What is Rejection Sensitive Dysphoria (RSD)?

Do you ever feel like your emotions are out of control, especially when it comes to rejection and failure? If so, you may be experiencing Rejection-Sensitive Dysphoria (RSD), an intense emotional sensitivity triggered by real or perceived rejection from people who matter to you or a sense of failure. 

While many people may feel disappointed or hurt when they experience rejection, for those with RSD, the consequences can be devastating and far more intense. Don’t let RSD control your life; seek help and support to manage your emotions and live life to the fullest. 

Signs of RSD:

Those with Rejection Sensitive Dysphoria (RSD), may experience the following:

• Become highly emotional when they experience real or perceived rejection.

• Often try to please people around them.

• Tend to avoid situations where there may be a risk of failure or rejection.

• Experience and display sudden outbursts of emotions.

• May face difficulties in maintaining relationships.

• Have low self-esteem and often experience self-doubt.

Causes of RSD:

The causes of RSD (Rejection Sensitivity Dysphoria) are not well understood, yet studies have found that people with ADHD are more likely to exhibit symptoms of RSD. This is mainly due to the fact that RSD is associated with reduced capacity in the regions of the brain that handle emotions and respond to critical messages or failure. These areas, such as the prefrontal cortex and amygdala, may also be affected in individuals with ADHD.

Symptoms of RSD:

Although Rejection Sensitive Dysphoria (RSD) is not yet officially recognized as a diagnosable condition, individuals who exhibit RSD tend to display some common symptoms.

These may include the following psychological symptoms:

  • Low self-esteem and self-doubt
  • Negative self-talk
  • Engaging in frequent rumination
  • Setting overly high standards for oneself
  • Feeling easily triggered towards guilt or shame

These may include the following behavioural symptoms:

  • Become highly emotional when experiencing real or perceived
  • Often engage in people pleasing behaviours.
  • Avoid situations where there may be a risk of failure or rejection.
  • Experience and display sudden outbursts of emotions.
  • Withdrawing from social situations.
  • Relationship difficulties, particularly when feeling attacked and
    responding defensively.
  • May engage in lying or “covering up” to not be perceived as failing.

Responses or Types of Rejection Sensitive Dysphoria (RSD):

Do you struggle with Rejection Sensitive Dysphoria (RSD)? If so, you may notice two common types of responses that you exhibit in high-stakes social situations. These responses are:

  • people pleasing and
  • a ‘why bother’ mindset

However, don’t worry – you’re not alone. Many people with RSD experience these same responses. So, if you want to learn more about these two types of responses and how to overcome them, keep reading. We’re here to help you navigate social situations with confidence and ease.

The People Pleaser

A person with this rejection sensitive dysphoria response will find themselves frequently falling in to the pattern of people pleasing. They may go above and beyond to present a polished and often untrue version of themselves to people they care about, and aspire to gain another persons approval and praises.
For this type of person, the goal to gain others approval and making sure others aren't displeased with them may result in loosing their own identity, ignoring their own wants and needs, as it is more important to appear competent to those they admire, than it is to be true to themselves.

The "Why Bother" Type

A person with this rejection sensitive dysphoria response will find themselves frequently giving up before even starting. Even the slightest possibility of failure results in this type of person finding a reason to not try at all. For this person, trying and potentially failing (even when unlikely) is too risky and painful, and as such they may opt out from any situation they don’t feel 100% confident in. This could include anything from educational activities, dating, applying for new jobs or reaching for promotions. Often these individuals are incredibly skilled/talented, but are ‘held back’ as they don’t have the confidence to pursue new tasks or situations

Treatment Plan for Rejection Sensitive Dysphoria (RSD)

It is important to understand your treatment options when it comes to seeking help for RSD.

There is some evidence to say that Rejection Sensitive Dysphoria (RSD) can respond well to some types of medications. This is particularly true if you have been diagnosed with ADHD.

However, for others, it is often a combination of strategies and therapeutic work that will make the biggest difference when addressing RSD.

How we help those with Rejection Senstitive Dhyphoria (RSD)

Our dedicated team of Clinician are experienced and clinically trained to offer tailored Treatment Plans for those struggling with RSD. While your plan is suited to your individual presenting needs, a general treatment plan would include working through and developing the following areas: 

Building Confidence and Self Esteem

A common symptom of RSD and something that tends to worsen the prevalence of RSD is low confidence, self-esteem, coupled with high self-doubt. By working on strategies to build up your confidence you will often experience less of an emotional response to real or perceived rejection.

Overcoming People Pleasing

People pleasing behaviours are very common in individuals experiencing RSD. By working on strategies to minimise engagement in people pleasing behaviours, you are less likely to fall in to the pattern of looking to others for validation.

Learning about Warning Signs

It can be helpful to learn more about your own warning signs when feeling uncomfortable and anxious. These warning signs may look like negative thoughts and negative self talk, or physical sensations such as a tightness in the chest or “pit in the stomach” feeling. The earlier you can recognise your own warning signs, the more control you have over addressing them before they take control of your emotions.

Identify your Professional Support Network

RSD can be incredibly challenging to tackle on your own. If you find that nothing is working for you when trying strategies on your own, it can be a good idea to seek support from a psychologist or counsellor. 

How long is a typical Treatment Plan

A typical Treatment Plan solely for Rejection Sensitive Dysphoria (RSD) may require on average 10-15 sessions, however some clients may require less and some may require more – everyone is different. 

The duration of therapy depends on each indiviudal and we assess this at Initial Consultation, where you will be advised on how many sessions you may be looking at, how often and we will provide you with an estimate of the cost.

What age group is this Treatment Plan suited to?

Here at Brain Training Australia, we work with teens (14 years+) and adults presenting with Rejection Sensitive Dysphoria (RSD). 

How is the Treatment Program delivered?

Our Cognitive Behavioural Therapy (CBT) for Rejection Sensitive Dysphoria (RSD)  is delivered by phone or Telehealth only so clients can enjoy the experience of therapy from the comfort of their own home, on their lunchbreak, in their garden or at the beach – wherever their are.

We just ask for you to be free from loud noisey areas and to have a good wifi signal.   

From our experience, we prefer to do the Initial Consultation via Telehealth (video) and from there we have found a large population of our clients prefer phone support as they don’t need to dress up or present themselves in a polished way (this is especially useful for People Pleasers to support their therapeutic process!!). However, we work with your own indiviudal preference and what you feel comfortable with. 

How much does a Treatment Plan for Rejection Senstitive Dysphoria (RSD) cost?

The total cost really depends on how many sessions you will need, which we advise you of at Initital Consutlation. 

We do not ask for you to commit to a plan and pay for that plan in advance. 

Each appointment is charged at $150 per 50 minute session, and payment is required at the end of each session. This service can be provided by our Psychologists, Counnsellors and Mental Health Occupational Therapists.  In between sessions with your Clinician, clients are provided with worksheets to prompt the Cognitive Behavioural Therapy (CBT) for Rejection Sensitive Dysphoria (RSD). This helps our clients get the most from their therapeutic experience. If you are a client who does not enjoy homework, then you can work through these exercises during your sessions with your Clinician who can guide you through the process. 

At your Initital Consultuation appointment, we will advise you of what your plan will look like in terms of:

– how many sessions 

– how frequent your sessions need to be

– we will help you book your Treatment Plan, for days and times convenient to you. Payment is not required to secure your dates. You only pay at the end of your actual session, on the day of your session.  

For more information see our fees page. 

How do I get started?

Book online for an Initital Consultation with a member of our Counselling and Psychology Team. 

We conduct a Mental State Examination in every Initital Consultation and we will be able to screen for RSD alongside any other presentations / challenges you may be experiencing.

If you don’t feel ready yet to book in your first appointment, simply send us a message on whatsapp, email or on any web form and just say RSD – will will get in touch to help you make your first appointment.

How do I book in?


We look forward to seeing you there and supporting you your mental wellness.