Rejection Sensitivity Dysphoria in the ADHD Child

Imagine you are a child sitting in a classroom next to your best friend. For every one time your friend is corrected you are corrected three or four times. Maybe you are the only student getting called out personally. Although to your mind you and your friend are behaving the same (you are best friends, after all), the teacher is relentlessly critiquing your behavior.

Now, imagine this happens to you every day, during every class, with every teacher. What do you tell yourself to reconcile this experience with what you know about the world?

  • “Teachers hate me.”
  • “I hate school. It’s torture.”
  • “I’m a bad person.”
  • “I’m must not be very smart.”
  • “I hate teachers.”

I have heard my son with ADHD say these remarks. As a mother and a teacher (and a homeschool mom), these are heartbreaking words, but they are common remarks for kids who have ADHD.

Rejection Sensitivity

Why? In addition to the sheer amount of corrections these kids receive from well-meaning teachers just trying to manage a classroom, they are more sensitive to this type of rejection. Dr. William Dodson, a board-certified adult psychiatrist in private practice at the Dodson ADHD Center in Denver, Colorado, explains that many — if not all — people with ADHD have an associated condition, something called Rejection Sensitive Dysphoria (RSD) that actually makes them more sensitive to correction.

The illustration that comes to my mind to describe the breakdown of self-esteem in a child with RSD is that of a candle burning at both ends. On one end the ADHD child causes more class (or homeschool family time) disruptions by talking out of turn, straying off subject, or zoning out. On the other end, the same child feels more deeply each negative comment about his or her behavior than a peer would have felt.

An article in ADDitude Magazine Online explains that RSD is an emotional response to perceived rejection, teasing, and criticism as well as to failure or falling short of a goal (even if it’s a self-inflicted goal). Kids allowed to wallow in this type of negative emotion eventually turn all of that anger in towards themselves. This, my friends, is the definition of depression. It’s no wonder that many children with ADHD begin the process of diagnosis by first being treated for depression.

That is how our journey began — in a counselor’s office. And, looking back over our journey so far, I think that was absolutely the correct move. Before we could even begin testing for ADHD, we had to find a counselor who could be another adult in his corner.  Also, driving him to the appointments each week sent a message to our son, “We acknowledge your pain. We want to help,” even when we did not know how to help.

Answers to RSD

So, what’s the solution? Even if I could, should I remove my son from every situation that could potentially make him feel rejected? Or, should I let the pendulum swing the other way and toss him into several situations that could potentially reject him and hope for him to become desensitized?

I think maybe the solution isn’t quite so obvious. There is a place in society for sensitive people. Our senses, after all, help to contribute to our perceptions and observations. They are what connect us to the world. But, an unhealthy over-sensitivity can get in between us and the world. Perhaps the best treatment plan is one that heals the emotional senses and helps us to perceive reality.

For our son (and probably for many with RSD), that means long-term counseling. We’ve had great luck with cognitive behavioral therapy in which the therapist gives assignments (i.e. keeping a journal, giving writing prompts, altering habits, etc.) and works with “who you are now” as opposed to continually rehashing events from childhood.

Another method we’ve used to cope with RSD is to be more mindful of who we are allowing to be in authority over our son. Although many adults are well-meaning, not all adults are capable or knowledgeable enough to separate ADHD behaviors from disobedience. For a child who is already keeping track of the number of negative corrections, it does him no good to receive extra comments from someone who doesn’t know he needs to move (or talk aloud) in order to think.

We have also worked to attain accurate diagnoses so we can specifically treat specific problems or disabilities. Children with ADHD often have comorbid disorders (i.e. dyslexia, dysgraphia, processing disorders) that stem from the same neurological location of the brain. Sometimes this collection of disorders is combined with high IQ, which can really muddy the water! It’s important to set goals that are attainable and to utilize assistance when needed. A quote typically attributed to Albert Einstein says:

Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.

For a child who is already keenly aware of failure, the last thing you want to do is set impossible goals.

Finally, I think it’s important to remember that, ultimately, you (the parent) are not in control of the outcome of your child’s upbringing. Yes, you are responsible — obligated — to set your child up for success. We do this by:

  1. Setting the right atmosphere — one with attainable goals and assistance when needed.
  2. Instilling in them a discipline of good habits. For the ADHD child sometimes that means externalizing reminders & rewards as well as creating habits of gratitude and productivity.
  3. Providing living resources (books, audiobooks, experiences, etc.) that inspire your child to think and learn dynamically instead of using repetitive, canned, information.

You only control what you put into your child. You do not (and, honestly, would not want to) control what comes out. Each child is an individual — a born person, as Charlotte Mason would say. With the right help and plenty of love and support, you will be pleasantly surprised someday to find that your ADHD child has grown into the adult (quirks and all!) who you never knew you were creating.

Until next time, I’m reading:


Moderately challenging books:

Stiff books:


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