Rejection Sensitive Dysphoria (RSD) is a common phenomenon among individuals with ADHD. An extreme and exaggerated response to criticism, rejection, and failure in personal, professional, and romantic aspects of life characterises it. This can also lead to emotional dysregulation and easily changeable moods, which can be frustrating for both the person experiencing RSD and the people around them. Clinicians and individuals with suspected ADHD must understand and identify RSD to differentiate it from mood disorders and personality disorders.
The limbic system (the part of the brain involved in our behavioural and emotional responses) is usually smaller in volume in people with ADHD and as a result can impact person response to emotional situations. Due to the possible less regulated processing, reactions will lead to impulsive and less calculated responses to any conflict and confrontation, which will put the person with ADHD and neurodiversity in a vulnerable position. This makes it very difficult to regulate reactions, leading them to present with emotional impatience and impulsivity. Individuals with ADHD often try to avoid situations or interactions that may result in conflict which can be more frustrating for them. One of the ways they do this is by compensating for their deficits by constantly trying to please others and seeking their approvalin order to avoid any conflict.
In mood disorder, the limbic disorder is over-activated and, as a result, fails to regulate the
response. Unlike people with ADHD in mood disorder, people develop emotional dysregulation in response to trauma over time instead, and their mood disorder is less reactive to external stressors.
RSD can be one of the very early manifestations of ADHD, which can present in children with oppositional defiant disorder and conduct disorder and later with task and challenge avoidance due to fear of failure, being judged and criticised. This can also impact people’s self-image.
Since early childhood, we all develop perceptions about who we are, including awareness of our strengths and disadvantages. However, our perception does not necessarily fit precisely with our actual and real perspective or what we portrait as our image to others or what others perceive from our true strengths and advantages.
When there is a noticeable difference between how we see ourselves and our actual character and personality traits, it can distort our self-image and perception to the point that person that we know as ourselves is not exactly who we are. This can result in what is known as ‘imposter syndrome’, which is often experienced by individuals with neurodiversity or ADHD. Consequently, people may miss out on opportunities that could have helped them achieve their personal, professional, and social goals as they are not fully aware about their positive and perhaps negative personal qualities.
The issues of the self-image in neurodiversity and personality disorders is more longstanding and pervasive, whereas, in affective disorders, like depressive or manic episodes, feeling worthless or believing that one has incredible power or talent, are more temporary, and can improve when symptoms subside with treatment over time.
Humility is one of the great qualities of any human being. Being modest when one is aware of their advantages and achievements, generally, help people to connect better, but when there is a lack of awareness of one’s great achievements, which can be misunderstood as modesty, people may present as humble but they suffer from disbelief in their own ability which can also present as imposter syndrome, which can impact important choices and decisions in life and be one the reasons for people avoidingchallenges and opportunities in personal, professional, and even romantic situations.
Over-estimation of one’s success and achievements in life can lead to overconfidence. When someone has pervasive tendency to see themselves much more important than who they really are, this can present and can be perceived as narcissistic which also can impact their life, and their relationships with people around them, in a very negative way.
In summary lack of awareness of our own characteristics can cause significant and ongoing struggles in every aspect of life. With true awareness that people will get from assessment and diagnosis of their ADHD characteristics they often feel validated and by embracing ADHD strengths, like being caring, creative and being resilient and optimising characteristics reaching their peace with themselves and achieving their goals which can be a turning point in improving their ongoing issues in their life as well as their metal wellbeing. Overtime they will be to develop further emotional regulation, distress toleranceand with additional ability to be focused and content they manage to have easier and happier life.
