Understanding Why Rejection Hits Harder in Children with ADHD

You can see your son wince when his uncle corrects his batting stance. Your daughter breaks into a sobs when she discovers that she wasn’t invited to a friend’s party and your heart breaks right along with hers. As a parent, you know that every shed tear that rolls down their face and every word of criticism that comes to their ears somehow makes it into their heart …. and your heart too.

You can’t shelter your children from every emotional pain, although most parents would if they could. However, that isn’t reality. Honestly, it isn’t healthy for them to be sheltered from every woe in life. It doesn’t prepare them for the future. In fact, sheltering doesn’t even seem necessary for some children who are just naturally better able to handle correction or perceived rejection than others.

For some children, though, rejection is much harder. If your child is one, you understand the deep-seated pain I’m talking about. They feel it. You feel it, every time they feel chastised or rejected. You’re probably familiar with the fact that these intense emotions can result even from a seemingly benign interaction. A simple comment, a forgotten invitation (even when it’s an oversight) might hit harder for children with ADHD (Attention Deficit Hyperactivity Disorder).

If this sounds familiar, keep reading. These seeming overreactions might not indicate they are being “overly sensitive” as some people in their lives may assert. Your child could be experiencing Rejection Sensitive Dysphoria (RSD).

What is Rejection Sensitive Dysphoria (RSD)?

Have you heard of it? Rejection Sensitive Dysphoria, known as RSD, is not an official medical diagnosis, but a term that has gained a lot of attention in the ADHD community in recent years and for good reason. It puts to words what a lot of parents of children who suffer from it have been thinking for years.

RSD is the intense emotional pain that some people with ADHD feel when they perceive rejection, criticism, or failure. Even if others consider it minor or unintentional, children with ADHD RSD will take it in deeply. As one child with RSD explained, “When someone says that I did something wrong, it feels like my whole world is crashing in on me and I will never be good enough again.”

For someone with RSD, a passing, nonchalant comment such as, “You forgot again?” can feel like a massive personal failure. We’re talking jumbo-sized reactions for a seemingly mini offense. An unanswered text might spiral into thoughts like, “They hate me!” These reactions are visceral, overwhelming, and often disproportionate. However, they are real to the person experiencing them and to those who love that hurting child.

Why does RSD affect people with ADHD?

ADHD doesn’t just impact attention and focus, though those are the elements usually discussed and analyzed when dealing with ADHD. Additionally, ADHD is also deeply tied to emotional regulation. The brain’s prefrontal cortex, which helps manage emotions, can be less active or less efficient in people with ADHD. This makes emotional responses more intense and harder to control.

On top of that, many children with ADHD grow up hearing negative feedback. They’re told to “try harder,” “pay closer attention” or are accused of being lazy. Over time these negative experiences can create heightened sensitivity to criticism and rejection, even if it’s not intended that way.

Therapy’s Role in Managing RSD

When a child who is physically inclined to perceive rejection or correction in an intense way interacts with loved ones who aren’t aware of the disorder, nor how to positively interact with the child, you have a recipe for deep pain. No parent wants that for their child.

If you can’t shelter your child from situations that might make them criticize themselves or make them feel rejected, what can you do? You can manage it, but you don’t have to do it alone. Therapy can play an important role in helping children manage their intense emotions associated with RSD.

Your therapist might use Cognitive Behavioral Therapy (CBT) which can be a particularly effective tool. By teaching children how to identify and reframe negative thought patterns, your child’s cycle of critical self-talk can be interrupted. This in turn can help them learn how to respond more calmly to perceived rejection or criticism, both internally (their thought and emotional cycle) and externally (socially).

Sometimes just understanding that these critical words that are floating around in their heads are more of a result of RSD than of anyone’s actual rejection or criticism of them can help minimize their effect.

Therapy may also involve parents and caregivers. A family therapist can teach each member of the family how to better interact with each other and how to defuse negative interactions during particularly emotionally intense times. They can also help explain the more subtle and specific effects of RSD as it pertains to your child and your family dynamic.

Your therapist can also teach your child stress management techniques such as deep breathing. These they can lean on when they are confronted with their negative emotions. The therapist may also stress the importance of prioritizing self-care for overall well-being. They might give your child practical ways to respond and interact in potentially stressful situations through role-playing exercises.

When seeking a therapist, it’s important to find a professional who shares your Christian values and who is experienced in ADHD and RSD to ensure that your child receives the most effective and compassionate care.

Other Ways to Help Children with ADHD and RSD

While therapy is a practical and important way to help children with ADHD and RSD, there are other things parents can do to minimize the negative effects.

Having transparent conversations with the adults such as teachers, coaches, family members and friends that are in your child’s life can also reduce the negative impacts of RSD. Simply explain your child’s RSD and how it affects their life with those in regular contact with them. This will help to ensure that these important adults can be mindful of their interactions with your child.

There may still be people in your child’s life who regularly trigger their RSD or who are being critical of them, even after you have explained the negative impacts this causes. If this is the case, consider eliminating or restricting their time with your child. Try to be present during their interactions and remind the adult that they are a role model for your child. It’s important to surround them with a community of supportive individuals who will value and affirm them.

Helping children with ADHD to thrive with RSD requires creating an environment where they feel understood, prioritized, and supported. That doesn’t mean that you will shield them from every challenge or criticism life hands them, but it does mean equipping them to face life’s ups and downs with skill and grace.

Encourage activities that are likely to boost their self-esteem and that provide an outlet for their emotions such as sports, art, music, church activities, or volunteer work. These activities can give them a purpose and offer a sense of accomplishment, helping them to feel less defined by their perceived failures or rejection.

Thriving with RSD

Most importantly, remind your child that God created them beautifully and wonderfully. RSD, just like ADHD, may be part of your child’s life, but it does not define it. Everyone has challenges and your child is no different. Realize this: God did not make a mistake when He knit your child together.

While RSD may make your child more self-critical or may make them feel the sting of rejection a little more than someone else, it also makes them more compassionate to others and gives them the ability to forgive freely. Those qualities will help your child thrive!

If you or your child would like to start counseling, reach out to our office today. We will schedule an appointment for you with one of the therapists in our practice.