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Rejection Sensitive Dysphoria

9 replies

WelcomeToMonkeyTown · 14/01/2024 08:17

Hi all

Does anyone have any advice on dealing with a partner with Rejection Sensitive Dysphoria?

I would always have described my husband as "over sensitive" but he has recently read about the condition and he believes he has it.

I want to be supportive but it's exhausting..

He had a fairly big mental health dip over Christmas and our relationship has taking a real beating. We are trying to get things back on track but I feel like I am constantly on tiptoe. Sometimes simply disagreeing with him on something small will trigger him.

We had an issue yesterday where a misunderstanding led to me being pissed off. I told him I was a bit miffed because of X, he explained his reasons, I realised it was a misunderstanding and said OK. But this has then caused him to spiral.

Now I feel I can't tell him if he has hurt my feelings and I don't want to live like that.

OP posts:
HundredMilesAnHour · 14/01/2024 10:24

This sounds miserable. Is he getting professional health with his mental health?

WelcomeToMonkeyTown · 14/01/2024 16:24

HundredMilesAnHour · 14/01/2024 10:24

This sounds miserable. Is he getting professional health with his mental health?

Yes, he has just started ADHD medication- which may in fact be making the RSD worse - and he's seeing a psychotherapist, but it's early days.

I am so happy he's getting help but it will take a while for anything to really change (if it even does?) and I'm just so tired of it all

OP posts:
BertieBotts · 14/01/2024 16:45

RSD is not really something that you "have" as in a medical condition. It is basically a description of an experience that some people have, which is very commonly associated with ADHD, though can also appear in other conditions (like borderline personality disorder, depression, PTSD). There isn't really much research on it and it is mostly an "internet thing" (if that makes sense).

I do think it can be a useful term in that it can be quite a useful shorthand to say to myself "Ah yep, that's rejection sensitivity again!" and it can be useful in the sense that finding out other people have similar intense reactions to things can make you feel less alone. On the other hand I do tend to feel a bit like - is every bad feeling really a "dysphoria"? But I think that might just be me being annoyed by the social media buzzword thing - it's clearly a useful concept. I just wouldn't get too caught up in it being a thing that you can "have" if that makes sense. It's more of a symptom than a separate disorder.

Experts tend to say that it's part of the emotional dysregulation part of ADHD - this is the recognised medical term, if he did want to talk to his doctor about it. Most adults with mature emotional regulation tend to be aware of their emotional state and when they feel that they are ramping up towards anger, distress, excitement etc can rein it in to a socially acceptable level - but with ADHD a lot of people say it's like you don't get the "warning stage" in the middle (I definitely relate to this) so it's almost like a switch flips and you go from perfectly fine to rage or despair etc - a bit like toddlers can do, and this is why any of the normal suggested techniques like take a deep breath, count to 10, go for a walk etc don't work because you don't have a chance to use them before you're in a state where it's basically impossible to access rational thought. Even something like CBT that is supposed to help you correct the distorted thoughts is difficult to implement - because that's thinking/rational again, and it's too late for that. What someone needs to do when they recognise they have got into that despair/rage/etc state is to go and use some kind of non verbal tool, preferably not near other people as you just take it out on them, which is not fair. Whether that's going off to use a punching bag or meditation or rage cleaning or smoking a cigarette or going off to cry or whatever it is. Recognising that you're in an "irrational" state and taking yourself off away from others is helpful (as long as there is no self-injurious behaviour etc). And if it's a very sensitive emotional bruise that gets hit easily, maybe therapy can help.

ADHD medication can help as it can sort of raise the threshold for what triggers intense emotions - at least it does for me. I think another issue in ADHD is that interoception (fancy word for the sensations inside your body - hunger, bladder fullness, tiredness, emotional state etc) is typically poor. I think this is definitely related, because working on this has helped me notice the warning stage, which I didn't think I could before.

Walking on eggshells isn't good. It's stressful for you, it's unhealthy for the relationship if you can't discuss things and it sounds like it's happening a lot, which might be a signal there is something more underlying like burnout or depression maybe? You definitely need to be able to talk about things. After the spiral, does he then recognise that he was spiralling, and is it possible to talk about (anything?) when he is calmer or does it just start everything off all over again? Because that is totally unsustainable and like PP said, miserable to live with. It's fair to be aware of the RSD and for example if you are annoyed, say something like "I am annoyed, but I'll be fine, I just need some time." if he needs that piece of reassurance (but then he needs to let you have the time) - or for example, it might help to have difficult conversations in a less direct way. I sometimes write to DH on whatsapp (even if we're in the same room!) instead of talking out loud because for anything complicated, it's helpful if I can rearrange sentences and paragraphs, delete irrelevant details etc. And it also means that I don't blurt out something unhelpful in response to half a sentence that he hasn't even finished yet. Just slowing down helps rather than quick fire reaction to reaction to reaction, and the process of writing a reply makes me think more about what I'm replying to, rather than my snap emotional response which has probably picked out one word rather than the whole meaning and context of what is being said. Apparently I once told my mum that we used to have conversations sitting back to back so that I didn't have to look at him Confused I don't remember ever doing this! But it's possible that it was a similar thing of trying to avoid an intensely emotional reaction getting in the way of me being able to say what I wanted to say/hear what he had to say.

BertieBotts · 14/01/2024 16:47

Sorry I was writing for so long the post did not show up Blush

Def if new medication and difference in strength or frequency of emotional dysregulation coincide, it could be related. It says something in the pack leaflet about mood changes but I can't look it up right now.

WelcomeToMonkeyTown · 14/01/2024 19:55

Thank you @BertieBotts this is really helpful .

We have found that having difficult conversations over WhatsApp is wayyy easier than in person - often when we are just in different rooms. He gets flustered and says it's not fair because im "better at words" so typing massively helps.

He does tend to realise afterwards that it's the RSD and that he's spiralled and doesn't mean the horrible things he's said to me. But - and I'm sorry if this makes me a bad person - that's not enough. I can't live with having to constantly tiptoe around or just accept that he will be horrible sometimes and then apologise for it.

He is trying to get back in with his dr to change medication to see if that helps

OP posts:
BertieBotts · 14/01/2024 20:28

Of COURSE it doesn't make you a bad person! Nobody should have to live with that, it's not a safe environment to be in.

You should never have to tiptoe around - that's not sustainable at all IMO - and I think everyone is horrible sometimes, but there is a huge difference between being a dick occasionally, and actually regularly hurting/upsetting someone that you're supposed to love and care about. It's not on, and while I totally sympathise that it's difficult to navigate frustrating bits of the system, if he thinks he's doing it because of ADHD related reasons, then that needs to be the priority. It's just about taking responsibility for your own behaviour and not putting it on someone else.

Roui · 27/01/2024 16:50

I don’t have a diagnosis of ADHD but I strongly think I have it and I struggle with RSD. The thing is I am amazing at masking it, inside I am screaming and I am wanting to cry my eyes out and then for at least 24 hours I will feel like I am completely useless, unlikeable, and I might as well not exists. I ride through it. It happened last week when my manager actually gaslighted me and made a huge issue over one thing I said to my higher manager. I held it together at the time but I have now had to take a step back from work as I need a break. It’s so exhausting masking!

I would just give your partner reassurance, let him feel safe to make mistakes because he is human and we all do. It honestly feels like you are the worst human ever at the time so try to understand where he is and ask him what he needs to feel better about the situation.

toodizzyizzy · 02/02/2024 17:39

I'm in a similar situation with my partner. We are finding the description of RSD helpful in identifying certain behaviours, but now I think he's hiding some very serious mental health issues behind RSD. Is it normal for RSD to manifest in suicidal ideation? He's refusing to go to the GP as he thinks they won't understand RSD...maybe not, but we could at least use it to open up a conversation about the suicidal ideation?

Roui · 02/02/2024 22:12

He can request to be assessed through right to choose. He’s best off going in armed with examples of why he thinks he may have some neurodivergence.
Has he done any online screening tests… there are some good ones here… https://www.clinical-partners.co.uk/online-tests

I have done loads and they say I am highly likely to be adhd and have autism.

Online Tests for Mental Health Self-Assessment

Online tests for mental health self-assessment, including tests for ADHD, autism, anxiety, depression and bipolar disorder.

https://www.clinical-partners.co.uk/online-tests

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