It’s a truth universally acknowledged that no one likes being rejected. Whether it’s related to work, friendship or love, any kind of rejection can be hurtful, so it’s hardly surprising when we take steps to try to minimise our chances of getting rejected.

But for people who deal with rejection sensitivity, being rejected is a lot more than a bad experience. Sometimes referred to as rejection sensitivity dysphoria or RSD (usually in cases where it’s particularly severe), rejection sensitivity isn’t just about taking rejection or criticism ‘hard’. 

In fact, it can lead those affected to experience an intensely emotional, painful, visceral response to rejection – even when that rejection is simply perceived to be true. And while rejection sensitivity is primarily concerned with the reaction a person has towards perceived or actual rejection, it can also bring about a number of symptoms.  

If you’ve heard about rejection sensitivity before, you might know that it’s common among people with ADHD – but it’s not exclusive to those with the disorder.

So, to find out more about rejection sensitivity – including what the common symptoms are and how to deal with it – we asked Dee Johnson, a psychotherapist and senior addiction therapist at Priory, to share her expertise. Here’s what she had to say.  

According to Johnson, the main signs and symptoms of rejection sensitivity include:

• Responding to rejection with an outburst of “upset and anger” which is “quick”, “aggressive” and “disproportionate”
• Getting embarrassed/ashamed really easily from this disproportionate response
• Having low self-worth and struggling with self-respect
• General anxiety
• Social anxiety that causes you to avoid social settings and isolate yourself from others
• Putting high expectations on the self, living in fear of failure and letting people down (people with RSD will also feel like they’re being criticised a lot of the time and become instantly defensive as a result)
• Ruminating over insecurities
• Having thoughts about hurting yourself through self-harm or substance abuse, and feeling unable to share that pain with others for fear of being rejected or judged negatively
• Experiencing rejection as physical pain

Because many of these signs are typical of someone struggling with emotional dysregulation – and RSD tends to be quite episodic – rejection sensitivity can often be confused with bipolar disorder, PTSD or emotionally unstable personality disorder (EUPD), Johnson explains. 

“It’s important to note that with RSD the emotional outbursts (albeit very intense) are short-lived events and are more likely to be triggered by a clear emotional response rather than just coming out of nowhere, as is the case for other conditions,” she says.

“For example, someone with RSD might experience a reaction when a partner or friend announces they are not able to go out to dinner with them, as opposed to becoming upset without any indication that this may even happen.” 

While the emotional dysregulation associated with ADHD means rejection sensitivity is particularly common among those with the condition, people who don’t have ADHD can also experience it.

“We are complex beings, so rejection sensitivity can also present as a result of childhood neglect and other types of abuse, especially psychological,” Johnson explains. 

“For example, someone might develop rejection sensitivity as a result of always being criticised and put down as a child, because this can lead to the formation of distorted belief symptoms such as feelings of worthlessness.”

Johnson continues: “Living in long-term uncertainty and anxiety might also be a trigger.” 

If you think you might have rejection sensitivity, or simply want to reduce the amount of fear rejection instils in you, there are things you can do to alleviate some of the pressure you feel.

To start with, Johnson recommends making sure you’re living a healthy lifestyle and engaging in self-care (not taking care of yourself can contribute to feelings of low self-worth), as well as scheduling in activities that relax and ground you, including socialising (even though it may scare you).

Getting to know your emotions is also important, Johnson explains. “Keep a diary or journal as often as you can and become aware of your emotions (all of them, whether happy, bad or sad). Note how your body responds. This will help you to learn to tune into yourself.” 

Part of coping with rejection sensitivity disorder is also dealing with the negative self-talk you might be feeding yourself. The first step towards doing this, Johnson explains, is being aware of the way you’re speaking to yourself – talking therapy can be good for this – and then trying to notice when you get trapped in unhelpful thought patterns.

“I often recommend my clients to get a ‘negative self-talk jar’ (a bit like swear-word jars) and put money in it every time they do it,” Johnson says. “You can also ask trusted friends and family around you to join in – negative self-talk is often so embedded in your psyche that you will not always be aware when you’re doing it.” 

If you’re struggling, Johnson adds, it’s important to get help – no matter how ‘silly’ or ‘unimportant’ you may think your issues are. “You do not have to struggle with emotional issues, whatever they are,” she says. “These kinds of issues are life-affecting, both mentally and physically, and finding the right diagnosis and support is vital.”

If you’re struggling with rejection sensitivity, or feel you may have undiagnosed or untreated ADHD, make sure to discuss your concerns with your GP, who may refer you to a specialist.

If you, or someone you know, is struggling with their mental health, you can find support and resources on the mental health charity Mind’s website and NHS Every Mind Matters or access the NHS’s list of mental health helplines and services.

If you are struggling with your mental health, you can also ask your GP for a referral to NHS Talking Therapies, or you can self-refer.

For confidential support, you can also call the Samaritans in the UK on 116 123 or email jo@samaritans.org. In a crisis, call 999.

Images: Getty