It’s a common issue: you’re helping your child with your homework and any suggestions or corrections by you are met with yelling or tears or complete shutdown. Or, you’re trying to talk to them about a problem at school, helping them see their role in a conflict, or trying to debrief a social situation, but your child’s reaction to you is over-the-top and shuts down any conversation.
Some might dismiss these interactions as the storm of puberty. Others might suggest their child needs stricter discipline or to “toughen up”. However, if your child has ADHD, there’s a reasonable chance that what you and they are experiencing is actually rejection sensitive dysphoria (RSD). RSD, while not yet recognized as its own medical condition, is increasingly identified as a type of emotional dysregulation,
most commonly found among people with ADHD, that makes any non-positive interactions (even neutral or vague ones) feel extremely negative—even painful.
Rejection sensitive dysphoria is more than just being sensitive to criticism; it can lead to anxiety about anticipated failures, feelings of social rejection, perseveration, depression, or even self-harm. In extreme cases, it can lead to fear of taking any risks and ultimately, social isolation—in short, a shrinking of a life.
RSD isn’t present all the time. It is a reaction to triggers such as a real or perceived rejection or failure, teasing, criticism, or negative self-talk.
What can you do?
Talking to your child’s doctor and/or therapist about strategies and treatments is a good first step. Many ADHD medications positively impact symptoms of RSD as well. Beyond that, consider some of the following strategies:
- Help your child recognize what is happening so they can try to put the negative thoughts into perspective: “This is RSD/anxiety talking, and we know it lies to you.”
- Set small, achievable goals so that your child can see many successes for every failure. For example, if you are going rock climbing, the goal can be getting one rock higher than last time instead of going all the way up to the top of the wall.
- Get them to practice new skills incrementally and in private before they risk demonstrating the skill in a less supportive environment. For example, if your child has to give a speech, ask if it can be delivered initially only to the teacher. If that goes well, then give your child the opportunity to deliver it to the whole class.
- Propose an alternative narrative if the RSD is in response to a perceived rejection. For example, if someone doesn’t text back, and your child is using that as irrefutable evidence that the friend doesn’t like them, try to brainstorm a few other possible explanations. Maybe their phone battery died, or they are visiting with their grandma, or they’re taking a nap.
- Pay attention to your reactions to your child’s emotional outbursts. Make sure not to shame them for their tears or anger. Reassure them that it’s okay to express their emotions and give them time to collect themselves before trying again. As a parent, this is very hard. Be kind to yourself if you don’t get it right each time but try again to approach your child’s emotions in a supportive, loving way the next time they erupt.
- Consider working with your child to come up with a signal so that they can tell you if your reaction is unhelpful or if they need time to compose themselves.
Identifying and naming the problem can reassure you and your child that this is both real and manageable. By recognizing the signs, implementing strategies, and fostering open communication, you empower your child to overcome the challenges and build resilience, ensuring a path towards emotional well-being and helping them rewrite the narrative of their experiences.