazing and special to be able to contain such enormous, intense feelings – and come out on the other side.”

The year 2020 didn’t deliver much good, but it did spark something incredibly important: my ADHD diagnosis – and my ability to (at long last) find peace with Rejection Sensitive Dysphoria (RSD).

Maybe it sounds strange to label my diagnosis as a good thing. But it is – because knowing that I have an ADHD brain explains so much about my life and my experiences that previously didn’t make sense. My diagnosis was like a blurry lens suddenly coming into focus.

It was a long, four-year journey from thinking I could have ADHD to finally getting an official diagnosis. Learning about RSD was actually one of the first dominos to fall.

You see, I had spent nearly 40 years unknowingly masking and compensating for what I now know are ADHD symptoms. As I had done all my life, I felt I could continue to learn new strategies to work with time blindness, executive dysfunction, and other issues. But something was amiss – the emotional component seemed to be getting worse, not better, with age.

As I researched ADHD and intense emotions during those pre-diagnosis years, I learned that guanfacine and clonidine, both blood-pressure medications, are sometimes used to treat RSD symptoms in ADHD patients. And as I learned about people’s experiences on these medications and how their emotional symptoms dissipated, I thought, That’s what I want.

[Read This: New Insights Into Rejection Sensitive Dysphoria]

The Rejection Sensitive Dysphoria Experience

For anyone who doesn’t experience RSD, let me try to describe it.

Let’s say I read something directed toward me that isn’t really a rejection or criticism, but feels like it could be. Before I can even think, my guts immediately feel like they are in a giant blender. My veins feel like they are on fire. Then, my brain clicks into full panic mode, spinning scenarios about how the person on the other end of the message doesn’t like me. My brain then decides that no one, in fact, likes me.

Even if I know these thoughts to be objectively false, I worry that they could be true. The episode comes on quickly, and it consumes my entire day. Efforts to “calm down” barely seem to make a dent.

It’s not that people with RSD want to feel this way. It very much feels out of our control, which is why it’s frustrating to hear advice like, “Everyone is in control of their feelings.” That’s just not true for those of us with RSD, and for many other people with the emotional dysregulation associated with ADHD.

[Click to Read: Shame – The Devil on My Shoulder]

Besides, my reactions feel valid to me. They are an appropriate response to the situation, according to my brain in that moment.

I think of RSD and emotions like tsunamis versus regular waves. If you are neurotypical, the waves in your emotional sea could be calm, or choppy, or even harrowing. But, for the most part, you can ride out the waves, maybe even swim or play or surf on them.

With RSD, you have a fairly calm sea interrupted by frequent tsunamis. They come on suddenly, without warning, triggered by things you cannot control. And once you realize what’s about to happen, you have two choices – get out of Dodge, or stay and risk drowning. Either way, you are displaced, and left to deal with the destruction left behind. 

Plus, no one ever talks about controlling a tsunami.

Coming to Terms with Rejection Sensitive Dysphoria

Despite all the problems inherent to RSD, it is not the worst thing in the world, even when I believe it to be in the moment. Just as a force of nature can be powerful and destructive, RSD can also bring me to my knees in awe and wonder. It feels amazing and special to be able to contain such enormous, intense feelings – and come out on the other side.

I’ve also realized that it’s not me who feels most uncomfortable with RSD – it’s those around me. For them, it would be easier if I could just make my feelings “smaller.” But I don’t always have that option. Over the years, RSD has wreaked havoc on my relationships — friendships, family, and even professional connections. The memories and the losses are painful to think about.

Thankfully, guanfacine has been an absolute game-changer for my RSD.

Nothing changed overnight, but slowly I noticed that situations and remarks that normally would have sent me over the edge were not doing so. I was perceiving them as neutral.

Don’t get me wrong – I still feel the pain sometimes. It’s just not as excruciating.

Is this how “normal” people feel all the time? Who knew! No wonder they were so confused by me before.

But also, how sad. How much of my life have I spent feeling physically ill and mentally anguished over situations that perhaps were not as threatening as they seemed to be? How many of us have endured “helpful” critiques about controlling feelings — ones that suggested our reactions were a personal failing — when we weren’t failing at all? We were doing the best we could.

Now that I am starting to see RSD in the rearview mirror, I feel grateful that I have a little bit of extra mental space, the “spoons” to deal with the challenges in my life. But at the same time, I can look back and feel grateful for my RSD.

I was blessed with an immense capacity for feeling, and I love that. It has made me a stronger person, a more empathic person. Though the painful moments were plentiful, I can’t deny that those powerful feelings probably steered me away from situations that were not beneficial to me in the long run.

Ultimately, I know that what might have appeared like “weakness” to some was actually, all along, my greatest source of strength.

ADHD Rejection Sensitive Dysphoria: Next Steps


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2 Comments & Reviews

  1. I talked to my doctor about medication and because they are for blood pressure, he would not even think about it. It took a lot for me to even gwt him to prescribe adderal, I was open to try anything but my insurance wouldn’t cover anything he wanted to give me. $500/month was just not something that I could do.
    The adderal didn’t seem to do much or just that he wouldn’t up the dosage, not sure.

    I just know that I would love to manage the emotions. I was going to start seeing a therapist and they had never heard of RSD because it is not in the diagnosis book. UGH

  2. Thank you for this perspective. I was diagnosed in my mid 40s with ADD. My psych prescribed Guanfacine after I brought an article from ADDitude re RSD to her attention in one of our sessions. She has had good experience with it and was encouraging to try it. I agree, as I am still adjusting the dose in combo with Adderrall, I am confident that it has had a significant shift in my ability to manage my emotions in a more positive way and not get swept away in the tsunami of feelings, yet have a more curious approach. I haven’t gotten to the grateful part of accepting, but with the work of Positive Intelligence (PQ) meditation practice as part of my training, my tool box finally feels up to the challenge to boost me to my best self.

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