Rejection-sensitive dysphoria: what it is, symptoms, causes and treatment

We all feel bad about being rejected by others, but there are people who find this feeling more overwhelming, so they have a harder time getting over it and moving on.

When a person suffers from what has been called Rejection Sensitive Dysphoria, they often experience pain when they feel rejected by others, either this rejection or it may even be imaginary in some cases. Therefore, this person has a great sensitivity towards criticism or judgments towards himself, as well as towards rejection.

In this article we will explain in more detail who is dysphoria sensitive to rejection and we will also show some signs that could detect when a person is suffering from this type of dysphoria and we will also see what mental disorders are generally associated with.

    What is Rejection Sensitive Dysphoria?

    When a person experiences dysphoria that is sensitive to rejection he is more sensitive to criticism, appreciation and rejection from others, experiences that everyone has lived more or less at one time or another in their life.

    However, with rejection sensitive dysphoria these experiences can become unbearable for the person and in many cases a bad social experience will be the starting point for the person to work very hard and obsessively in various aspects of their life. life in order to please others (physically, academically, in the way they dress, at work, etc.).

    Dysphoria susceptible to rejection it can even cause the person to be constantly alert to any possible sign of disapproval, criticism, rejection or dissatisfaction with him or her., so that many times an action that hurts their feelings could come from an act of another person that was misinterpreted and, in fact, what he thinks the other person did with contempt, in fact was the figment of his imagination.

    Therefore, such misinterpretations could have an effect on their relationship, so rejection would occur. what you might call a self-fulfilling negative prophecy.

    Causes associated with rejection-sensitive dysphoria include negative social experiences (eg, bullying, bullying by classmates, having overly critical parents, or emotional rejection).

      Diagnosis of rejection-sensitive dysphoria

      Mental Disorder Diagnostic Manuals (DSM-5 and ICD-11) do not contain the official criteria for diagnosing rejection-sensitive dysphoria. However, this psychopathological condition is widely recognized among mental health professionals, besides being the subject of many studies, so it is worth keeping this in mind.

      Rejection-Sensitive Dysphoria shares a number of common symptoms with other mental health issues, so it would be advisable to “diagnose” Rejection-Sensitive Dysphoria beforehand. find out if the symptoms you are experiencing are due to another mental health problem.

      To find out if this is rejection-sensitive dysphoria, a number of questions can be asked, such as the following:

      How do you feel after being criticized or rejected by others? Have you ever experienced a neutral act of another as if it were rejection? Are you too worried about failing in any area of ​​your life? Have you been told several times that you are too sensitive? Are you afraid of being judged by others? Do you like to please others? From 1 to 10, how would they rate your level of self-esteem?


        Symptoms most commonly associated with rejection-sensitive dysphoria are the following:

        • Symptoms of anxiety.
        • Avoid situations that you think could lead to rejection of the person.
        • Be very perfectionist in various fields.
        • Tendency to act to please others in order to be socially accepted.
        • Belief that you are not accepted and / or loved by others.
        • Have low self-esteem.
        • Negative cognitive bias.
        • Acts of impulsivity with feelings of anger in situations of social rejection
        • Ruminative thoughts on experiences of social rejection.
        • Rejection-sensitive dysphoria can significantly interfere with a person’s life.
        • Rejection-sensitive dysphoria can negatively interfere with all relationships.

        In more severe cases, people with rejection-sensitive dysphoria may be very afraid of rejection. reach the point of social isolation in order to avoid possible future rejection by other people, which forms a vicious cycle of weakening their relationships and increased isolation, so that you feel that you are suffering from even greater rejection.

        While it is true that we all feel bad about having negative social experiences or rejection from others, people with dysphoria who are susceptible to rejection they tend to be more likely to become obsessed with any negative social experience, so it is more difficult for them than others to forget and overcome this experience.

          Mental disorders in which it is more common

          Rejection-sensitive dysphoria has been linked to a wide variety of mental disorders, including the following: mood disorders (depression and bipolar disorder), social phobia, schizoid personality disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), borderline personality disorder (BPD), Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), the latter two being the most studied for their relationship to rejection-sensitive dysphoria.

          A study of people with ADHD and others with ASD found a high prevalence of cases of rejection-sensitive dysphoria, who had high emotional sensitivity.

          It has also been observed that they may have difficulty regulating their emotions and communicating, this therefore leads them to have the perception of being rejected by others, which can also lead to misinterpretations of the actions of others, which can sometimes be neutral acts with no intention of offending anyone.

          Outraged, this high sensitivity to rejection makes those who suffer from it more likely to experience symptoms of depression and anxiety, in addition to having thoughts of self-harm, special attention should therefore be paid in therapy when cases of dysphoria sensitive to rejection are detected, with particular emphasis on the treatment of associated symptoms.

          On the other hand, it should be noted that anyone can suffer from rejection sensitive dysphoria without any mental disorder.

            Rejection-sensitive dysphoria in people with ADHD

            A study of 1,235 young Germans measured sensitivity to justice, self-esteem, behavior problems, ADHD symptoms and dysphoria sensitive to rejection.

            The results showed a strong relationship between rejection-responsive dysphoria and ADHD symptoms, which led to the development of a hypothesis on the contribution of rejection-responsive dysphoria and sensitivity to justice in it. onset and also in the maintenance of problems commonly associated with ADHD symptoms. Therefore, rejection-sensitive dysphoria should be considered during psychological therapy sessions with people with ADHD.

            Studies have shown that ADHD symptoms can worsen the suffering of rejection-sensitive dysphoria and thus heighten feelings of rejection.

            Likewise, these studies have shown that more than 60% of people with ADHD reported having symptoms related to dysphoria sensitive to rejection (for example, suffering from scandalous negative emotions that they could not control); while people without ADHD found symptoms of dysphoria sensitive to rejection in 15% of cases.


              For ADHD co-morbidly with rejection-sensitive dysphoria, the most commonly used treatment in Within the national health system is usually the medication, which is often used to treat the central symptoms of ADHD. In addition to medication, psychotherapy and lifestyle recommendation are often used in order to establish a series of healthy habits in the patient’s life.

              Cognitive Behavioral Therapy (CBT) has the largest number of studies that have shown its effectiveness in these cases, with psychologists using this model in therapy aimed at helping the patient identify these destructive or ineffective patterns in their behavior and outcomes. thoughts, as well as teaching and training with the patient a number of effective techniques for dealing with rejection, stressful situations and other associated problems.

              CBT may be effective in helping people with rejection-sensitive dysphoria recognize those negative emotions that cause so much discomfort in their lives, learning to detect if they might be disproportionate, and also process negative emotions in healthy ways. .

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