By Caroline Maguire, M.Ed., PCC
Sometimes, as an adult with ADHD, things can feel quite intense. When we try to make friends and build relationships, it’s not so simple for us to just “reach out.” We tend to negatively perceive even the slightest change in tone or response to text or comment, which in turn triggers Rejection Sensitivity.
Rejection Sensitivity (RS) is Not the Same as Rejection Sensitivity Dysphoria (RSD)
Rejection Sensitivity Dysphoria (RSD)
Rejection Sensitivity Dysphoria (RSD) is a term coined by Dr. William Dodson, who notes that it is exclusive only to people with ADHD. He recommends treating RSD with medication. While the definition is not in the DSM manual, nor is there much research on it yet, I do believe it is a real and valid condition.
- Rejection Sensitivity (RS)
“The tendency to anxiously expect, readily perceive, and intensely react to rejection.”
Rejection Sensitivity (RS) is a huge issue for many people with ADHD and is validated by research and mentioned in many ADHD journals. RS is not only specific to ADHD, but can be found in other psychiatric conditions as well. With ADHD, we have difficulty regulating emotions in general. Most of us have a long history of actual rejection. It is common for people with ADHD to feel emotions more intensely, to have less friends, fewer invites, and greater rejection by peers. Feeling emotions intensely is actually painful and makes reaching out and having relationships harder.
Even perceived or expected rejection may cause the person with ADHD to get angry, cry, or even say things that eventually lead to the rejection. The actual cause or intensity of the situation is often not proportional to the reaction. Even if we sense rejection, our bodies may go into Fight, Flight or Freeze mode. Our bodies and brains have an ancient alert system that literally believes and reacts as if a Saber Tooth Tiger is coming to eat us! We end up in a terrifying cascade of emotions and reactions that feel terrible. To avoid these sensations, we end up people-pleasing, not inviting others or not asking for what we need or is in our best interest.
The 4 R’s
Rather than missing out, I created a tool called the 4 R’s – to gauge the intensity of our emotions. These steps can help you calm your body and mind and figure out how intense your emotions feel.
Identify where you are emotionally. The first step is to check in with your emotions. Is your face flushed? Are you fighting back tears? Is your stomach or fist clenched? The higher emotions go up, the more cognitive ability goes down. When emotions are in the red – or very high – it is not the time to act out, bring up heated topics or ask for things that may not be granted.
Once you recognize where you are on the intensity meter, respond with an appropriate strategy.
Green – This is a time to implement daily preventative strategies to help you cope with stress and triggers. In the green, you can increase positive emotions and engage in strategies to help increase your dopamine production, such as walking in bare feet (a grounding activity), sewing, doing crafts, and engaging in guided meditation.
Yellow – In this emotionally heightened state, you may still have control over your emotions, but too much conflict is not advised. In this state, it helps to have portable strategies at the ready in order to calm your limbic system and help avoid moving into Fight, Flight or Freeze. Try to get yourself back into the green by walking the dog or drawing in an adult coloring book. An engaging mindfulness activity, such as unclenching your jaw or noting and relaxing your tongue as if it were liquid resting like a pool, can be helpful. Also, breathing in and out or engaging in a technique called Havening will help self-sooth and calm your limbic system. Watch this to learn more about Havening.
Red – In this state, you may be entering Flight, Fight or Freeze mode. The strategies to use now are the ones you have honed well in advance. Strategies can be active to help you with the physical changes that take place due to Fight, Flight and Freeze such as increased blood pressure and a rapid heart rate or even struggles to breath. These can include cuddling a pet, jogging, meditating and doing jumping jacks to expel energy and increase serotonin and dopamine levels.
This part is super important for 2 reasons. First, our initial interpretation of a situation is often incorrect due to heighted emotions or personalization. Second, if we perceive rejection, even if it isn’t true, we will be more likely to react and anticipate rejection in the future. Double check your reasoning by asking yourself questions, such as: “What story am I telling myself?” “What evidence is there that this story is true?” “What else could it be?”
Instead of falling into the “rabbit hole,” try to adopt healthy strategies such as considering other possible reasons for their response. Perhaps they didn’t accept the invitation because they were busy, or already saw that movie. Often, what we perceive as rejection is just a conflict of needs.
What if People Really Don’t Want to Play with You?
If RS is a big issue for you, consider working with a therapist. Evaluating past situations can help you move forward in a more confident manner. In addition, CBT and DBT workbooks can help you work through these issues on your own.
And what if people really don’t want to play with you? If this is the case, work on your social skills to help reduce the risk of being rejected in the future.
Caroline Maguire, PCC, M.ed., is a mom, wife, daughter, writer, lifelong learner & SEL advocate dedicated to helping people become their best self: socially engaged, confident, and open to the unlimited world of learning and connection. Caroline is also the author of Why Will No One Play With Me?
Adults with ADHD Social Skills Training: How to Get Along with Everyone begins March 21, 2022.
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