Do you have a child who has ADHD and projects moments of utter frustration due to the fear of rejection or failure? It may be that your child has RSD ADHD. Rejection sensitive dysphoria (RSD) is when an individual frequently perceives criticism or rejection, resulting in feelings of extreme emotional pain. The emotional pain can become so intense that it becomes indescribable through words, especially since the rejection is most often perceived from important people in their lives.


William W. Dodson, MD, RSD ADHD Expert

William W. Dodson, MD, explains that “rejection sensitive dysphoria appears to be the one emotional condition found in ADHD.” RSD not only impacts emotions. It can result in years of lost opportunities and negative impacts on mental health. It can also produce relationship struggles with friends and family. Understanding how RSD impacts children with ADHD can make a big difference in learning how to deal with RSD.

Dr. Dodson further explains, “Dysphoria is Greek for ‘difficult to bear.’ It’s not that people with attention deficit disorder (ADHD or ADD) are wimps, or weak; it’s that the emotional response hurts them much more than it does people without the condition. No one likes to be rejected, criticized, or fail. For people with RSD, these universal life experiences are much more severe than for neurotypical individuals. They are unbearable, restricting, and highly impairing.”

RSD ADHD versus anxiety and depression

RSD ADHDChildren with anxiety or the more scientific term generalized anxiety disorder (GAD) may feel anxious for long periods of time: weeks or months. They are irritable, restless, easily tired, cannot sleep, and cannot concentrate. Those with ADHD and RSD will feel anxious about rejection based on a situation, sometimes even before the situation actually happens, causing intense shame, dread, and depression.

Someone with depression – feeling hopeless or sad, who overeat or undereat, who has feelings of guilt or worthlessness, oversleep or lack sleep, all these feelings may stay long or linger. On the other hand, is more situational despair.  He will think, do, and feel sad consistently. Someone with RSD, meanwhile, will feel major depression for hours or days after a real or perceived criticism. While RSD can turn into depression, they are separate mental health concerns.

Responding to Feelings of Rejection

Dr. Dodson, in, says that people with RSD ADHD respond to feelings of rejection or failure through two things: they become people-pleasers, which becomes a dominant goal thereby losing sight of the person’s real ambitions in life; and they stop trying. The paralyzing fear of rejection and failure leads to the person’s lack of desire to exert any more effort; it is much better to stop than to provoke anxiety.

You may have seen it countless times in your child. Forgetting what it is they really want to do, they will extend ways to please other people. Or they will totally stop trying to do anything. Both ways, due to the fear of rejection.


RSD ADHDAre relationships affected?

The feeling of rejection in any given situation, for someone with RSD, affects his ability to make and keep relationships. There is always that perceived fear of being rejected, being constantly terrified, and leading with overcompensation, introversion, or isolation. A child with RSD ADHD will need parents, who are extremely understanding of their child’s RSD condition, because there may be good days without RSD, but there may also belong, very bad days with RSD.

Children will feel social phobia, as the fear of being rejected is always there. Since they struggle with managing their emotions, there will always be feelings of disappointment, sadness, regret, and even shame. The rejection is hyper-focused, and they dwell with that feeling. Their relationships with peers and friends are affected, with siblings and family members.


Dealing with RSD ADHD

Rejection among children can definitely trigger low self-esteem and many other negative emotions. Someone with RSD ADHD will feel even much worse. Teaching your child resilience may be the first step. Seek coping strategies that may help him overcome the feeling of rejection. Give stories of personalities who have also overcome the same feelings of fear, such as Michael Jordan, JK Rowling, even Oprah Winfrey. Seek professional help. There may be medications available, or behavioral therapy to undergo. And for each step of seeking treatment, be patient with your child; be honest and involved. Make sure they feel loved and understood.

Schedule regular activities that may keep your child’s mind away from the feeling of rejection. Walking, mindful meditation, yoga, listening to music, doing outdoor activities, or playing family games can be very helpful.



There are also neurofeedback solutions that can be helpful in treating children with ADHD. The CogoLand program has undergone clinical trials with validated results. Developed by Neeuro, in partnership with Singapore’s Institute of Mental Health (IMH), Duke-NUS, and A*STAR, it is a patented digital Attention Training Program for children, based on Brain-Computer Interface (BCI) technology developed through a decade’s worth of extensive research that improves attention in children.

As part of the clinical trials, 66 children were given fMRI brain scans to show the efficacy of the CogoLand training program. Results from these scans were published in the Translational Psychiatry Nature Journal, the premier publication for research papers. The outcomes from these fMRI scans showed significant results, suggesting that this intervention is an option for treating milder cases or as an adjunctive treatment for ADHD.

The CogoLand app, considered a digital therapeutic, is a game that trains the user on attention and inhibition. Cogo, the virtual character’s name, is driven by EEG signals to run faster. This real-time visual feedback of Cogo motivates the user to focus better.

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