Living with Rejection Sensitivity Dysphoria

When your brain convinces you that everyone secretly dislikes you

Have you ever left work absolutely convinced that you’re the office pariah? That your coworkers are all friends with each other but merely tolerate you? That the small mistake you made in that meeting three hours ago is still being discussed in hushed, disapproving tones?

Welcome to my daily reality with Rejection Sensitivity Dysphoria (RSD).

What Is This Monster?

For those unfamiliar with RSD, it’s like having an overeager smoke detector in your brain that screams “DANGER!” at the faintest hint of social disapproval. It’s not being “thin-skinned” or “too sensitive” — it’s an intense neurological response commonly experienced by people with ADHD and autism.

The “dysphoria” part is crucial — this isn’t just feeling sad about rejection. It’s an overwhelming, all-consuming wave of emotional pain that feels completely disproportionate to the trigger. A slight frown during my presentation becomes evidence that I’ve failed catastrophically. A coworker being too busy for lunch becomes proof they’re avoiding me.

My Daily Dance with RSD

My commute home isn’t filled with music or podcasts like most people. Instead, it’s an involuntary highlight reel of every possible misstep from my day:

• Did my boss think my idea was stupid when she paused before responding?
• Was that colleague annoyed when I interrupted the meeting with my question?
• Did I talk too much at lunch? Too little? Too loudly? About the wrong things?
• Why didn’t anyone respond to my Slack message with an emoji like they did with everyone else’s?

By the time I pull into my driveway, I’ve convinced myself I’m on the verge of being fired, friendless, and fundamentally flawed.

The cruel irony? In my heart, I know these catastrophic interpretations are false. My rational brain can identify the cognitive distortions. My performance reviews are excellent. People regularly seek my input. I’ve been invited to birthday parties and happy hours.

But RSD doesn’t speak the language of logic. It speaks in emotional absolutes and worst-case scenarios.

The Self-Doubt Spiral

“Am I just making excuses for myself?”

This question haunts me constantly. When I try to explain RSD to others (or even to myself), that critical inner voice suggests I’m just manufacturing a fancy label for being emotionally immature. That voice says:

“Everyone feels rejection. You’re just weak.”
“You’re using ADHD as a crutch.”
“Real adults don’t obsess over what others think.”

This creates a meta-anxiety — anxiety about having anxiety — that compounds the original distress. I become convinced that my emotional reactions are character flaws rather than neurological differences.

The Social Disconnect

The most painful manifestation of my RSD is the absolute certainty that everyone in my workplace is friends with each other, except with me. I see colleagues laughing together in the break room and immediately assume:

1. They’re all much closer with each other than with me
2. They probably meet up regularly without inviting me
3. They find me awkward or annoying
4. They’re relieved when I’m not around

I fabricate entire friendship networks and social calendars from which I’m deliberately excluded, based on glimpsing two people sharing coffee. My brain constructs elaborate narratives about why I don’t belong, despite having zero evidence.

Would CBT Help? My Exploration

After months of this exhausting mental gymnastics, I finally asked my therapist if Cognitive Behavioral Therapy (CBT) might help with my RSD symptoms.

Her answer was nuanced: CBT can be helpful, but it needs to be adapted for neurodivergent brains.

Traditional CBT focuses on identifying irrational thoughts and replacing them with more realistic ones. For example, changing “My boss hates my work” to “My boss hasn’t given me any negative feedback, so my work is probably fine.”

This works well for neurotypical anxiety but can miss the mark with RSD because:

1. We often know our thoughts are irrational but feel powerless to stop the emotional cascade
2. The intensity of RSD emotions can override logical thinking in the moment
3. Standard CBT may not account for actual differences in how neurodivergent people are sometimes treated

What has helped me more is a modified approach that:

• Acknowledges the physiological reality of my emotional responses
• Focuses on self-compassion rather than just thought correction
• Includes concrete coping strategies for emotional regulation
• Recognizes the genuine social challenges that can come with neurodivergence

My Daily Management Strategies

Through therapy and painful trial-and-error, I’ve developed some approaches that help me manage my RSD:

1. The reality check system
I have a trusted colleague and friend who I can text with a simple “RSD check?” followed by my worry. They know this means I need an objective reality assessment, not reassurance. Their job is to tell me honestly if my concern has any basis.

2. The evidence journal
I keep a digital note of positive interactions, feedback, and inclusions. When RSD tells me I’m disliked, I force myself to read concrete examples that contradict this narrative.

3. The cognitive distance technique
When RSD hits, I mentally label it: “I’m having an RSD response right now.” This creates a tiny space between me and the emotion — I’m experiencing it, but it isn’t me.

4. The physical reset
RSD has physical symptoms for me — tight chest, racing heart. I use intense sensory experiences (cold shower, spicy food, loud music) to interrupt the physiological feedback loop.

5. The social script
I’ve actually told some colleagues about RSD. Not everyone, but my immediate team knows that sometimes my brain misinterprets social cues. This openness has been surprisingly liberating.

The Ongoing Journey

I wish I could end this post with “And now I’m cured!” But that wouldn’t be authentic. RSD is still my companion, showing up uninvited at the most inconvenient moments.

What has changed is my relationship with it. I no longer believe everything it tells me. I no longer see it as evidence of my failure as a person. I recognize it as part of my neurodivergent experience — not a character flaw, but a challenge to manage.

To others swimming in these same waters: You’re not alone. Your feelings are real and valid, even when they’re distorted. You’re not making excuses by acknowledging how your brain works. And most importantly, you’re not fundamentally flawed or unlovable.

The stories RSD tells us are compelling fiction, not documented fact. Our challenge is learning to be critical readers of those stories, questioning their premises and conclusions while showing compassion to ourselves in the process.

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Have you experienced RSD? What strategies help you manage it? I’d love to hear your experiences in the comments.

#RejectionSensitivityDysphoria #ADHD #NeurodivergentLife #MentalHealthJourney #SelfCompassion #WorkplaceAnxiety