Dysphoria

"I feel rejection far more intensely than most people.”

The last time I lost a relationship to ADD issues, I reflected long and hard about what I’d done wrong, and for the obvious reason – I had made the same mistakes I’d made in the past, and I wanted to stop making them.

One fact stood out: we’d had a big argument (about what, I still have no idea), and it was bad enough that she was furious with me; but the stand-out fact was that over the next few weeks, she gave me several opportunities to set things right – and I fumbled every one.

I kept reflecting, and thought farther back, to the two previous ADD relationship-enders. In both cases, my partner had given me multiple opportunities to fix things. One gave me eight months – and I still blew it.

Aha! I thought. Now we’re onto something.

Parsing this realization, one thing stands out: the period of time following each rift was, to put it mildly, an on-going anxiety storm. I can remember feeling the world crashing down around me, demolishing my peace of mind, my self-esteem, and my belief that I was even worthy of love. At work and with friends, I felt like I was sleep-walking; in interactions with my estranged partner, I must have seemed overbearing and desperate – and in each case, there came a point at which she said, “Enough!”

An anxiety storm – well, that was something I could work with. I started digging into the ADD research.

It didn’t take long. It turns out there’s something called rejection-sensitive dysphoria.

Rejection-sensitive dysphoria (from the Greek word dysphoros, meaning ‘too difficult to bear’) is a strong and sustained emotional response, akin to fear, occurring in the wake of rejection or abandonment. Almost 100% of those adults with ADD have experienced RSD at one time or another, in the course of trying to maintain their relationships, and many have experienced it over and over.2

Per WebMD, the effects of this dysphoria are severe anxiety and diminished self-esteem, often accompanied by a pervasive feeling of hopelessness. Other symptoms include emotional outbursts, social discomfort, and contemplation of self-harm or suicide.

A person with RSD will tend to be easily embarrassed, more uncomfortable in their own skin than they already were. They will try to ‘earn’ their way back into the world through performance, and set impossibly high standards for themselves – and then punish themselves when they fail to meet them.

These symptoms resemble those often seen in bipolar disorder, PTSD, OCD, and depression. Unlike those, however, RSD is temporary; the anxiety storm passes after several weeks or months.

How does RSD come about? Put simply, it’s the surfacing of a vast reservoir of feelings that an ADD individual has accumulated since childhood. From an early age, they have been mocked or teased or otherwise made to feel excluded by other children, and have suffered endless disapproval from the adults in their lives, from teachers to camp counselors, and often within their own families. They have wrestled with the devastating effects of constantly being labeled ‘trouble’ or ‘difficult’. By the time an ADD child finishes middle school, they have experienced thousands more negative comments and interactions than their non-ADD peers, from all sides – and this is on top of having far fewer friends, supportive adults and inclusive experiences in the first place. Is it any wonder that such a child grows to be an adult whose self-worth and lovability are easily knocked askew? Any rejection – even an imaginary one! - swiftly brings those many years of feeling inadequate right to the surface, upsetting the equilibrium of an already-precarious life.

More than one-third of adults with ADD say that rejection-sensitive dysphoria is the most difficult part of living with ADD (I’m one of them).

Have you felt that way? Has rejection by a partner or abandonment by a friend left you wondering how anyone could ever love you in the first place, and made you want to crawl into a hole? What did that episode do to your life?

Clearly, no one should ever have to go through such a thing. It’s a good idea to go over this one with a friend or partner before it ever occurs. It’s important to stress that RSD is something that almost all ADD individuals experience, not a feature of your own personality:

“There’s a thing you should know about people like me, who have ADD: we sometimes feel a sense of rejection even when it isn’t justified, and we can over-react. I’m really not a drama queen, I just might seem like one! If I begin acting that way, please just sit me down and bring it to my attention, and if there’s really something that needs work, we’ll do that work together.”