Rejection Sensitive Dysphoria

How ADHD Ignites Rejection Sensitive Dysphoria

For people with ADHD or ADD, Rejection Sensitive Dysphoria can mean extreme emotional sensitivity and emotional pain — and it may imitate mood disorders with suicidal ideation and manifest as instantaneous rage at the person responsible for causing the pain. Learn more about potential treatments here.

A woman with rejection sensitive dysphoria hiding her face with her hand
Woman showing hand stop sign while standing at night

What is Rejection Sensitive Dysphoria?

Rejection sensitive dysphoria (RSD) is extreme emotional sensitivity and pain triggered by the perception that a person has been rejected or criticized by important people in their life. It may also be triggered by a sense of falling short—failing to meet their own high standards or others’ expectations.

Dysphoria is Greek for “difficult to bear.” It’s not that people with attention deficit disorder (ADHD or ADD) are wimps, or weak; it’s that the emotional response hurts them much more than it does people without the condition. No one likes to be rejected, criticized or fail. For people with RSD, these universal life experiences are much more severe than for neurotypical individuals. They are unbearable, restricting, and highly impairing.

When this emotional response is internalized (and it often is for people with RSD), it can imitate a full, major mood disorder complete with suicidal ideation. The sudden change from feeling perfectly fine to feeling intensely sad that results from RSD is often misdiagnosed as rapid cycling mood disorder.

It can take a long time for physicians to recognize that these symptoms are caused by the sudden emotional changes associated with ADHD and rejection sensitivity, while all other aspects of relating to others seem typical. RSD is, in fact, a common ADHD symptom, particularly in adults.

When this emotional response is externalized, it looks like an impressive, instantaneous rage at the person or situation responsible for causing the pain. In fact, 50% of people who are assigned court-mandated anger-management treatment have previously unrecognized ADHD.

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

RSD can make adults with ADHD anticipate rejection — even when it is anything but certain. This can make them vigilant about avoiding it, which can be misdiagnosed as social phobia. Social phobia is an intense anticipatory fear that you will embarrass or humiliate yourself in public, or that you will be scrutinized harshly by the outside world.

Rejection sensitivity is hard to tease apart. Often, people can’t find the words to describe its pain. They say it’s intense, awful, terrible, overwhelming. It is always triggered by the perceived or real loss of approval, love, or respect.

People with ADHD cope with this huge emotional elephant in two main ways, which are not mutually exclusive.

1. They become people pleasers. They scan every person they meet to figure out what that person admires and praises. Then they present that false self to others. Often this becomes such a dominating goal that they forget what they actually wanted from their own lives. They are too busy making sure other people aren’t displeased with them.

[ADHD, Women, and the Danger of Emotional Withdrawal]

2. They stop trying. . If there is the slightest possibility that a person might try something new and fail or fall short in front of anyone else, it becomes too painful or too risky to make the effort. These bright, capable people avoid any activities that are anxiety-provoking and end up giving up things like dating, applying for jobs, or speaking up in public (both socially and professionally).

Some people use the pain of RSD to find adaptations and overachieve. They constantly work to be the best at what they do and strive for idealized perfection. Sometimes they are driven to be above reproach. They lead admirable lives, but at what cost?

How do I get over RSD?

Rejection sensitivity is part of ADHD. It’s neurologic and genetic. Early childhood trauma makes anything worse, but it does not cause RSD. Often, patients are comforted just to know there is a name for this feeling. It makes a difference knowing what it is, that they are not alone, and that almost 100% of people with ADHD experience rejection sensitivity. After hearing this diagnosis, they’re relieved to know it’s not their fault and that they are not damaged.

Psychotherapy does not particularly help patients with RSD because the emotions hit suddenly and completely overwhelm the mind and senses. It takes a while for someone with RSD to get back on his feet after an episode.

There are two possible medication solutions for RSD.

The simplest solution is to prescribe an alpha agonist like guanfacine or clonidine. These were originally designed as blood pressure medications. The optimal dose varies from half a milligram up to seven milligrams for guanfacine, and from a tenth of a milligram to five tenths of a milligram for clonidine. Within that dosage range, about one in three people feel relief from RSD. When that happens, the change is life altering. Sometimes this treatment can make an even greater impact than a stimulant does to treat ADHD, although the stimulant can be just as effective for some people.

These two medications seem to work equally well, but for different groups of people. If the first medication does not work, it should be stopped, and the other one tried. They should not be used at the same time, just one or the other.

The second treatment is prescribing monoamine oxidase inhibitors (MAOI) off-label. This has traditionally been the treatment of choice for RSD among experienced clinicians. It can be dramatically effective for both the attention/impulsivity component of ADHD and the emotional component. Parnate (tranylcypromine) often works best, with the fewest side effects. Common side effects are low blood pressure, agitation, sedation, and confusion.

MAOIs were found to be as effective for ADHD as methylphenidate in one head-to-head trial conducted in the 1960s. They also produce very few side effects with true once-a-day dosing, are not a controlled substance (no abuse potential), come in inexpensive, high-quality generic versions, and are FDA-approved for both mood and anxiety disorders. The disadvantage is that patients must avoid foods that are aged instead of cooked, as well as first-line ADHD stimulant medications, all antidepressant medications, OTC cold, sinus, and hay fever medications, OTC cough remedies. Some forms of anesthesia can’t be administered.

Rejection Sensitive Dysphoria: Next Steps

Dr. William Dodson is a member of ADDitude’s ADHD Medical Review Panel.

Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Updated on October 8, 2020

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  1. I think it is unlikely that only those with a ADHD diagnosis suffer from rejection sensitivity. I think people with all sorts of mental health issues suffer from it as well. In addition, I know many people with ADD who do not suffer from rejection sensitivity. ADHD seems to me to be more and more of a grab-all diagnosis for which there appear to be more and more medications that are recommended whether they are FDA approved or not. We need a major overhaul of the entire diagnosis rather than this shot-gun approach that comes up with more and more symptoms, more and more patients and more and more pharmaceutical treatments that may, or may not, be effective. It has gotten out of hand.

    1. RSD is a very real ‘condition’ that can be comorbid with ADHD. I speak from personal experience with my husband. For years I have been trying to figure out why he turns angry within an instant of the slightest rejection from me regarding an idea he has or how he thinks something should go. It’s like he forgets I’m his wife and I don’t criticize him. I have to be so careful how I word offering another idea to the table. I’m a special education teacher, so I have a lot of experience with unstable and displaced emotions with individuals, but I just could not find a root cause for his severely hurt and angry outbursts with my slightest nonagreement with something he has suggested. Until….I read about RSD. It was like my husband was being described in detail. I have been studying dyslexia this summer and see big connections between RSD’s perceived understanding of a false reality and a person’s perceived reality with dyslexia. When they get get triggered into frustration, whether it be emotions or letters or numbers, that confusion causes the person to perceive a false sense of reality. So, my point and realization is that I see a strong connection between ADHD, RSD, and dyslexia….in very intelligent and capable individuals.

      1. I too have struggled for 34 years with an amazing man who I felt had an anger management problem. Then anxiety and depression. Once I read about RSD this summer, like you, I felt it was describing exactly what we’ve been going through for 34 years, often I’d want to divorce a man who truly felt I was trying to bring him down but he was such a wonderful man otherwise. I felt I was living with a Jekyll/Hyde it was such an extreme change in personality. He is still having a hard time wrapping his head around having ADHD and RSD, he still wants to point and find something wrong with me as the issue, but I feel we can get somewhere with a therapist now. Marriage counseling never worked, it would highlight a few issues but never get to why these explosive reactions kept occurring on a very regular basis, with days of agitation and anger as he kept trying to verbalize what was happening, and all he could say was why was I trying to tear him down all the time which is exactly opposite from what I’ve always done for him. I have in fact given up most of my career, friendships, family ties etc to be what made him feel safe. He intellectually knows how much I love him but every day feels anxious that I will leave him which I’ve promised never to do. Though I do tell him we may have to separate, live on the same property in different dwellings and date but never divorce because I am getting to the point I’ve given up all I wanted to do with my life to make this wonderful man feel secure and I’m still getting emotionally and verbally abused because of his extreme RSD. This is not a wimpy man, he in fact owns and operates an excavation company. We’ve never gotten any support for this because everyone just chalked it up to it being a marital issue which I knew it was not. I’ve been so frustrated and desperate to determine what is going on, not get him medicated, but to give him an answer that doesn’t make him feel he’s stupid which is what he’s always felt. I really hope we do not get a therapist like bruce.macleod I really hope we get a therapist who will listen and trust us and not try to tell us what we’ve experienced. One who will help my husband decide if medications are good for him and support him if he decides not to medicate. I do believe psychotherapy can help if someone does not want to medicate, but it can often be hard to get an appointment quickly to process the situation with the therapist so I understand why the author said it may not be effective.

    2. Walk a mile in our shoes. I was diagnosed almost 30 yrs ago with ADD/ADHD. I have spent most of my life telling people I don’t care what people think about me and secretly worrying myself sick and losing sleep over rejection or the perception of rejection. I have basically no friends because when I talk, tell a story or describe something I ramble or include too much detail. I have seen the way someone looks at me while I am talking and assume they are bored or think I am stupid. So at 39 I have basically stopped trying to make friends because that seems easier and less painful than seeing that look again. At work I am a perfectionist and when something goes wrong I am so affected I would rather quit than have to come in and see my boss with a questionable look on their face. Since reading this article I feel like I might have a chance to take control of my life again. Knowing I’m not just a crybaby to be a crybaby makes me feel a little better. I don’t feel like I can give up my ADHD medication to test this because I know I would end up jobless inside 1 week, either getting fired or quitting because I don’t feel like working. So it’s not about pills, pills, pills. It just means my enemy has a name.

    3. Having been a 34 year spouse of an ADHD sufferer long undiagnosed this is so exciting for us to hope we can see the chaos that RSD has caused us finally be explained. We are fortunate to still be together 34 years because it’s been excruciating the pain and trauma it has caused. Knowing what it is will help even if he decides not to take medications. Just knowing what is happening to him is going to change our lives immensely!!

    4. Salum comment is absolutely correct about the blanket diagnosis of ADHD.
      Lmao to all the adder comments slamming him before thinking.. 😂😂
      I have adhd and I also recognise RSD in my behaviour.
      My ex has BPD. After supporting her through 4 years of DBT for her Bpd she then went on her own. Within 9 months the psycologist in her wisdom changed the diagnosis to ADHD! I objected the diagnosis and begged them not to give her the stimulant as she was just manipulating them to change the diagnosis. (because they had now taught her what she needed to show them after 4 years of DBT) But they knew better than the one person who lived with her and they prescribed Ritilin! Let me tell you stimulants an BPD dont mix well! Over the next Year she covertly had my 11 year old step daughter diagnised with OCD and ADHD (all symptoms caused by sleep deprivation and malnutrition) The result was a prescribed drug induced psycotic episode and she nearly killed herself! After her admission she has had no medication and lives happily with dad fulltime.
      Misdiagnosis is out of control in Australia and the psycological profession has a lot too answer for! But they get to hidenjoy behind the confidentiality code and mental health legislation.
      It has destroyed our family beyond belief and now I am fighting the family court system as well!

  2. I actually disagree. I believe that Dr. Dodson’s description of RSD (and other emotion-focused characteristics of AD/HD) are extremely accurate and represent my and many others’ greatest challenge of the disorder. While I agree that diagnostic criteria, and conceptualizations of the disorder need an overhaul, I very much favour extending the popular understanding and the clinical model of AD/HD to include the dysregulation of emotion rather than focussing solely at the cognitively inattentive and behaviourally hyperactive symptoms that currently are highlighted.

  3. can’t wait to tell my next client with ADHD/RSD – it’s ok, your not damaged. your defective. that will make such a difference. the idea that psychotherapy is not effective for so called RSD is a flagrant abuse of his authority as a psychiatrist and expert on ADHD. the whole article is an advertisement/promotion for old drugs in search of a new markets.

    1. I find it hard to understand why a mental health professional would choose words like “damaged” or “defective” to describe patients. Having a “name” for something, and using it as a lens through which a person can better understanding behavior or symptoms they have experienced throughout their entire life, can be highly empowering. This label/lens model of disease treatment is critical for all areas of medicine; it’s the difference between treating “cancer” or a highly-specific and genetically-based subtype of breast cancer, or even the distinctions in treating MDD and Bipolar depression.

      I also don’t understand your interpretation of the author’s discussion of possible treatment options. Patients experiencing RSD would almost certainly benefit from psychotherapy to help manage co-morbid disorders or even simply as supportive care, but knowing that approach may not effective treat for RSD directly is critical information. And identifying old and inexpensive medication options hardly seems like a drug sell, especially since the negative side effects are clearly mentioned and the author proposes that this type of treatment may negate the need for stimulant medications in some patients.

      And I agree that we need better diagnostic and treatment methods for ADHD. I find Dr. Daniel Amen’s work with SPECT brain imaging and it’s potential to clinically confirm and further specify subtleties in psychological and neurological disorders to be truly revolutionary for the
      future of ADHD, and brain science in general.

      1. Ok Jennifer “I find it hard to understand why a mental health professional would choose words like “damaged” or “defective” to describe patients”. Let me explain.
        first off, Dr Dobson offers this drivel as expert opinion with no reference to research other than some old studies that validated drugs with sedentary side effects (unlike trauma, sedation makes anything that involves consciousness less bad). So his pronouncement that.. “Rejection sensitivity is part of ADHD. It’s neurologic and genetic. Early childhood trauma makes anything worse, but it does not cause RSD.” is simply a statement made by a guy who is advertising some older medications that are not currently used for ADHD.
        In making the statement it is genetic (with no evidence)he is in fact saying that it is a genetic defect, just like my red hair. obviously I would not say this to a client, as you should have been able to tell from my statement. But saying you are not damaged (which can be repaired) you have defective genes shouldn’t be much comfort to anyone. Particularly the clients I see with early severe parental rejection.

        If this had been a report on RSD with some research to support, it would have provided useful focus for treatment with Psychotherapy. Dr. Dobson cut that off with his statement that psychotherapy is not effective, a pronouncement made with no research to back it up. Interesting as I work effectively with clients who have sensitivity to rejection every day.

        1. Do you seriously believe that every well-accepted commonplace in psychology has to be documented, annotated, and footnoted every time it’s mentioned? The solution here is not for the author to better document things which are not in dispute. It’s for you to do enough reading to know that they’re so generally accepted that doing what you suggest would be meaningless- and remedy your ignorance a bit, eh?

        2. Thank you, Bruce, for trying to shed some light on the huge problems with this piece—and the resulting copycats throughout the Internet.

          I am receiving reports from adults with late-diagnosis ADHD that their mental-healthcare providers are “stupid” because the providers don’t realize they have RSD — and some have never heard of it.

          This demagoguing of psychiatric issues should frighten everyone, and it is pervasive on the Internet given the simplicity of the message.

          Gina Pera

    2. I find it hard to understand why a mental health professional would choose words like “damaged” or “defective” to describe patients. Having a “name” for something, and using it as a lens through which a person can better understanding behavior or symptoms they have experienced throughout their entire life, can be highly empowering. This label/lens model of disease treatment is critical for all areas of medicine; it’s the difference between treating “cancer” or a highly-specific and genetically-based subtype of breast cancer, or even the distinctions in treating MDD and Bipolar depression.

      I also don’t understand your interpretation of the author’s discussion of possible treatment options. Patients experiencing RSD would almost certainly benefit from psychotherapy to help manage co-morbid disorders or even simply as supportive care, but knowing that approach may not effectively treat RSD directly is critical information. And identifying old and inexpensive medication options hardly seems like a drug sell, especially since the negative side effects are clearly mentioned and the author proposes that this type of treatment may negate the need for stimulant medications in some patients.

      I do agree that we need better conceptions of ADHD. I find Dr. Daniel Amen’s work with SPECT brain imaging and it’s potential to clinically confirm and further specify subtleties in psychological and neurological disorders to be truly revolutionary for the
      future of ADHD diagnosis and treatment, and brain science in general.

    3. Dr Macleod,
      Although I appreciate your candor in your commentary on the veracity and credibility of Dr. Dodson’s statements, I can not stop myself from feeling that your analysis has several critical flaws as well.
      I do not understand the basis of your assertion that the author is saying that ADHD patients who suffer from RSD are “defective”, rather than “damaged”. He neither expressly states so nor even uses the word in his entire piece. I further contend that what he is trying to say, based on the context, is that patients many times feel relief when told that there is educated consensus that what they have been suffering from their entire lives is a result of physiology and genetics, as opposed to something that could have been avoided had circumstances of their upbringing and influences been different: that they had not missed out on an opportunity to avoid what many times has caused severe unhappiness in their lives through lack of due dilligence on their part. I think that it is “not their fault”, nor anyone else’s, that they suffer comes with a strange sort of but not insignificant relief. As an MD neurologist whom also suffers from ADHD and now recognizes the symptoms of RSD being present in my entire life, this article has had that exact effect.

      You also mention several times that he presents his conclusions with no accompanying evidence. But this does not seem to be an appropriate forum to present an argument in that form, with pages of references longer than the article itself. The intended audience of this article seems to be lay people with loved ones whom, or even themselves, suffer from the symptoms of RSD and not those trained in evidence based practice. I admit that I have not looked up Dr Dodson’s body of work nor any other systematic studies on RSD in the context of ADHD, but I question whether you have reviwed the literature as well. Are you sure that Dr Dodson just woke up one morning and decided to pull these arguments out of his… yeah…? If you are instead accusing him of lacking intellectual rigor or academic dishonesty, I would caution you that those be fightin’ words and that Enigo Montoya would Not be happy about that.

      What is truly confounding me is that you also say that Dr Dodson is advertising new uses for old medications that are not used for ADHD. First I point out that guanfacine is first line treatment for ADHD in the pediatric population. Clonidine is second or third line I believe, and I myself was trained in its use during my training. Admittedly my current practice is in vascular and interventional neurology, with little to no exposure to patients with ADHD as their chief complaint, but your assertion that these medications are not used to treat ADHD is baseless. I also wonder what exactly you mean that he is “advertising” for the use of obsolete medication over more modern and therefore better meds. I can not think of anything that a physician would gain from advocating for the use of drugs of which the patents have long since expired, other than mitigating the suffering of their patients. I can understand that you may have inherent bias when someone suggests greater efficacy of an approach to a problem over the methodology that you may practice. I find myself suffering from that exact bias when I hear Dr Oz advocating for the use of some exotic potion collected from the sweat glands of pigmy walruses during a full moon over conventional therapeutics. But it is WALRUS derived… Or, do you know of a drug company that gives free lunches and kickbacks for clonidine? Hook a brother up then because the neurosurgeons do some of the same things that I do but get paid three times as much. No lies.
      I would appreciate any feedback you would have. But I still feel the need to emphasize one thing. I apologize to whomever else may be reading this about the all-caps, but DO YOUR F******G HOMEWORK BEFORE YOU OPEN YOUR MOUTH.

      1. I would appreciate any feedback you would have. But I still feel the need to emphasize one thing. I apologize to whomever else may be reading this about the all-caps, but DO YOUR F******G HOMEWORK BEFORE YOU OPEN YOUR MOUTH.
        How quickly you descend into personal attack. no point in continuing this, I said and clarified what I think and have no interest in engaging or changing your mind.

          1. Exactly! We lay person’s are just trying to find information to help the ones we love and keep our marriages from being yet another divorce statistic. I literally have gotten good information from every single person who commented EXCEPT YOU. So please just be quiet and go away. Obviously not a single person here is happy with your input.

  4. I am a 68 yo female, who was diagnosed with ADD when I was in my 40’s. I did not do well in school. My parents moved, so that I could attend high school where there were a lot of Jewish girls and make friends with them. I am Jewish. Wearing brand names didn’t make me accepted by them. They were snotty bitches. A lot of them became friendly in the early years, because they grew up in certain neighborhoods, went through elementary, middle and high school together. I was a Hebrew School drop out. At age 17, my parents took me to a neurologist, child psychologist and child psychiatrist. College was out of the question. The neurologist told my parents that I was capable of making C’s or better in high school. I had trouble focusing,listening and paying attention. Then, how come my GPA was 1.73 when I graduated in 1967? All I can remember about the psychologist is her saying that I had no motor and cognitive skills. The psychologist asked me what don’t put all your eggs in one basket means? I said that one could easily break. I’ve had trouble in all of my jobs as a secretary, because I was constantly late. The tasks were difficult. My evaluations were far from perfect. My father told me that I’d be lucky if I got a job in a dime store as a cashier, that I wouldn’t amount to anything. He didn’t understand. His IQ was 140. I lack self-confidence and don’t like myself. I am a failure, who is weak and gets taken advantage of. I’m tired of people telling me that I use ADD as an excuse. If they don’t have it, they don’t know what’s it’s like living with it.

    1. You are not crazy. My husband says that a lot and it breaks my heart. He is an amazing person! Smart, funny, loving, supportive he’s so much better than most men yet he is plagued with this. I’m so sorry you are, I’m so sorry you are feeling that low. I do know that our close relationship with Christ has been the absolute number one thing that helps my husband know that he is not alone. I hope you have faith or a close friend you can turn to, I’ve never met a person with ADHD that wasn’t smart. My husband is very smart in physics but he did not do well in school so he was never able to achieve his full potential. At some point you have to realize we don’t all get to make our lives what we wanted but we can find good in the daily living. Please find a good therapist, support group and a friend. It’s not too late for you to find joy in life, I so pray that you will and I’ll be keeping you in my prayers if that’s ok with you.

  5. One more thing. My parents rented a pool for me to have a pool party when I was 13. I invited some of those bitches. They weren’t decent enough to respond. One guy I had a crush on, came. Children can be cruel, but adults are worse. I live in a resort city. Some of the residents are rather snobby and rude. They have their clicks. I truly have a distaste for snobs. There are people who don’t have a pot to piss in but, when they suddenly get money, they change for the worse. It’s time to hit the sack. One psychotherapist I saw said that normal people see him. It’s the sick ones who don’t.

  6. Speaking of second and thied line meds and their effect on ADHD and RSD disabilities, I am 72 yrs old and A recently diagnosed severe ADHD combined type. As so kany others are I was diagnosed withsevere depression following 14 day hospital evaluation and prescribed Venlafaxine and for a very short tim ranrisparadone 5 years ago. The venlafaxine initially increased to 150 mg and later reduced to 75 mg took amore than a few months and a third divorce to achieve its greatest effects. They were however awesome. Things slowed dwn enough fir me to note the similarities of what i was going thru to my sons and grandson who were both diagnosed with AdHD and as adults were on medication. online tests followed by a full evaluation folllowed and my drug regime had concerta and amitryptilene added which didnt really help as i returned to being more aggressive. And were discontinued.
    The results so far have been a major increase in working memory, in not losing things, in accomplishing tasks on my todo lists ( this still needs work) in patience notoriously LFT , and in accepting and encouraging criticism. And the complete disappearance of what I now fecognize was RSD. Things helped but not as much include Timeliness better but not all that good,
    Downside Recently I ran out of Venlafaxine after giving the Pharmacy a months notice to contact my doctor and then another 4 days notice. They sent him a fax but neglected to follow up. My Family Physician had recently left the city and his brother in the same clinic became my FP. A few hours after the first missing dose I went balistic at an email that dared to assume i knew the user ID and PW for a site that would provide a set of instructions to forward to others. Although i had correponded with them 3 weeks before I completely forgot who they were and was totally upset and felt they were implying i was auditioning for their approval. One of the nastiest emails i can recall was sent to them saying everything but that their mother wore army boots. It was bad enough and scary enough that they fired me from a vlounteer choir. Anyway believe everything you have heard about withdrawl on this med. it is however very good at eliminating the RSD issues. In fact I would never have been in that choir in the first place fearing rejection. As two of my divorces are directly related to RSD i wish i had met this diagnosis and treatment two divorces and a million dollars ago.
    Love those second and third line meds.

    1. Thank you for saying this because I’ve spent God knows how long on this particular webpage reading the article then all the tons of comments thus far, all the while it’s been eating at me wondering why this is being portrayed as something exclusive to ADHD!? I have inattentive type ADHD & while I can somewhat relate to this so called “RSD” I’m still on this page bc it described my fiance (whom I’ve been with going on 8 yrs) to a “T” and he has only recently confided to me that he was diagnosed with autism at one point during his childhood. I haven’t done hardly any research on autism but I can say this article described him exactly and he does NOT have ADHD. He grew up with an alcoholic abusive father and also struggles with anxiety. Did your DH perhaps have a similar childhood? Just curious bc I wonder if that aspect has anything 2 do with my mans RSD.

  7. Many people can have one or a few of the traits associated with ADD., and not have ADD. Everyday I’m see new traits that I have that have impacted my life severly and that fall under my ADD diagnosis. My diagnosis has explained my entire screwed up life to me finally. If you treated each trait that we have, we would be taking pills non stop all day long, which with the stimulants I already feel like I do take pills all day long.

    My point is, a true ADD diagnosis has so many traits associated with it that you can’t possible treat them all.

    If anyone wants to do some really helpful research, figure out how we can get a grip on this crap while it’s happening and purposefully turn it around while it’s happening. Impulsive comments, intense feelings of rejection before an actual rejection, brain freeze, overwhelm and lack of motivation, just to mention a few. Fact is stimulants affect the biggest one, focus.

  8. These symptoms are similar to those of Borderline Personality disorder – fear of abandonment causes people pleasing behaviour, perceived or real rejection can cause angry outbursts and the person being vilified even for a small misdemeanour. There is a feeling of no sense of self, no,real identity as mentioned in this article as the person is constantly trying to please/form attachments and therefore they don’t connect with what they want and need. BDP can be comorb with ADHD/ASD. I think that all of these developmental disorders have common connections, lack of impulse control, emotional dysregulation, anxiety, low mood, lack or organisation. With ASD people are constantly reading social cues to try to make sense of the social world, with BDP people are constantly trying to please to make sense and belong in the social world, with ADHD people are constantly trying to curtail their impulses to fit in to the social world. In all cases the difficulties fitting in to the social world causes anxiety, sometimes depression, sometimes depersonalisation, sometimes loss of identity. The key is to treat people earlier as children and help them as children with anxiety control such as exercise, Mindfullness, CBT. They can’t comtrol others but they can learn with these interventions how to control their reactions to others and hence miniimise their anxiety feelings of low self worth,

    1. I agree with you but we have to come up with a clinical inexpensive test or vacine that accomplishes. While I was not diagnosed until I was seventy I grew up in a family of with 11’siblings and countless neices and nephews almost my age. The tremendous support given by olders and the neighborhood grapevine worked better than any facbook or twitter info line and i was fortunate to have such a system that very few today benefit from. The key iss in a. Clinical a,larm test since so many will slip thru the other safeguards we have.I was also fortunate to inherit the families genius level IQ. Unfortunately having the patience to correct all these errors or mis intuitive spelling suggestions on this ipad doesnt come with my set of genes.

    2. I am one of those unfortunate people that got misdiagnosed with Borderline Personality Disorder by a psychiatrist after a few minutes in her office. It did not matter that I have stable Whole Object Relations and Object Constancy. Because of my emotional flooding I self harmed and that was that – in her eyes I was borderline. It did not matter to her that I have a strong sense of self, I do not split; I do not do the ‘I love you, I hate you’s’; I do not sabotage my relationships; I do not ‘push pull’; and I am a black, white and all shades between thinker.

      I have rejection sensitive dysphoria (RSD) but because it’s not in the DSM it is not considered part of ADHD. Dr. Dobson might be the lone voice on this but his articles and on-line talks have helped me understand what is going on. His lone voice and the countless other ADDers talking about how they too grapple with this ‘emotional flooding’ has helped me in a major way deal with my RSD.

  9. O it does exist. You can have it but never let it determine how you respond to others becauseof how they make you feel.

    You can beat this but the solution comes from an very unexpected source. The 7 habits of highly effective people, The 17 laws of teamwork, Thinking for a change, 21 laws of leadership, Intentional Living, etc and any other book on managing and leading in the business and church environment.

    Regardless of what position or work you do, learn to lead yourself first well by learning how to lead others well. people may start to listen you and even follow you and you will have no idea why.

    after 19 years after going no where I went from teacher to principal in only 7 years. This despite being no confirm diagnosis of being ADHD.

    Being appointed as a Principal and diagnosed in the same week may have been a bit of a shock to everybody else’s system.

    What happen when you despite all odds you have made it to a position like mine and with it your ability to do things improve suddenly beyond even your own understanding.

    Does this create further success? I take 90mg concerta. Perfect recall, good listening skills, on time, etc etc. everything everybody else is that has some measure of success. So what can go wrong.

    A people pleaser wants to do the right thing at all times and never wants to disappoint. so they refuse to compromise their values and their integrity.

    Put yourself in a a position where everybody else is hurting and you are the only one that understands why.

    Let us just say I no longer work and just because i think differently.

    So the moral of the story is. If you worry you die and if you don’t worry you die. So let no ever take your dignity from you and if they do, Knowledge couple with Character with a dose of integrity will always pull you through.

    This from a John Maxwell team member with ADHD. With or without medicine being ADHD is going to set you apart from the rest. The choice always remain ours how we will be remember for the choices we made. Rather be the exception than the rule.

    When you lose everything just because your are ADHD then being a person of character and if you are a person of faith and surrounded with the an inner circle of support we will not be defeated by who we are are. It is can also be our biggest asset if channeled correctly.

  10. If there is lots of grammar mistakes and words left out etc it proves that even on medication our brain is a very busy place. We don’t have place for obnoxious people who do not know better.

  11. Thank you so much to each of you that has shared. I’m sitting here with tears flowing down my 53 year old face. I have hope my marriage can last, hope my lovely man can get some peace, hope our family can help others with this too. I’m thrilled more doctors are pushing their patients to get diagnosed even if they don’t want meds. Knowing what is happening to you is the first step in breaking free from its constraint’s and finding a new way to deal with it can save you and your family.

  12. Having been diagnosed privately and treated with Meds for ADHD as NHS will not support diagnoses and after going through a lot of info on Additude site does anyone know if you can get meds in the UK for ADHD and Rejection Sensitive Dysphoria (Privately) NHS has had me on various SSRI for depression for years but have now decided to come off them slowly. NHS now looking at Post Traumatic Stress Disorder and have been on waiting list to see psychologist for approx 9 months and also think I have ME but won’t even discuss or test for ADHD.

  13. Rejection Sensitive Dysphoria makes sense. After being diagnosed with ADHD @ age 63 I realized that I’ve spent much of my life preparing daily for failure and rejection. Perhaps best described as a continuum of trauma and fertile ground for Complex PTSD.

  14. > “50% of people who are assigned court-mandated anger-management treatment have previously unrecognized ADHD.”

    Is there a source for this? Google returned other blog posts and no research on the matter.

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