Is Rejection Sensitive Dysphoria Real?

You may be asking yourself “what is Rejection Sensitive Dysphoria (RSD)?” Well, some individuals feel the sting of rejection much more intensely than others and have an exaggerated fear of being rejected by others around them. These people are high in a trait known as Rejection Sensitivity. Some people with Rejections Sensitivity may see cues such as a partner not answering their phone call or text message immediately as a sign of outright rejection. They may disregard more logical explanations. Such behavior may end up pushing others away creating a self-fulfilling prophecy. They may overcompensate and bend over backwards in a attempt to keep themselves in others’ good graces. Others may see those with RSD as overly perfectionistic, over-sensitive, or over-reactive to the mildest types of criticism.

Evidence suggests that sensitivity to rejections isn’t just “in their head.” Social rejection activates the same part of the brain as physical pain does. Brain imaging shows that people who have the trait of sensitivity and feel rejected may trigger physiological changes, including the fight-or-flight response, and can be physically painful. Studies also show that rejection-sensitive individuals who see disapproving facial expressions may show heightened activity in areas that influence blood-pressure, decision-making, and emotions.

The causes of rejection sensitivity are unknown, but some evidence shows that genetic factors and feeling rejected by a parent or primary caregiver as a child may play a role. Some clinicians and psychologists in the ADHD community have proposed that high levels of rejection sensitivity may be classified as RSD. Certain mental health conditions, including ADHD, are associated with high emotional reactivity and is theorized that RSD occurs with ADHD for that reason. Some adults with ADHD have severe RSD to the point that it interferes with daily life and the formation of healthy relationships. However, RSD has not been recognized by the DSM, and the concept has not been widely studied to give validated diagnostic guidelines, but it has gained attention in recent years in adults with ADHD.

Can Rejection Sensitivity Be Treated?
Certain strategies have been shown to be beneficial. Therapy, particularly cognitive behavioral therapy, may help people identify negative thoughts. Couples’ therapy can also help break out of negative cycles caused by a partner’s high rejection sensitivity. Treating co-occurring mental health conditions like ADHD and depression may provide relief as well. Simply recognizing an increased sensitivity to rejection can help people cope more effectively in some cases.

Possible Signs of RSD
Due to RSD not being in the DSM-5, there are no empirically quantifiable criteria, but according to psychologist Andrea Bonior, Ph.D., some of these characteristics can help spot an overly sensitive individual:

  • High sensitivity about possible rejection
  • Feeling easily triggered toward guilt or shame
  • Isolating themselves in a preemptive strike to withdraw from socializing with others in an attempt to avoid rejection
  • Aggressive or rageful behavior toward those who have been perceived to have slighted the person
  • Frequently feeling an uncomfortable physical reaction due to “not fitting in” or being misunderstood
  • Self-Esteem that is entirely dependent on what others think, and rises and falls accordingly
  • Frequent and intense ruminating after an interaction
  • Get easily embarrassed
  • Set high standards for themselves they often can’t meet
  • Have low self-esteem
  • Feel anxious in social settings
  • Have problems with relationships
  • Feel like a failure because they haven’t lived up to other people’s expectations

Some of the signs listed are also common in other mental health conditions and can be confused with:

  • Bipolar disorder
  • Borderline personality disorder
  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)
  • Depression
  • Social phobia

RSD episodes can be intense, but don’t typically last very long. Because RSD can look like other mental health disorders, it is essential that you get the right diagnosis. If you have any of these symptoms, please see a psychologist, counselor, or other mental health providers for help. We have licensed professionals here at Affiliated Family Counselors who are willing to meet with you to help any way they can. Visit our website at for more information on our providers or call us at 316-636-2888. 

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How To Cope With OCD During The COVID-19 Pandemic

Those with obsessive-compulsive disorder (OCD) experience constant or recurring thoughts that can cause anxiety and may try to cope with those thoughts through compulsions. Compulsions are repetitive behaviors or mental acts that a person feels that they must perform. With what is going on right now in the world with COVID-19, some aspects of the virus can trigger anxiety and OCD behaviors like frequent handwashing and constantly checking the news. Here are some ways to take precautions and other coping techniques for OCD tendencies during the pandemic.

Contamination is one of the most common fears among those with OCD. It can be difficult for someone to cope with under normal circumstances, but during the COVID-19 pandemic, it can become even more of a challenge.

The real possibility of illness for people with OCD can cause them to take extreme measures to keep themselves and their families safe, like repetitive handwashing, cleaning, or being afraid to even leave their homes.

Harming Others
The worry of possibly harming others, either by accident or on purpose, is a common fear of OCD. During the pandemic, people with OCD may worry that they will transmit the virus to another person, and may go to extremes to try avoid doing so.

Researchers consider hoarding as a separate disorder from OCD, but many people with OCD also struggle with hoarding. People who hoarder usually collect things that are not useful, however during a pandemic, they may hoard things like medications, alcohol-based hand sanitizers, and toilet paper.

OCD Triggers During A Pandemic
There are many aspects of the COVID-19 pandemic that may trigger OCD-related fears and behaviors like:

  • The advice to wash hands more often
  • The emphasis on proper handwashing techniques
  • The need to clean hands every time a person returns home
  • The advice to only leave the home for food and necessities

Those triggers can contribute to behaviors like:

  • Widespread panic-shopping that can trigger hoarding (which we have seen with the toilet paper and cleaning supplies shortage)
  • Frequent reminding family members to wash their hands
  • Searching for information on how long the virus stays active on certain surfaces
  • Normalizing frequent washing and/or bathing

Sensible Precautions to Take
Most people with anxiety feel pressure to follow rules to the T, and as a result of this, someone with OCD may find it difficult to tell the difference between sensible precautions against COVID-19 and excessive or perfectionistic behavior. Many therapists suggest that those with OCD have a safety plan in place for themselves based on official public health guidelines. By following that plan, people with OCD will know if they are taking reasonable steps.

Therapists also encourage people to think about their cleaning and hygiene habits. If they did not go outside and no one came into their home, then they do not need to disinfect anything. However, disinfecting commonly used surfaces once a day is a reasonable plan.

When washing your hands try limiting your handwashing to 20 seconds each time and only wash them:

  • After going outside
  • Before eating
  • After going to the bathroom
  • After coughing, sneezing, or blowing your nose

If you have OCD and find yourself adding extra steps to your plan and find it difficult to stop, you may consider seeking support.

Limit News and Social Media
Many news outlets offer free live streaming during the COVID-19 pandemic and publish news updated frequently. The American Psychological Association (APA) advise that people that notice they are checking the news more than usual set a limit on how many time a day you check the news updates or watch the live streams.

Seek Online Support and Teletherapy
To limit the virus from spreading, many therapists have stopped offering in-person sessions and allow access for people to have teletherapy online or over the phone. Online support groups, such as the International OCD Foundation’s My OCD Community, may also help others cope with OCD during a pandemic.

When To Seek Help
Pandemics do not have biological or medical implications. They also impact many people psychologically and socially, including people with mental health conditions. During a pandemic, those with preexisting mental health conditions are at higher risk of experiencing a relapse, stopping their medication, not engaging in self-care, or having suicidal thoughts. If you or a person you know with OCD is struggling with their symptoms during this pandemic encourage them to call us or:

  • Their doctor or therapist
  • A mental health helpline (Suicide Prevention Lifeline has talk and text options)
  • Their local public health center

Suicide Prevention
If you or someone you know is at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question “Are you considering suicide?”
  • Listen to the person without judgement
  • Call 911 or your local emergency number, or you can text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives
  • Try to remove any weapons, medications, or any other potentially harmful objects.

If you or someone you know is having thoughts of suicide, The National Suicide Prevention Lifeline is available 24 hours per day at 1-800-273-8255, people who are hard of hearing can call 1-800-799-4889.

Here is another helpful suicide prevention link:


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