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What role does neurodiversity play in the experience of RSD in ADHD? 

Author: Dr. Rebecca Fernandez, MBBS

The concept of neurodiversity recognises that brains work in different but equally valid ways. For people with ADHD, this difference often includes intense emotional responsiveness and a heightened sensitivity to social cues. Rejection Sensitivity Dysphoria (RSD), which describes the sharp emotional pain that follows perceived criticism or rejection, reflects how these neurological differences influence emotion and self-perception. 

According to NICE guidance (NG87), ADHD is associated with differences in emotional regulation, impulse control and attention that can make rejection feel more threatening. The Royal College of Psychiatrists notes that emotional lability and low frustration tolerance are part of the neurodevelopmental profile of ADHD rather than separate personality traits. 

How neurodiversity shapes emotional experience 

Neuroimaging research in Frontiers in Psychiatry shows that people with ADHD process emotion differently because of altered communication between the prefrontal cortex, which regulates emotion, and the amygdala, which detects threat. This means emotional experiences are felt more vividly and take longer to settle. When someone perceives criticism or disapproval, the response can feel immediate and overwhelming. 

Rather than seeing this as overreaction, neurodiversity framing recognises it as a product of a uniquely sensitive brain network. Understanding this helps shift the focus from blame to self-acceptance and supportive strategies. 

Social context and masking 

The social expectations placed on neurodivergent individuals often intensify RSD. Many people with ADHD describe masking, where they hide their true reactions to appear calm or typical. This effort can be exhausting and heighten internalised shame when rejection occurs. NHS guidance highlights that consistent misunderstanding or stigma around ADHD can erode confidence and reinforce fear of criticism, fuelling the emotional intensity of RSD. 

Supporting neurodiverse emotional regulation 

Effective management focuses on building self-understanding rather than suppressing emotion. 

  • Psychoeducation helps individuals and families see emotional sensitivity as part of neurodiversity, not a flaw. 
  • Cognitive Behavioural Therapy (CBT) and mindfulness techniques support awareness of emotional triggers and promote self-compassion. 
  • Coaching and peer groups for neurodivergent adults and students provide validation and shared strategies for navigating social environments. 

Private services such as ADHD Certify provide structured ADHD assessments and post-diagnostic reviews that can support individuals in understanding their emotional profiles within a neurodiversity-affirming framework. 

The takeaway 

Neurodiversity shapes how people with ADHD feel, interpret and recover from rejection. Viewing RSD through this lens encourages compassion, self-awareness and inclusive care, helping individuals move from self-criticism toward emotional confidence and acceptance. 

Dr. Rebecca Fernandez, MBBS
Author

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy. 

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