American media personality Paris Hilton has revealed she suffers from rejection sensitivity dysphoria (RSD), a condition she says is common among people with ADHD. Hilton, who has been diagnosed with ADHD, described the impact of RSD on her mental health as “like a demon in your mind” and “extremely painful”.
However, RSD is not a recognised clinical condition in diagnostic manuals. Experts suggest Hilton may be referring to two related psychological concepts: emotional regulation and rejection sensitivity. Emotion regulation refers to a person's ability to manage emotional reactions, while rejection sensitivity involves strong emotional responses to perceived rejection, such as anger, shame, or defensiveness.
Research indicates that 25% to 45% of children with ADHD and 30% to 70% of adults with ADHD have difficulties with emotion regulation. These difficulties can manifest as catastrophising, blaming others, and feeling vulnerable to rejection. Brain studies have shown that people with ADHD may be hyper-vigilant to threats and have heightened brain reactions to rejection.
Rejection sensitivity is also linked to other conditions such as autism, borderline personality disorder, depression, and anxiety, though it manifests differently in each. For example, people with ADHD may become emotionally reactive, while autistic individuals may withdraw.
While some ADHD medications can temporarily relieve emotional distress, they do not cure rejection sensitivity. Experts recommend focusing on building supportive environments for people with ADHD rather than solely trying to resolve the condition.
