Teens with ADHD

“I Feel Judged and Attacked:” A Teen’s Eye View of RSD

A 15-year-old boy with ADHD expresses how rejection sensitive dysphoria manifests in his daily life. A therapist responds.

male teen sitting at desk talking cheerfully with another male student
male teen sitting at desk talking cheerfully with another male student

Q: “When friends or classmates at school say that one of my favorite books or movies is bad, I feel very hurt. It doesn’t feel like they just disagree. It feels like a personal attack. When I mentioned at lunch that I liked the Jack Reacher book series, Brendan said, “Ew, that’s a bad book. Why are you reading that?” I got very upset because it felt like he was saying I had bad taste, that I was strange and weird for reading that book. I said softly that I liked it and changed the subject. When someone says something that hurts me, I feel like I’ve messed up somehow.

If someone doesn’t value spending time with me as much as I value spending time with them, I feel rejected. Last month, I said to one of my closest friends that I would like to hang out with him more like we used to. He said that he was cool with the way things are. This hurts a lot. What can I do to make this less painful?”

When teens with ADHD struggle with rejection sensitive dysphoria, it affects their relationships — and their self-esteem. Often, they don’t know how to cope with their intense emotions and, feeling overwhelmed, they may lash out at friends and/or family members.

[Read: Why ADD Makes You Feel. So. Much.]

One of my teen clients told me: “When I come home from school, sometimes I just can’t hold it all together. I yell at my mom and then I feel bad afterward, but I know that I can’t get kicked out of my family.” Other kids will withdraw quietly into their rooms and swallow their pain. As parents, there’s a fine line between supporting your adolescent in managing their big feelings and intervening to diminish their distress.

While some ADHD non-stimulant medications or antidepressants, such as SSRIs, can reduce sensitivity and overwhelm, the following behavioral tools can be very effective to quiet the inner critic, shift perspectives, and develop self-confidence.

How to Deal With Rejection: Help For ADHD Teens

1. Identify limiting core beliefs.

Remind them of situations that contradict those beliefs. Help them to recall times when they felt uncomfortable and did something anyway.

[Self-Test: Could You Have Rejection Sensitive Dysphoria?]

2. Challenge negative self-talk.

Name and reinforce their strengths. Pay attention to what is going well. Give examples of their successes.

3. Help quiet their inner critic.

Help them combat the negative messages they tell themselves by prompting them to create positive self-talk phrases. Practice these so they will be familiar and handy when they are needed most.

How to Deal With Rejection: Next Steps

Sharon Saline, Psy.D., a licensed clinical psychologist, is an expert in how ADHD, learning disabilities, and mental health issues affect children, teens, and families. She is the author of What Your ADHD Child Wishes You Knew.

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