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  • Kristen Stuppy, MD

Watch Out for Rejection Sensitivity

Updated: Apr 3, 2021

People with ADHD tend to have something unofficially called rejection sensitivity or rejection sensitive dysphoria. Watch out for this!  


Rejection Sensitivity is not an official diagnosis, but rather a collection of commonly seen feelings and reactions.


What is rejection sensitivity?


It’s the tendency to perceive a situation negatively, when in reality it is not meant to be negative at all. It can lead to significant anxiety or low self esteem.


For example


An example of this may be that you attempt to text a friend multiple times. There may be many reasons they don’t reply, but you automatically assume they’re mad at you or don’t value your friendship. Even after hearing that their phone died or they didn’t have it with them, you still may feel that their delayed response was somehow due to them not wanting to answer your text.

Stress response


When you have ADHD, your nervous system overreacts to things from the outside world. Any sense of rejection can set off your stress response. This leads to an emotional reaction that is out of proportion to the situation. Sometimes whatever really occured was not a negative thing at all, but your reaction to it is negative.

Symptoms of rejection sensitivity. Learn to recognize them so you can work on it.

Why does this happen?


It’s estimated that the typical 12 year old with ADHD has received 20,000 more negative messages than other kids their age.


  • They are constantly reminded that they’re not on task.

  • Chores are often forgotten.

  • Homework is lost.

  • They may interrupt others and speak without a filter.

Sitting quietly without constant movement is expected in certain situations, but very difficult for many kids with ADHD.


Each of these situations is due to all of the executive functioning shortcomings, not intentionally bad behavior. But the scoldings and reminders make kids feel like they were bad. All that criticism can take a real toll on their self-esteem.


Over time people who are chronically made to feel like they didn’t meet expectations grow more sensitive to all situations. They might attempt to be perfect in what they do to cover up real or perceived shortcomings. Since it’s impossible to always be perfect, they fail, which serves to further lower their self esteem.


What does low self esteem look like?


When people experience repeated failures to do things as expected, they may lose the drive to try. They often give up. This can look like laziness, which can lead to more shame.

Only when people who are affected in this way are guaranteed success will they even try. There aren’t many situations in life that we’re guaranteed anything, so this can be a big problem.


Many people are afraid to ask for help when needed, so they simply don’t do perceived difficult tasks. Some children fail to do homework because they’re ashamed to ask for help when they don’t understand it. Parents may mistake this for willfully not doing homework or being lazy, which isn’t the case. Often kids wish to do the work, but they’re overwhelmed and too embarrassed to get help.


Some people try to overcompensate and show more confidence than they have. They might state that they are really good at something when they don’t really believe it. The overconfidence can backfire when it hurts someone else’s feelings or when they fail to live up to the set expectation. People can simply view their statements as bragging. No one wants to be around someone who thinks they’re better than others. The irony is that in this situation, the person really doesn’t think that. They have a low self esteem and are overcompensating or simply trying to hide their fears about themselves.


How does this affect relationships?


It’s not surprising that rejection sensitivity leads to a lot of problems within relationships.


Blaming


Many people with very low self esteem attempt to blame others for all of their problems.

They are unable to accept responsibility for their shortcomings. This prevents them from learning from their mistakes.


It of course also affects how the other person feels – which isn’t good.


No one wants to stay around someone who makes them feel bad, so it can strain relationships.


Drive people away


With the texting example above, if you accuse your friend of not valuing your friendship, they will be annoyed. Maybe not at first. With the first occurrence, they might simply blow it off and say you’re being silly. But if you consistently treat them like they need to be at your beck and call because you get angry or jealous when they’re not, they’re likely to get tired of it. They’d have every reason to ask for space and intentionally stop making plans to do things with you.


Jealousy


Dating relationships can be even more affected, since it’s a one on one situation. Many people with rejection sensitivity easily get jealous. If their boyfriend/girlfriend talks to someone, they might misinterpret the situation and jump to the conclusion that they’re cheating with – or at least have a crush on – the other person. Relationships should be based on trust, but when there’s jealousy, all trust is lost.


When a person gets jealous easily, they often become very controlling. This can lead to emotional abuse of the partner. It brings forth negative emotions in both people in the relationship. It isn’t healthy to stay in relationships like this. Even if you really care for one another, it is important that everyone in a relationship is safe and respected.


Failed relationships


It is not uncommon for people with ADHD to have more failed relationships (including marriages) than people without ADHD. This is not exclusively due to rejection sensitivity, but rejection sensitivity certainly plays a part. Recognizing this trait and working to improve self esteem and decrease the rejection sensitivity can help with maintaining strong relationships.


What can be done to treat rejection sensitivity?


Recognize it


The first step in treating this is recognizing what is going on when your extreme negative emotions are driving your thoughts and actions. If people tell you you’re being too sensitive, reflect on it with an open mind. Don’t just get angry, blame others, or avoid the issue.


Treat your ADHD


Treating the underlying ADHD can help some of the issues with rejection sensitivity, but not all of the symptoms.


Impulsive behaviors can exacerbate the emotional response to a perceived negative situation. Controlling the impulsivity appropriately can help with the response directly, as well as to help preserve your self esteem by allowing you to think before acting and speaking.

Improving your focus can help you be successful in completing tasks without rushing through them. Again, this helps to preserve your self esteem because you achieve success.

If you don’t think your ADHD symptoms are properly managed, talk to your parents and your doctor.


Talk to others


It’s important to not hide or cover up your negative thoughts and concerns. Doctors, therapists, and loved ones can help if they can be told what is going on in a way that helps them understand. Too many people are afraid to talk about why they stop trying, are negative or jealous, and about their overall low self esteem. Many might not even realize what is going on and why they feel like they do, but if the above list of symptoms reminds you of yourself, talk to someone you trust about it.


If the person you tell is not familiar with rejection sensitivity, they might not understand what you’re trying to tell them. Please don’t let that knock down your self esteem even more because they don’t understand. Show them this post and and other information about rejection sensitivity. Help them learn rather than accepting their ignorance and going further down in your own self esteem. Talk to your doctor, a school counselor, or a therapist. If they don’t know about the condition, show them the resources you have too.

Accept yourself for who you are


Learning to accept yourself for who you are – faults and all- can be difficult for anyone, but it’s possible.

Focusing on the positives can help.


Take the time each day to think about and write down what you’re grateful for from that day.

Also write down the things you did that day that made you proud or accomplished. Don’t focus on the tasks that you haven’t finished – think about all the parts you have done.

Celebrate all you do, even the little things! It can help build self esteem.

Humor can be a good healer


Learn to use humor when situations get tough. It’s okay to laugh at situations to help avoid negative thinking.


Don’t forget to learn from the situation, but keeping the mood light helps to not have negative self talk.


Medications and other treatment


Rejection sensitivity treatment can benefit from managing your ADHD better with medication and/or therapy.

Talk to your physician about your symptoms and begin or adjust your ADHD medications as needed.


Work with a therapist to find ways to identify and name your feelings then to change your response.



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