When One Comment Ruins Your Day: Rejection Sensitive Dysphoria at Work
In my coaching work with adults with ADHD, there is something that shows up quite often - sometimes it’s spoken out loud, sometimes it’s hidden behind competence and professionalism but often accompanied by a great deal of quiet suffering. It’s the intense sensitivity to rejection, criticism, or the feeling of having disappointed someone. And in the workplace, this sensitivity can become especially painful.
Many of us don’t struggle at work because we lack motivation, skills, or resilience. We struggle because we care deeply. A short comment in a meeting, a slightly critical email, a manager’s tone, or a piece of feedback that feels ambiguous can be enough to send our nervous system into overdrive. What might register as constructive feedback for someone else can feel like a personal collapse for us.
What we’re often experiencing in these moments is something commonly referred to as Rejection Sensitive Dysphoria, or RSD. While it is not a formal diagnosis, the term captures a very real pattern that many people with ADHD recognize instantly once they hear it. It finally puts words to something that has shaped our working lives for years.
When criticism at work feels physically painful
One client once described workplace criticism to me as feeling like a physical stab in the stomach. She is intelligent, conscientious, and deeply committed to doing good work. Yet because she is so afraid of making mistakes or disappointing others, she spends two to three times as long on tasks as her colleagues, checking and refining every detail. Not because the work requires it, but because the emotional stakes feel so high.
And still, when feedback comes, it doesn’t land as neutral information. It lands as proof that she has failed. Afterwards, she cannot simply move on. She replays the situation again and again in her mind, questioning what she said, how she sounded, and what the other person really meant. The emotional pain lingers until the next perceived mistake comes along and replaces the old one. Criticism doesn’t fade for her. It stays in her body.
What is Rejection Sensitive Dysphoria?
Rejection Sensitive Dysphoria describes an extreme emotional response to real or perceived rejection, criticism, or failure. What makes RSD so distressing is not only the intensity of the emotion, but how suddenly it appears. The reaction often bypasses rational thought entirely. Within seconds, the nervous system reacts as if a serious threat has occurred.
Many people experience this response as physical pain: tightness in the chest, a sinking feeling in the stomach, heat rushing through the body, dizziness, or an overwhelming urge to escape the situation. Shame, self-blame, emotional shutdown, or anger turned inward are common. Most of us know on a cognitive level that our reaction is disproportionate but knowing that rarely stops it. Instead, it often adds another layer of suffering: the belief that we shouldn’t be reacting this way at all.
What does research say about RSD?
Although RSD is not listed as a standalone diagnosis in the DSM-5 or ICD-11, it is closely linked to what research increasingly recognizes as a core aspect of ADHD: emotional dysregulation. ADHD is no longer understood solely as a disorder of attention or impulse control. Heightened emotional reactivity, difficulty regulating intense feelings, and increased sensitivity to stress are now widely acknowledged as central features of the condition.
There is also a substantial body of research on rejection sensitivity, the tendency to anxiously expect, perceive, and overreact to rejection. While this concept originally emerged from attachment research, studies suggest that people with ADHD are particularly vulnerable. This vulnerability likely arises from a combination of neurobiology and lived experience.
Why are people with ADHD especially vulnerable?
On a neurobiological level, ADHD involves differences in dopamine and norepinephrine regulation, neurotransmitters that play a role not only in attention and motivation, but also in emotional stability and reward processing. In the workplace, criticism or perceived disapproval can feel like a sudden withdrawal of safety, connection, or value. The brain interprets feedback not as information, but as danger.
Equally important is history. Many people with ADHD grow up receiving frequent correction, criticism, or negative feedback long before they understand that their brain works differently. Over time, comments like “You’re too sensitive,” “You’re not trying hard enough,” or “You always mess this up” can crystallize into a deeply internalized belief: something is fundamentally wrong with me. Work environments, with their evaluations, hierarchies, and unspoken expectations, often reactivate this belief with painful precision.
How RSD shows up in daily work life
In daily professional life, RSD can appear in subtle but far-reaching ways. Some of us avoid feedback or visibility altogether, staying quiet in meetings or hesitating to ask questions. Others overprepare, overwork, or strive for perfection as a form of emotional self-protection. Some withdraw emotionally after criticism, mentally disengage, or fantasize about quitting after a single difficult interaction.
What makes RSD particularly challenging in the workplace is the expectation to be professional and resilient at all times. There is rarely room to acknowledge that for some nervous systems, feedback lands much harder. And so the struggle remains invisible, carried quietly from meeting to meeting, email to email.
What helps when dealing with RSD at work?
The first and most important step is understanding. When we realize that RSD is a known pattern linked to ADHD and nervous system sensitivity, and not a personal flaw, something begins to soften. The experience becomes contextualized rather than moralized.
Learning to recognize early signs of an RSD reaction can also be transformative. Often the body signals distress before the mind spirals: a sudden tension, a familiar rush of heat, the urge to withdraw or defend. Noticing these moments can create a pause, and sometimes that pause is enough to prevent a full emotional cascade.
Because RSD is deeply embodied, strategies that focus only on changing thoughts are often insufficient. When the nervous system is overwhelmed, logic has limited access. Grounding, breathing, gentle movement, and sensory regulation can help calm the physiological surge when words and reasoning no longer reach us. Regulation comes first; reflection can follow later.
Over time, working on self-worth outside of performance also makes a profound difference. Many people with ADHD have learned, often unconsciously, to tie their value to productivity, approval, or harmony. When our sense of worth becomes more stable, moments of criticism lose some of their existential weight.
Therapy and medication: Do they help?
Therapy and ADHD-informed coaching can support this process, especially when they focus on emotional regulation, self-compassion, and relational patterns. Some people also find that ADHD medication reduces emotional reactivity, making RSD episodes less intense. As always, this varies from person to person and should be explored carefully with a qualified professional.
A final thought
Rejection Sensitive Dysphoria is not a side issue in ADHD. For many of us, it is one of the most painful and limiting aspects of our professional lives, quietly shaping how we work, relate, and see ourselves.
And yet, it is also an area where meaningful change is possible. Not through toughening up or suppressing emotions, but through understanding, gentleness, and learning how to work with a sensitive nervous system rather than against it.
When we stop treating emotional intensity as a flaw and start recognizing it as part of a neurodivergent reality, something shifts. There is more room for self-compassion, more choice in how we respond, and more possibility for a working life that feels not just productive, but emotionally sustainable.
If you need extra help and support with your ADHD symptoms, book a free discovery call - and we can figure it out together!
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