Rejection sensitive dysphoria?

[Startingnew]

Hi

Does anyone have any experience or knowledge of rejection sensitive dysphoria? I believe I have it, but when researching it suggests it’s often alongside ADHD which I don’t think I have. It also says there’s not really an official diagnosis of it, and therefore there’s no specific treatment, just perhaps people who are on ADHD medication can notice it reduces it. As it’s neurological everything I read suggests CBT or talking therapies won’t help it.

I’m finding it crippling. It’s truly like I’m in crisis mode, or go into meltdown, my emotional reactions are way way out of proportion to any event/issue.

I have been diagnosed with general anxiety and social anxiety, also health anxiety, but talking therapies just isn’t helping even though I’m all in and really really wanting it to work.

I’m not on any medication (health anxiety means I worry even taking paracetamol for a headache!).

Anyone have any advice?? I can’t live like this

Not something I've heard of but from your description ("It’s truly like I’m in crisis mode, or go into meltdown, my emotional reactions are way way out of proportion to any event/issue") this is a issue with your subconscious mind - which is charge of your emotions, memories, imagination and automatic thoughts and actions - rather than your conscious/logical mind.

Can you remember when and why this started?

I’ve always been a worrier, even as a child. No major trauma or event that’s triggered a change I think this is how I’ve always been. I get embarrassed easily, very self conscious, I’ve been described in the past as taking things too personally or I’m too sensitive. I have low self esteem, don’t enjoy social events. I’m a people pleaser and don’t want anyone to dislike me.

If something slightly embarrassing happens, a normal persons reaction seems to be perhaps they cringe in the moment, then laugh about it and then they move on. My reaction is so extreme in comparison. I feel immense embarrassment, I go over the event constantly in my mind or talking it over with someone afterwards, wishing I could go back in time to change it, I feel deep deep shame, I then usually have a anxiety attack, tears, shaking, hyperventilating, I want to hide away or run away.

For example I nearly quit my job when I accidentally spilt a drink over in the work kitchen. The shame I felt was awful. Only one person saw it when they came in to see me wiping the worktop. I was convinced that they’d told everyone about it, that everyone would now be talking behind my back, judging me, thinking negatively of me from now on. Or that they’d mention it and I’d relive the embarrassment. Totally disproportionate to a spilt drink!

I dread opening my emails, or if a long text comes through I daren’t open it for ages as I think they’re going to be criticising me for something.

This is more than social or general anxiety isn’t it?

Yes. Debilitating isn’t it.
It’s quite common when related to early trauma I believe.

Was your mum, dad or a grandparent a worrier?

I can understand how awful this must be OP.

It does sound like an anxiety response though, but yes severe, and does fit within usual definitions of social anxiety ie low self esteem, fearing what people are thinking, how they might be judging us, or what they might do next.

So although I expect most people calling this a new thing mean well, I don’t believe this is new separate diagnosis or a set in stone neurological difference with no possibility of relief even though it of course sometimes feels that way, especially if we have suffered a long time, until we find what works. Thankfully that means there is hope for symptoms to reduce or even go away altogether.

From experience, the right therapies with the right therapists can definitely help to work through things like low self esteem and trauma and emotional/ traumatic responses. Sometimes the early trauma we experience isn’t just something obvious like violence but could be a more subtle event or pattern, a family bereavement or even something the child misunderstands but has an impact at a crucial time.

I think DBT might also be more helpful to you than CBT. It has a different focus and delivery and helps with understanding emotions and self compassion etc.

EMDR might also be useful to help ‘reset’ the level of hypervigilance you might feel. Hypervigilance is often talked about in connection with PTSD and being constantly (over)primed to look for threats to physical life or safety, but hypervigilance can also be seen or felt as emotional sensitivity when the mind is always primed to look for emotional threats/ dangers to the sense of self. The triggering of these overwhelming and unpleasant emotions is in itself traumatic, as you know only too well OP, and the mind can become locked into a traumatic cycle of hypervigilance, repeating emotional responses and then fear and avoidance. As you say it’s no way to live however it isn’t inevitable that you will suffer to this degree forever and the right treatments can help.

There are DBT and other resources online that might help before you find the right therapist.

Don’t give up hope and keep looking for the right treatments and people to help

This might be a good place to start
https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/dialectical-behaviour-therapy-dbt/#:~:text=Dialectical%20behaviour%20therapy%20(DBT)%20is,and%20accept%20your%20difficult%20feelings

Thank you for your replies. Yes traumatic and debilitating is exactly how it feels, it’s hard to fully describe what happens but it’s overwhelming and exhausting.

I’ve had counselling as a child and a few blocks of CBT over the years (the CBT I had for my health anxiety did improve things in that respect and I manage it well now).

Im currently having NHS CBT for general anxiety and really wasn’t seeing any changes, he thinks perhaps my social anxiety is greater actually and we’re now going to try and work on that instead apparently.

I’ve just had a search for DBT and that sounds like it might fit me better. I hadn’t heard of it before! I’m going to mention it to my CBT therapist.

I did have a tricky childhood, no abuse but just felt unwanted I suppose, I was past from pillar to post mostly and never felt at home or settled anywhere until I got myself my own little house at 18. I feel a great need to be a certain way or be a certain person and I get embarrassed or feel shame often.

I’ve been married for 20 years and we thankfully have a good relationship, but it would send me into a spin if we divorced, mainly due to the “what would people think” mindset!

I don’t believe anyone in the family were worriers. My mum and sibling have “mental health problems” I was once told (I have no contact with them). One has BPD and the other “had a mental breakdown at 20” but no other details

I did have a tricky childhood, no abuse but just felt unwanted I suppose This stood out for me.

Have you looked into therapy with anyone who does inner child work?

You say there was no major trauma but living with a parent who has mental health problems and feeling unwanted is very hard for a child. No wonder you feel like you do. It sounds like you are still putting the blame all on yourself for why you feel like this.

I suspect your NHS CBT is pointless. Can you afford to see a psychotherapist or trauma therapist who understands complex PTSD?

No I’ve never looked into inner child therapy. What would that involve?

Regarding PTSD, every CBT therapist dismisses any suggestion of PTSD as there’s no defining trauma as such. And just says it’s anxiety but I feel it’s more deep rooted

I could afford private, and I have done in the past but I think I just get stuck in a cycle of CBT as that’s what’s always recommended to me

I don’t have much advice OP but just wanted to post to say I completely understand how you feel .

I hadn’t heard of this term before until a few years ago but I have had this pretty much my whole life. Even as an adult I struggle with any perceived rejection or disapproval and it continues to have a negative impact on my life.

I’m currently on the waiting list for an ASD assessment although I feel I have traits of ADHD also.

As I know how debilitating it can be I just want to let you know that you’re not alone .

Thank you so much for your kind words, I’m sorry that you are also feeling like this. Did a therapist mention it you and have you found anything that helps you cope a little better?

I just hope there’s something out there that can help with it, I’d try anything at this point, I’d even give medication a go if I knew it would help despite my health anxiety!

RSD is a part of ADHD because ADHDers have great difficulty regulating their emotions. In ADHD this is because of developmental issue.

But there are lots of conditions can have emotional dysregulation as a symptom. The cause can be varying.

What you describe does sound like an anxiety response. You are doing lots of the classic "cognitive distortions" eg catastrophising, discounting positives, jumping to conclusions, mind reading. Anxiety on its own can be deep rooted. There are often lots of core beliefs at the root of all that dysfunctional thinking. And I'm not judging. I have had CBT for anxiety and depression and done a lot of dysfunctional thinking myself.

Ongoing anxiety that's resistant to treatment can be because of underlying neurodiversity. Have you considered/looked into that before?

Agree with PPs re DBT, and also considering/looking into EUPD and cPTSD.

That's how my Borderline Personality Disorder presents, though if I were to get a diagnosis now it would probably be cPTSD.

DBT helped me immensely, as did finding the right combination of meda.

@Startingnew I’ve had some therapy for anxiety/depression/trauma in the past but I don’t think it massively helped.

Unfortunately I have issues with extreme procrastination (hence seeking out ADHD diagnosis), coupled with the difficulties in actually getting a telephone Drs appt, let alone any form of NHS mental health support, I’ve just reached the stage of giving up. My wider family is complex and I feel my childhood and early adulthood was definitely a bit dysfunctional which I struggle with (although there was no major trauma or serious abuse).

On a practical level, I’m fortunate that I have some flexibility at work so if I do get upset (doesn’t actually happen that often) I can wfh. My manager is supportive and it helps just chatting something through even just to rationalise something. I also manage staff with anxiety so I take a similar approach. My current role really suits me and my skill set which also helps after years of working in jobs where I felt I didn’t fit in.

As I’ve got older and more settled I find the ‘dysphoria’ doesn’t happen as often but if I do get irrationally upset, sometimes I just need to take the day and just let it pass through me if that makes sense.

I would love to know if anyone had a managed to tackle this severe anxiety though.

I would say I have similar issues. Actual diagnoses of ptsd and gad but last psychiatrist said probably c-ptsd. For me it's absolutely childhood I think. Tiny mistakes would make my mum explode and I live in fear of people being angry with me. Minor mistakes become sticks to beat myself with.

Unfortunately I have no answers other than I found cbt useless. Schema therapy worked a better for me but I'm still not "fixed".

💐

Yep have adhd and yep have rsj.
Luckily have remote job so if something triggers me at work, I can have a cry without people seeing me.
Otherwise in public spaces it's about getting to a bathroom or safe space to be able to show your emotions.

They say you're not meant to mask. But the flip side is society brands you as abnormal and you get a lot of ostrasicing.

... To help.
Watch Jessica mcabe how to adhd. Adhd is very different to what I thought it was. Being female and knowing guys with it. I am different. It's internalised in a sense that the hyperactivity is in the mind ie thinking of a thousand things. And feeling very overwhelmed to the point of tears.

Good news - there are meds - intuiniv - that helps with the rsj a bit and busy mind a bit.

But they're if you get an adhd diagnosis and lucky with the person prescribing meds.

Apparently wine helps with the busy mind. But not rsj.

What I found is just making friends with people similar who get you. Who don't call you too sensitive of shame you. But instead also have the same thing ish. And therefore you can be yourself and kind to eachother. It's nice to feel understood.

It is a right hell hole, the rsj and adhd and anxiety.
Look after your base health. Ie eat regular meals. Get sunlight. Learn about circadian rhythm and limit blue wavelengths later on at night.
Eat more protein and complex carbohydrates.
Make sure you get magnesium, vit d and b vits.

I think it's just one of those things where it sucks.
But on the plus side you're one of those people with bigger hearts. You have the capacity for more empathy, and this means you're able to form deeper relationships. And also you will be more driven to make change and challenge injustice.

Work on your internal language. Ie being kind to yourself as rsj is not just outward to others but also works within yourself. Weirdly, you can reject yourself and predict being rejected and yeah.

Also mindfulness helps.
Like find a mindfulness group.
And if you are on it, it calms you and you have more capacity to handle things for a bit.

Working on regulating stress/ staying calmer helps.

I did have a tricky childhood, no abuse but just felt unwanted I suppose, I was past from pillar to post mostly and never felt at home or settled anywhere until I got myself my own little house at 18. I feel a great need to be a certain way or be a certain person and I get embarrassed or feel shame often.

And that's exactly where your problems stem from.

Have a look at this article on core beliefs;

https://www.betterrelationships.org.au/well-being/core-beliefs-self-acceptance/

Remedial hypnosis would help you identify the parts of your mind (aka your inner child) which are using the strategies they devised to protect you in your youth and change your thought patterns to those more appropriate for an adult.

@Dorriethelittlewitch Yes this is similar to me. Growing up in a blended family, my dad had been the ‘worst’ out of my mother’s partners, and no-one was shy about keeping this from me, so I internalised this.

Everything seemed to be a massive deal in my family and I couldn’t do anything right and I felt I couldn’t let anyone down, so now I’m terrified of making anyone angry. However my mum was raised very similarly…

@Lalalalala555 yes mindfulness has also helped me in the past when I’ve been able to engage with it. It definitely helps calm you down and helps break the negative thinking a bit. A do a bit of sleep hypnosis on YouTube at night which also helps reduce anxiety at nighttime.

Inner child work involves ‘going back’ to when you were a child and re-parenting yourself. It’s very intense. There are books on it but you might be able to find a therapist who can help.

For me, CBT is useless because it doesn’t look at the root cause. It’s too surface.

Wow some points I can really relate to.

Yes I do have difficulty regulating my emotions. The catastrophising, discounting positives, jumping to conclusions, mind reading are all big yes’s.

Extreme procrastination, big yes.

I have wondered in the past if I was neurodivergent, I do have a number of traits which fit with this. But I’ve always dismissed ADHD as I do know a few adults, and children, with this and I’m not like them at all.

I’m very organised, never late (it would make me panic), never impulsive. I Like routine, i plan things meticulously, I do have friends but I also enjoy and need time alone. I have a “thing” about smells. I’m great one on one especially, I’m a good listener and don’t have problems reading expressions etc.

But @Lalalalala555 when you said “It's internalised in a sense that the hyperactivity is in the mind ie thinking of a thousand things. And feeling very overwhelmed to the point of tears” YES this is me!

I will take a look at Jessica Mcabe, thank you. And inner child sounds fascinating, I shall research more about that.

I have tried mindfulness but i wonder if im doing it wrong as I can never really get into it. My mind is still busy?

Thank you all, this is so insightful. I never really realised some of these things about myself

If you look at ADHD UK under events there is a talk on RSD and ADHD.

I have ADHD and experience RSD. I am yet to overcome it but I think it lies in self compassion - learning to practise a compassionate voice with yourself when it takes over. Also separating facts and feelings. Distraction techniques.

I’d try going somewhere private rather than NHS if you can manage it. I found when I went once to an NHS counsellor the whole vibe was entirely different – it’s from the attitude of a problem to be fixed, and CBT is favoured because in the short term it shows results which can be measured. But in the longer term the results don’t always last (evidenced by research). For some things it can work great, but often it’s a bit of s sticking plaster where proper talking therapy would be more suitable.

I also think a CBT counsellor may not be best placed to understand CPTSD and similar. It can be quite a simplistic model.

I once saw a CBT counsellor at uni and she told me that in life feelings will ‘bubble up and then bubble back down again’. I got the sense she dealt with everything by thinking it away.

Tell me you know Julie Langton Smith 😂