It’s Not 'All In Your Head': It Could Be Rejection Sensitivity

Rejection sensitivity is a trait that makes a person expect, perceive, and react intensely to rejection, real or perceived. For instance, things like not answering a text message can convince someone with rejection sensitivity that they are no longer liked. These feelings override any other, more logical response or explanation and can impact relationships of all types.

Statistics about rejection sensitivity are difficult to find since it’s not a clinical disorder. Different studies characterize it differently. It can be associated with other clinical diagnoses, too, including attention deficit hyperactivity disorder (ADHD), certain depressive disorders, and autism.

Read on to learn more about rejection sensitivity: what it is, what it’s associated with, and ways to better manage rejection.

Person interacting over laptop, reacting to perceived rejection

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Characteristics of Rejection Sensitivity

Someone with rejection sensitivity may:

  • Misinterpret harmless or mildly negative social cues or behaviors as blatant rejection
  • Ignore other explanations or reasons for the perceived rejection, including reassurances from the perceived rejector
  • Expect rejection and overreact to any type of negative social cues
  • Be avoidant and anxious in romantic relationships
  • Pay more attention to all of the times they were rejected than the times they were accepted
  • Evaluate every interaction for perceived rejections

Rejection Sensitivity vs. RSD

Rejection sensitivity and rejection sensitivity dysphoria (RSD) are not exactly the same thing, but rejection sensitivity can lead to RSD. Although not an official diagnosis, RSD is a syndrome of severe emotional pain triggered by the perception of interpersonal rejection or criticism. It has been associated with ADHD.

In People With ADHD or Autism

For people with ADHD, RSD is thought to be a fairly common manifestation of emotional dysregulation, which is part of ADHD. It’s not caused by trauma, but rather is brain-based. People with RSD often say it’s been part of them for as long as they can remember.

Rejection sensitivity is not a formal symptom of ADHD, but emotional dysregulation is often part of ADHD.

While the link between ADHD and RSD is better known, there is also thought to be a link between autism and RSD. Brain studies of children with autism have found different brain reactions than non-autistic children when experiencing rejection. They may be processing rejection differently, especially if they have difficulty with interpreting social cues.

Role of Nervous System

There are not a lot of studies on rejection dysphoria and the brain. It is thought that though rejection sensitivity is present in a variety of mental health disorders, the specific behavioral, emotional, and neural responses may differ in each disorder. However, in those with ADHD, the nervous system processes stimuli in a way that might lead to overreacting to any perceived rejection.

Rejection has been found to activate parts of the brain associated with attention and emotional processing, along with emotional regulation. People with high rejection sensitivity may not be able to activate structures in their brains to regulate the emotional distress that goes along with rejection.

Rejection cues may also trigger the defensive motivational system (DMS) in those with high rejection sensitivity. This system unconsciously responds with avoidance and a fight-or-flight response.

If a person has trauma from previous rejection, a structure of your brain called the amygdala helps the brain store memories of trauma and attaches meaning to the memory. The pain associated with this rejection gains meaning.

Emotional pain causes more brain activity than physical pain and hurts more. This is why those with high rejection sensitivity or RSD can feel physical pain when perceiving rejection.

If you are later rejected again, this triggers the amygdala, causing that stored emotional pain and trauma to flare up again.

Trauma From Other Causes

For some people, rejection sensitivity can be a response to trauma. Trauma, especially in childhood, can impact attachment, which can cause emotional dysregulation. This can interfere with forming meaningful relationships, contributing to rejection sensitivity.

It may also arise from childhood maltreatment and rejection, harsh discipline, conditional parental love, exposure to family violence, and emotional neglect.

Rejection Sensitivity Complicates Relationships

Rejection sensitivity can interfere with relationships in a variety of ways. People who have high rejection sensitivity may misinterpret any behavior to be a rejection of them, instead of thinking of any other possible explanation.

They may then act in ways that end up pushing the partner away from them, further reinforcing these mistaken interpretations. Consistently believing they are being rejected can also lead to conflict.

All of this can lead to a lack of happiness in relationships. Some research has found a link between rejection sensitivity and a small but significant increase in the risk of aggression toward others, especially if they are very invested in their relationships. This is thought to be because of the defensive motivational system (DMS).

In situations in which rejection is a possibility, the DMS theory proposes that someone with high rejection sensitivity is more likely to act aggressively in "self-defense."

Co-Occurring Mental Health Conditions

In addition to ADHD and autism, rejection sensitivity is associated with several other mental health conditions. These can include:

If you are being treated for any of these conditions, talk with your mental health professional about your reactions to rejection and rejection sensitivity. They can work with you to create a treatment plan suitable for your needs and help you manage your emotional reactions.

Healthy Ways to Deal With Rejection

Rejection can be painful, but there are healthy ways to deal with itincluding:

  • Feel the pain and acknowledge any loss: It’s OK to feel sad or disappointed over rejections such as losing a relationship or job. Feel your feelings so you can then work through them.
  • Reframe the situation: People with rejection sensitivity tend to blame themselves and take any slight as a major rejection. Reframe the situation in a way that does not blame yourself. Maybe the other person was simply too busy—that’s OK, now you can do what you want. By stepping back and reframing a rejection, you can minimize its emotional impact.
  • Take this as an opportunity to become resilient and bounce back: Rejection happens to everyone at various points throughout their lives. What matters is whether or not they let it derail them.
  • Keep going: Don’t let a rejection for a job or a place on a sports team derail your goals. Keep putting yourself out there and taking chances.

If rejection is a persistent issue, talk to a therapist. They can help you develop some tools to cope with it in a healthy way.


While rejection is often painful, for some people, the pain is so intense and so extreme that it goes above the typical emotional response. This is rejection sensitivity. It is often associated with neurodevelopmental and mental health conditions like ADHD, autism, and depression, but can also occur by itself.

While your reaction to rejection is painful, there are ways to deal with rejection that may help to manage your feelings until they pass.

A Word From Verywell

Rejection sensitivity is very real. Knowing more about rejection sensitivity or RSD can help you recognize what is happening and provide you with a framework from which to approach your emotions. If it is causing distress, ask your healthcare provider for a referral to a mental health professional to help you with rejection sensitivity.

Frequently Asked Questions

  • How do people with rejection sensitivity feel?

    RSD is very painful—almost to the point of physical pain, in which a person can feel like they were punched. The feelings about the real or perceived rejection are much more intense with RSD than a typical emotional response. It can almost feel unbearable to a person.


  • Can you have rejection sensitivity dysphoria without ADHD?

    Yes, you can. While rejection sensitivity dysphoria is associated with ADHD, it is also associated with other mental health conditions (although not always).

  • What can you do for a partner with rejection trauma?

    "Rejection trauma" is a term used to describe the effects of growing up in a consistently rejecting environment. Rejection trauma can be challenging to live with, and you can help your partner work through it. (A professional therapist should also be involved—you can only do so much.)

    Show your partner that you care about them and you are a stable support for them. Show up consistently for them. Let them know you appreciate them and they are valued. Maintain open communication so that misunderstandings are minimized.





11 Sources
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