Dear Dr. Sharon: Is Rejection Sensitivity All In My Head?

Rejection sensitivity can feel overwhelming, especially for people with ADHD who experience emotions more intensely than others. When even small slights feel like major setbacks, it can be tough to know how to cope—or how to support a loved one who struggles.

Dear Dr. Sharon,

I’ve recently learned about rejection sensitive dysphoria (RSD) online, and the descriptions feel uncomfortably familiar. I’ve always taken criticism really hard—sometimes replaying a comment for days—and as a parent, I notice my 12-year-old (who has ADHD) reacting the same way. Even small corrections can spiral into tears, anger, or shutting down. I feel overwhelmed trying to support my child while also managing my own sensitivities. Is RSD real? And if so, how can I  cope with it in ways that will model a better response for my child?

-Pamela, Philadelphia

Dear Pamela,

You are not alone. What you’re describing is something I hear from many families, and yes—RSD is very real. While not an official diagnosis, rejection sensitive dysphoria describes the heightened emotional pain that kids and adults with ADHD often feel in response to criticism, perceived rejection, or failure. Research suggests that up to 70% of people with ADHD experience intense emotional dysregulation that looks a lot like RSD. Even though it isn’t listed in the DSM, it’s an everyday reality for countless adults and families.

Why does this happen? ADHD brains process emotions differently. They often “turn up the volume” on feelings, making even small rejections feel crushing. This is layered on top of the fact that children with ADHD are three times more likely than their peers to be bullied or socially excluded. Add to that the common pressure to “fit in” or “people please,” and you can see why rejection cuts so deeply in visible and invisible ways. 

Pamela - I know and believe that you and your child can build tools to manage rejection sensitivity and reduce its power over daily life. We just have to put a few more tools in your toolbox.  Take a look at some work I’ve done in the past related to your question, and read on for my response and recommendations.

1. Combat Rejection by Reinforcing Strengths

RSD thrives on self-doubt. When kids (and adults) feel capable and confident, rejection doesn’t sting as sharply. Make it a habit to notice what your child does well—whether it’s their creativity, persistence, sense of humor, or kindness. Research shows that strength-based parenting is linked to higher resilience and life satisfaction in children. Highlighting strengths helps shift the inner dialogue from “I always mess up” to “I have gifts and I can grow.”

2. QTIP: Quit Taking It Personally

One of my favorite tools is QTIP: Quit Taking It Personally. Many people with ADHD assume that a teacher’s correction or a friend’s bad mood means they did something wrong. Teach your child (and remind yourself!) to pause before reacting. Encourage phrases like:

“That’s an interesting comment. Let me think about it.”

“I wonder if this is more about them than about me.”

This small pause can create perspective—and reduce the emotional intensity of the moment. Then, they can better assess what's being said. Remind them that other people can say thoughtless or hurtful things sometimes that are more about them than you. The rejection they perceive may not be purposeful.

3. Develop Affirmations

Affirmations may sound cheesy, but they really help retrain the brain’s inner critic. Sit down with your child or teen and brainstorm some things to say to the negative voice in your heads. Post them on the fridge, bathroom mirror, or by the bed. Research shows that daily affirmations can reduce stress and improve performance under pressure. Consider making time in the morning or before bed when you both say your own affirmations together. Collaborate with your child and come up with affirmations you both like, such as:

“I can make mistakes and still be a good person.”

"My mind is uniquely wired and creative."

"I can take risks and see what happens."

“I am stronger than I think.”

4. Validate All Emotions

It’s tempting to rush in and “fix” your child’s hurt. But the most healing thing you can do is validate their feelings. Try saying, “I can see that really hurt,” or “That sounded disappointing.” Validation communicates that their emotions are real and worthy—even if they feel overwhelming. Remember, kids who feel emotionally validated develop better self-regulation and resilience.

5. Recover with My STAR Method

For some people, rejection triggers intense anger. That’s normal—RSD pain is sharp and immediate. Having a plan helps. Keep my “STAR Method” in your toolbox for those moments when your emotions feel especially intense:

Impulsive emotional reactions can often be the result of not pausing before responding. But taking that pause is oh-so-hard when emotions run hot. Use my STAR-“STOP, THINK, ACT, RECOVER” method when somebody (including yourself) is getting triggered. First, discuss in advance the physical signs of upset–tightness in chest, a headache, loud voices, tears. Then decide what your plan will be when they show up and how you will take that PAUSE. Using the STAR method can be a game-changer for you and your family.

Being proactive doesn’t mean you’ll prevent every outburst, but it gives your child (and you) a roadmap to recover more quickly.

Model Emotional Regulation

Thanks to the mirror neurons in our brains, your calm nervous system helps stabilize hers. When you lose your cool, focus on repair and accountability. Showing your daughter how to rebound without shame is a very powerful lesson. You might say:

“I got frustrated and I wish I had handled that differently. I’m sorry.”

This demonstrates self-awareness (metacognition) and self-control–two key executive functioning skills. You are showing her that emotional regulation includes being honest, owning your behavior and giving a genuine apology.

6. Build Safe Connections

Family connection is one of the best antidotes to rejection. Shared activities—game night, baking, walks—help kids feel loved and accepted. Invite friends into these experiences occasionally so your child can practice social skills in a low-pressure setting. For older teens and adults, seek out communities (online or in-person) where neurodivergence is normalized and celebrated.

Final Thoughts

Pamela, rejection sensitivity isn’t “just in your head.” It’s a real, lived experience for many with ADHD—and it can feel overwhelming. But with the right tools, validation, and support, you and your child can learn to navigate these moments with more confidence and compassion.

If you’d like more strategies, check out this episode of  “Mother Plus” podcast where I share more about the challenges women and mothers face as they navigate living with ADHD and RSD.  Remember, every step you take to understand RSD in yourself AND your child is also a step toward healing and becoming more confident.

Warmly,

Dr. Sharon