Your manager writes "can we chat later?" with no other context.
You have now been dead for approximately six hours. You've reviewed every piece of work you've submitted this quarter. You've drafted three apologies for unknown offences. You've considered whether you should quit before you're fired. Your body has committed fully - heart rate up, stomach gone, the specific full-body dread usually reserved for actual emergencies.
The chat, when it happens, is about parking.
If you've lived this, we should talk about rejection sensitive dysphoria.
WHAT RSD ACTUALLY IS
RSD describes an extreme, physically felt reaction to perceived rejection, criticism, or failure. It's most commonly discussed in relation to ADHD, where estimates suggest a substantial majority of adults experience it to some degree.
A note on the terminology, because I'd rather be accurate than tidy: RSD isn't a formal diagnosis in the DSM. It's a descriptive term that emerged from clinical observation, and there's ongoing debate about whether it's a distinct phenomenon or a specific presentation of emotional dysregulation, which is well-established in ADHD. Some clinicians dislike the term. I use it because it describes something real that people recognise immediately, and because having a name for it is often the first relief someone gets.
What isn't debated: emotional responses in ADHD tend to arrive faster, hit harder, and take longer to come down from. That part is solid.
The key features:
- It's fast. Not a thought process you can interrupt. The reaction is already complete before the reasoning arrives.
- It's physical. Chest, gut, throat, heat, nausea. People describe it as being winded. That's not metaphor.
- It's disproportionate to the trigger and you know it. Which adds a second layer of shame on top of the first one.
- It doesn't respond to evidence. You can hold twenty years of proof that you're competent and still be entirely certain, in the moment, that you're about to be found out.
- And crucially, the rejection doesn't have to be real. A short reply. A cancelled plan. A face doing something ambiguous. Someone not laughing at the right moment.
WHERE IT SHOWS UP
At work. Avoiding feedback entirely, or over-preparing to the point of exhaustion so there's nothing to criticise. Reading neutral messages as displeasure. Sometimes leaving jobs pre-emptively - not because of a problem, but because of an anticipated one.
In relationships. This one matters most and gets talked about least. RSD in a partnership looks like:
- Hearing "can we talk about something" as "I'm leaving you"
- Becoming defensive during small logistical conversations, then feeling awful about it
- Reassurance-seeking that never quite lands, because the reassurance is processed as politeness
- Apologising excessively, which puts the other person in the position of managing your distress about their mild complaint
- Not raising your own needs, because their potential rejection is unbearable
- Withdrawing hard and fast - the pre-emptive exit, leaving before you can be left
The painful part is the loop. Your partner raises something small. You react as though it were enormous. They learn that raising things is expensive. So they stop. Then resentment builds silently, which eventually produces the actual serious conversation you were afraid of in the first place.
In friendships. Reading a slow text reply as the end of a friendship. Slowly disappearing from group chats rather than risk being unwanted.
In therapy. Yes, here too. Some clients spend months being an excellent, easy, agreeable client because a therapist's disapproval feels catastrophic. Which is a real obstacle, and worth naming out loud early.
WHAT ACTUALLY HELPS
Not "developing thicker skin." I want to be clear about that, because it's the most common advice and it's useless. You cannot willpower your way out of a nervous system response.
Naming it in the moment. Not to talk yourself out of the feeling, but to change your relationship to it. "This is RSD. The feeling is real. The conclusion is not necessarily accurate." Weak-sounding, surprisingly effective with practice.
Delay before response. The rule I give most often: nothing important gets answered inside 30 minutes. Not because your feelings are invalid, but because the first draft is written by a threat response and the second one is written by you.
Telling your people. If your partner knows that "can we chat" costs you four hours, they can write "can we chat, nothing bad, it's about the car" instead. That is a two-second adjustment for them and a completely different day for you. This is not coddling. It's basic accessibility.
Working out where it came from. Many neurodivergent adults have decades of genuine feedback about being too much, too loud, too disorganised, too sensitive. RSD is not irrational in that light - it's a well-calibrated response to a history that actually happened. Grieving that history does more than managing the symptom.
Somatic regulation. Because it's a body event, body-based tools work better than arguing with yourself. Breath, cold water, movement, changing your physical position. Not a cure. But often the difference between sending the email and not.
Couples work. When RSD is shaping a relationship, doing it alone is doing it on hard mode. In couples sessions we work on both sides: how to raise things in a way that lands, and how to receive them without the floor falling out.
Medication, where relevant. Treating underlying ADHD often reduces emotional dysregulation meaningfully. That's a conversation for a physician or psychiatrist, not for me - but worth having.
WORKING WITH CINNAMON COUNSELLING
We offer ADHD therapy and coaching, individual counselling, and couples work from our Vancouver office at 525 W 8th Ave, plus virtual sessions across BC - Vancouver, Burnaby, Richmond, North Van and beyond.
This is a neurodivergent-affirming practice, which means we'll skip the part where someone explains ADHD to you. You've done the reading. We'll start from there.
Oliver the therapy dog has never rejected anyone and is unlikely to start.
If any of the above described a normal Tuesday for you, book a free consult.
