Several years ago, I hosted a small dinner party—just three guests, good wine, delicious food, and stimulating conversation. As the evening wore on, the talk turned to communal gardening. The guests became increasingly animated about the idea of building a shared garden, something they could tend together and enjoy the fruits of, quite literally.
I offered up my backyard as a possible location, but made it clear that my involvement would stop there. I hate gardening—bugs, heat, aching muscles. Not for me. They laughed and carried on with their planning. I made a suggestion—nothing. I repeated myself—still, no acknowledgement. In the space of a moment, I felt myself shrink.
I was suddenly 15 again, feeling invisible. But this time, I was invisible at my own table, in my own home. Rationally, I knew they weren’t being cruel or intentionally excluding me. But emotionally, I was spiralling. I could feel my reaction intensifying, a collision of old wounds, my ADHD brain, and a few glasses of wine. I knew myself well enough to see what was coming: I could either explode—unleashing my anger and losing friends in the process—or retreat. I chose the latter. I quietly excused myself, went upstairs, and never returned to the table.
It took them almost 40 minutes to even notice I was gone.
In the aftermath, I knew my response had been disproportionate. It wasn’t just the moment—it was the emotional history that moment had tapped into. It was my ADHD, my impulsivity, and my difficulty regulating rejection and emotion. A few weeks later, a term I hadn’t encountered before popped up in my social media feed: Rejection Sensitive Dysphoria (RSD).
Although I’d done a considerable amount of reading on ADHD, this was new to me—and it resonated immediately. I dove in, looking for more information. Online forums, blogs, and ADHD communities were abuzz. Many described experiences that mirrored my own. I thought: if this fits me so well, maybe it fits my clients, too.
Most of my clients with ADHD were late-diagnosed, like me. Many had lived for decades under the weight of criticism, shame, and social exclusion—all before understanding how their brains worked. It seemed logical that they’d be especially sensitive to perceived rejection, not unlike the emotional vulnerabilities we see in clients with borderline personality disorder. And then, layer on emotional impulsivity—something Dr. Russell Barkley has covered extensively in his work (I highly recommend his YouTube video on the subject: Barkley on Emotional Dysregulation in ADHD).
All of this led me to conclude that RSD could be a useful concept in understanding my clients’ experiences.
But here comes the rant.
Despite the popularity of RSD in clinical circles, I couldn’t find a single peer-reviewed article on the topic. None. Not one. I even purchased a self-published book on RSD and its management. The author cited plenty of general ADHD websites—but no original studies. Worse, some sources referenced “doctors” whose degrees came from non-accredited institutions, and who had no background in human behaviour or clinical research.
So I asked myself: Where’s the research?
I turned to Google Scholar, my alma mater’s library, and Consensus AI—a search engine that combs through scientific literature. One promising hit: a master’s thesis. But, that was it. One solitary, unpublished thesis. Even today, Consensus AI search yielded the following reply: “We did not find any relevant research papers related to your search for ‘rejection sensitive dysphoria.’”
RSD, as I understand it, was coined by Dr. William Dodson, a psychiatrist specialising in ADHD. He observed that many of his clients experienced this profound sensitivity to rejection. And while I believe he was onto something important, anecdotal evidence—even from an experienced clinician—is not a substitute for systematic, peer-reviewed research.
So here’s my plea:
If you’re a clinician writing or speaking about RSD, please, ground your claims. Don’t let enthusiasm for a compelling idea outpace the evidence base. RSD may well prove to be a valid and valuable construct—we certainly need more research into the emotional lives of people with ADHD. But as of now, RSD is not a formal diagnostic criterion, and it is not an empirically established subtype of ADHD.
Let’s stay curious, open-minded, and evidence-informed. Let’s not conflate plausible with proven.
RSD may be studied one day—and I hope it is. But that day hasn’t come yet.
A Taylor'd Life 