Be Honest… Do You Like This Article? An ADHD & RSD Unveiling

Seven minutes to midnight. 20+ browser tabs open. Decaf iced tea to my left, water to my right, and a chronic case of leg-shaking at the center of it all.

I have my garish ceiling light on because it offers extra stimuli, while the warm light from my desk lamp would only make me too drowsy to work.

My extensive internet history is a reminder that I’ve gotten next to nothing done since I first opened up this stupid ass document seven hours ago. 

This is a pretty typical night for me.

I could pin it on any number of excuses—a lackadaisical attitude, a shortage of creativity. Maybe I could keep it simple and just say that I’m a talentless hack.

I could, but I won’t.

I won’t because I don’t need an excuse—I need an explanation.

And I have an explanation: I have ADHD.

ADHD is one of the most well-researched mental disorders while simultaneously also being one of the most misunderstood.

We’re often fed unrealistic depictions of ADHD by the media, and even the more accurate portrayals only highlight the commonly recognizable presentations. See, ADHD exists on a spectrum with three broad types used to make more accurate diagnoses.

The type you’re probably most familiar with is known as hyperactive-impulsive ADHD. This is the type that’s most recognizable, especially in children. It’s characterized by things like constant movement and fidgeting, non-stop talking, and the tendency to interrupt others.

Because it exists on a spectrum, many children and adults with the other two types of ADHD go undiagnosed. They’re left wondering why they struggle to keep up with their peers, why they can never seem to master time management, and why they forget seemingly obvious things.

And, due to the outdated disorder name, there are even people with ADHD diagnoses who don’t fully understand all the complexities of the condition. I’ve done three years of independent study on ADHD, and I still learned a ton of new information while researching for this article alone.

I think you get my point. People only see the very tip of the ADHD iceberg—but there’s so much more lurking below.

So, grab your gear, ‘cause we’re going for a polar plunge.

Rejection Sensitive Dysphoria

If you dip below the surface, you’ll come across one of possibly the most debilitating ADHD symptoms: emotional dysregulation. If you dive a little bit deeper still, you’ll discover something known as rejection sensitive dysphoria (RSD).

RSD is one manifestation of emotional dysregulation. Put simply, people with RSD feel intense emotional pain when they experience either real or perceived rejection, criticism, or teasing.

You might be thinking, “Okay, but doesn’t everyone get a little upset when they face rejection?”

You’re right. Everyone has to deal with the negative feelings that accompany rejection or criticism. But for those with RSD, those feelings are magnified. Many people in the ADHD community compare it to having sunburn—even a playful tap on the shoulder can cause excruciating pain.

To make matters worse, ADHD brains have trouble differentiating between major and minor problems. This is why they may feel fearless in the face of high-risk situations but paralyzed and ashamed over a missed call.

Dr. William Dodson is a psychiatrist well-known among ADHD professionals for his work concerning RSD. In an article written for the magazine Attention, Dodson argues that RSD was intentionally ignored by researchers for years.

Why? Well, it’s tricky to measure the effects of rejection or criticism. It becomes doubly difficult when you realize that many people with RSD have learned to hide volatile feelings when they arise.

Dodson also claims that around one-third of adolescents and adults list RSD as the most impairing feature of their ADHD. These individuals struggle to apply for jobs, pursue education, go on dates, and even make friends.

And who can blame them? People with RSD are constantly wondering if people hate them, if they’re being scrutinized by their peers, if they said too much, if they said too little. 

They avoid trying new things because they’re afraid they’ll just screw up. They don’t join in on social situations because they’re scared they’ll embarrass themselves. They distance themselves from loved ones because they feel as though they’re simply failing at being a person.

For example, to your right you’ll see a stupid photo I sent to my friend in an attempt to be funny back in 2019 as I walked home from my restaurant job in the middle of a Minnesotan winter, eating poutine while crying ‘cause I was convinced all my coworkers hated me. It’s okay, you can laugh—I snort just about every time I see this photo.

Compound Irritation

It’s worth noting that this is all compounded by the fact that people with ADHD are far more used to getting criticism than their neurotypical peers. They’re accustomed to being called lazy, loud, unprofessional, spacey, etc.

They often feel as though they have to work twice as hard to compensate for all their failures. They become perfectionists and people-pleasers. They’ll take on too much work in order to prove they’re of value. They’ll lose sight of their own ambitions in an attempt to keep those around them happy.

Fortunately, the emotional aspect of ADHD is slowly becoming more recognized by both medical professionals and the ADHD community at large. While treatment of RSD is still in its infancy, challenging, and not always achievable, many of those suffering from it take comfort in simply knowing that what they’re feeling has a name—that they’re not alone in their struggle.

I know I do.

The moment I first learned about RSD, I was floored. You mean that’s why I felt like a pathetic, talentless loser for years upon years?

ADHD in general had already explained some of my behaviors, like dropping out of college twice or moving to a new state with only four suitcases in tow.

But RSD explained why I was absolutely wrecked when my best friend of 17 years began to slowly distance herself from me, or why I felt vaguely ashamed whenever I had to tell someone I was working as a server while I “took a break” from my university studies.

I still grieve over these things, but I’ve gotten so much better at managing my emotions. 

I’ve started working on accepting compliments as the praise they really are, rather than simply an absence of criticism. I’ve cultivated the most amazing friendships with people who I know love me unconditionally. I’ve picked up some old hobbies and am doing them because I enjoy them, not because I need to be perfect at them. 

I still have a long way to go, but I’m getting there.