How RSD Shaped My Life
how the thing I thought I didn't have turns out to be the thing that affected me the most
My brother was diagnosed with ADHD two years before I was. His symptoms - which were often crippling - turned out to be the result of Rejection Sensitive Dysphoria (RSD). My brother and I have different personalities - as siblings often do - and he is more introverted than I am. When I read about RSD, I said to myself, “thank god I don’t have that!”.
Of COURSE I didn’t have RSD! How could I? I am a playwright, and my career is nothing BUT rejection. I can’t sit here and say that it’s easy, and while there are some rejections I have taken a lot harder than others, I’ve managed to weather that part of it pretty well all things considered. It’s part of the job. Occupational hazard. It’s what I signed up for. I put RSD into the “NOPE” section of my brain, and didn’t think about it again until I was diagnosed.
Spoiler alert: I definitely have it.
As it turns out, nearly 100% of people with ADHD have RSD. In her book Understanding ADHD in Girls and Women (which I highly recommend), Joanne Steer defines RSD as follows:
“...RSD is a form of emotional over-reactivity and is described as the exquisite sensitivity to teasing, rejection or criticism, or the individual’s perception that they have fallen short of what was expected, whether this perception is real or imaginary. Provocation of RSD appears to result in either an attack of rage against the person that has triggered it, or an episode of profound low mood, usually accompanied by the physical sensation of having been wounded (such as a blow to the chest) and typically lasts a few hours to a few days.” p. 224
Like most things, RSD is on a spectrum. For some of us, its a minor annoyance. For some of us, its completely crippling. I’m not sure where I sit, but it’s definitely not minor. It’s only in looking back on my past that I realize how my RSD has manifested itself, and how much it actually has shaped my life.
Writing about this was more difficult than I expected, since it has affected nearly every aspect of my life, so I’ve chunked it down into sections for easier reading. Feel free to skim anything that isn’t useful for you.
To avoid criticism and rejection, I became a people pleaser. I have become very good at assessing the needs and wants of the people around me, and I used to do everything I could to accommodate them, often at the expense of my mental health and well being. In elementary school, I was bullied severely for about a year (is 6th grade the worst grade for everyone? It seems universally awful). When I started middle school, the experience I had in elementary school haunted me. I felt that I had to reinvent myself. I learned quickly how to mold my personality to whoever I was around. I became a chameleon, and my naturally outgoing nature made it easy for me to immediately find a way to relate to someone. I wasn’t exactly popular, but I was able to get along with a wide variety of people. This has served me very well in my life, even if it required an insane amount of energy and mental gymnastics.
I also have a deep rooted fear of abandonment, and some of that is linked to childhood trauma. The sudden death of my grandmother was my first “abandonment”, and what I hadn’t realized was how much of a buffer she was between me and the dysfunction of my parents’ marriage. After my parents divorced, I experienced familial estrangement. Due to the circumstances of my parents’ choices, I had to grow up very quickly, and I did what I could to survive it. I am aware of this abandonment wound, and have worked on knowing when it is triggered and what happens when it is. If I fear abandonment or rejection, I immediately try to find a way to “fix” it by being accommodating, going above and beyond for that person, or being self-deprecating and taking on all of the blame even when something is not my fault.
I am my own worst critic. I am a perfectionist who sets completely impossible standards for myself. When I don’t meet those standards, I punish myself more than anyone could ever punish me. I learned to be absolutely terrible to myself, and I am un-learning decades of negative self-talk. I’ve never been as mean to a single person on this earth as I’ve been to myself.
Common mistakes that happen to just about everyone will haunt me for weeks, months, even years, especially mistakes made in social settings. That weird thing I said once at a party - a thing the person I said it to probably doesn’t even remember - will pop into my mind unprompted in the middle of the night. I realize now it is anxiety because I let the mask “slip” and revealed too much of my true self to someone. The perceived cost of a mistake is that I will inevitably lose everyone and everything in my life.
As a child and adolescent, I had family members who enjoyed humiliating me, and then chastising me for being “too sensitive”. My masking is never stronger than when I am faced with criticism or embarrassment in public. Something takes over in me and I appear completely stone faced, or just plain old pissed off. What no one sees is that I completely dissociate, and my priority is to keep myself safe. Once the situation is over, I can plummet into a severe depression and think about the situation over and over again until it creates an unbearable amount of anxiety. Part of the anxiety stems from fear of my own anger. My rages were legendary when I was younger, and there were times I would “white out” and completely lose my shit, with almost no memory of what had happened. I know that I am capable of cruelty when that rage bubbles up, and I have coped by turning all that rage onto myself.
Losing friendships have been the most painful experiences of my life. Losing a friendship - especially for someone with ADHD - can feel like a death.
I am mostly a good friend. I’m not perfect, but I am fiercely loyal, generally fun to be around, have a good sense of humor, and I always make myself available to my friends when they need me. There have been a lot of times where I have overlooked the fact that I was not getting my needs met in friendships, and I would often brush it aside because I was afraid that standing up for myself would mean that person would inevitably reject me. As a result, I had some pretty toxic friendships in the past.
If I was rejected by a friend - and we all experience this to some degree - the fallout was crippling. It is quite literally agonizing - it comes with physical pain - and even the memory associated with the rejection could trigger an anxiety attack. I had a terrible falling out with one of my friends in high school, and it's only now I can think about it without feeling like someone punched me in the chest.
About ten years ago, a person I considered a best friend ghosted me. I reached out a few times like “hey, did I do something to upset you?” and got no response. This was someone who I had spoken to pretty much every single day. It was brutal. I went over and over in my mind what I could have done differently, and I just assumed that it was my fault. My amazing therapist helped me work through this rejection, and helped me to understand that it didn’t mean I was a bad person that everyone inevitably would abandon at some point, and that even if I made mistakes, you can’t fix something you don’t know about. It was painful. It was triggering. Most of all, I deeply missed my friend and felt horrible that I may have hurt them somehow. It has taken a lot of work for me to make peace with it. The sad truth of life is that sometimes people are in your life only for a season. I will always treasure the fun times I had with my friend, and how much I learned about myself.
I’ll never know exactly why the friendship ended, and even if I did, it wouldn’t really solve anything. Closure is one of the most insane myths of modern life. There’s no tidy bookend, no period at the end of the sentence, and no cosmic lesson. There just comes a point when you realize that you need to move on with your life, and you have to grieve to get there.
I have a staggering fear of retribution. This is in part due to my upbringing, where any mistake or misstep I had made in the past was ultimately used against me. I was often harshly criticized. This is not uncommon for children and young adults with ADHD, as it is estimated by researchers that children with ADHD receive 20,000 more negative or critical messages about themselves by the age of 10, and on top of that, are less equipped to deal with these negative messages than a neurotypical person.
I have always felt intense impostor syndrome, because I knew I was different, and was terrified that everyone was going to find out that I was a fraud. I have always known this fear was irrational, but I absolutely could not stop it. I would lay awake at night, worried I’d angered someone, and thinking ten steps ahead about what they could possibly use to get back at me. When that fear bubbles up, I feel like a trapped animal. This is the time I get the most defensive and hostile. My brain and body are anticipating an attack. I don’t know when, why, or how it will happen. The anxiety can be unbearable.
The worst for me is when I can tell someone is angry, but when I ask if they are angry they deny it, or they go silent. I fear silent anger more than just about anything in this world. My husband tends to go quiet when he is pissed off, and I’ve had to tell him straight out that I cannot handle it. My brain goes into a full spiral. Growing up in a house of loud people, I knew that if someone went quiet, an emotional bomb was about to go off. My husband has never been abusive or cruel, but if I sense he is angry with no explanation, I assume its my fault, that I am a terrible wife, and my world is about to come crumbling down around me.
My perception of these situations is not always accurate. RSD involves sensitivity to rejection or criticism whether real or perceived, and it is still difficult for me to tell the difference. I think this has been one of the hardest things for me to accept - that sometimes I can’t tell if my intuition is correct or if I’ve entirely misread a situation. It’s really frustrating.
There are moments where I don’t feel like a real person. I’ve learned to mask and adapt so effectively that sometimes I wonder if my entire personality is just a construct, which makes me think maybe my entire life is a construct. If I think about it too much, I experience depersonalization, and before you know it I’m having an existential crisis at 3 am. It’s also another way of turning on myself, and I have to stop that. I have heaped enough abuse on myself for several lifetimes, and I don’t want to live this way anymore.
I keep hearing about this concept of the “No Fucks Forties” - the idea that as soon as you turn 40, there is a shedding of fucks and you suddenly don’t care what other people think of you. At 42, I am not sure this is possible for me. I am not sure I will truly ever not care what people think of me, because my brain is hard wired to care. I know that the RSD has held me back in my life, possibly more than any other aspect of ADHD. There are a lot of chances I didn’t take, a lot of times I should have stood up for myself, and also a lot of times where I completely overreacted to a situation that did not warrant it. It’s hard to parse out which is which.
I know what RuPaul says, but this idea of “self-love” is the most difficult thing for me. The idea of loving a self that I didn’t even understand for most of my life is a foreign concept. I don’t know that my self-esteem will entirely recover from 30 years of untreated ADHD. I don’t know how to just BE. Perhaps that is the focus on the last half of my life - how to just be who I am, and become more familiar with who that is.
The medication has helped, but it’s not a cure. I am always going to be sensitive. Criticism and rejection are always going to bother me more than it bothers most people. I can’t change that. The only thing I can do is go forward with awareness, and believe that the people in my life actually do love me for who I am, whoever she is. I imagine they might know her better than I do. And maybe once I get to know her, I’ll decide she’s pretty cool after all.
This is really well done. Thank you for sharing. I had NO IDEA that physical pain wasn't just some sort of anxiety attack. It was an ever-present part of my life from middle school on, with zero explanation until I was 42. It's amazing what the change in perspective does for someone struggling with RSD, and I hope this finds someone(s) that needs it.
As I sit here reading this, I am literally shaking. You and I share so many common elements to our personalities and life experiences. I can relate to what you have written in a way that is very rarely possible for me. I have never even heard of RSD before, but having read your article, I can say that it is a fair bet that I am also a sufferer. I mean, everything you wrote was just so familiar. The school bullying, the unsteady household growing up, the anxiety attacks, the actual physical pain that feels like a punch to your chest and can be reignited simply by reliving a memory from the distant past, the internal dissection of every interaction, word, conversation. Just wow. Mind blown.