• Stephanie Camilleri

Rejection Sensitive Dysphoria in the Workplace




'Rejection Sensitive Dysphoria' is one of the most crippling aspects of ADHD and unfortunately the least known, particularly in the workplace. Rejection Sensitive Dysphoria ("RSD") as a concept was developed by Dr William Dodson. Dr Hallowell describes it as "the painful syndrome of feeling acute and profound dejection at even the slightest perceived insult or “dis”" and it is pervasive among individuals with ADHD. It is not taken seriously in the workplace because it's not recognised as an official trait of ADHD. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) doesn't take into account RSD (or any type of emotional dysregulation) in the diagnostic criteria for ADHD. However, through my experience of coaching, practically all of my clients have reported experiencing RSD to varying levels. At times to such an extent that they become so mentally unwell that they have to either go on extended sick leave or quit.

Like with all things ADHD... we firstly need to name it to tame it. So what does RSD mean for employees with ADHD in the workplace? What do employees with ADHD do to avoid this crippling pain?

  • People pleasing - they lose sight of their boundaries in order to please others. In the workplace this might include working late, taking on extra responsibilities, not delegating, stopping at nothing to meet unrealistic deadlines and not pushing back to unreasonable bosses/clients. Being so scared to upset the status quo employees will far exceed their remit to avoid upsetting anyone or being reproached. It often comes at the cost of burning out.



  • Avoidance - the fear of failure is so great that employees will avoid anything that takes them out of their comfort zone including asking for a promotion or pay rise, speaking out in meetings, volunteering for the project or client that they want... anything that people do to progress and shine a light on themselves they will avoid. These employees keep their expectations small and themselves small in order to not fail or disappoint.


  • Aggression - other employees' sense of self is that delicate that they will stop at nothing to protect it from any perceived threat. They will use attack as the best form of defence, building their walls high and defending anything that even has the vaguest whiff of criticism. When their managers try to give them feedback on an area in which they could improve, they'll immediately retaliate and look to blame external forces. Everything feels personal and pointed.

Even “constructive” criticism can trigger RSD exacerbating already problematic ADHD traits further compromising performance. For example, workplace reviews are standard business practice but strongly triggering for an employee with ADHD, particularly if their ADHD challenges are misinterpreted as incompetence and they are placed under even more scrutiny and supervision. The unfairness of the situation compounds the feeling of RSD which often leaves these employees too emotionally overwhelmed to explain or otherwise protect themselves. They are understandably angry and frustrated by the hopelessness of their situation which usually makes matter worse.


Time off work unfortunately doesn't change the situation for the better. Arguably, it may make the situation worse. As time passes, employees' confidence in their ability to do their jobs tends to wane and imposter syndrome looms larger, particularly if upon their return their role has changed and their managers are still none the wiser when it comes to ADHD. The employee with ADHD will inevitably feel on the back foot now more than ever and under the strain of their executive function and other ADHD challenges will find their RSD being triggered again... and so the cycle repeats.


You see, RSD does not go away. It keeps getting triggered. The key is to eliminate the triggers, or at least minimise them.


We need to educate the workplace about ADHD and RSD.


Employers, if you want to know how you can help your employees with ADHD succeed in your organisations, get in touch with me.


Employees with ADHD - I hope in reading this that you'll recognise some of these RSD behaviours and feel some relief that this is a common and shared experience amongst ADHDers. You don't have to deal with this alone. Come and join our ADHD Unlocked Membership Community. Next week we will be showing you how to communicate your ADHD (and your RSD) to your employers to ensure you get the support that you need and deserve.

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