How can I cope with rejection sensitivity in ADHD?

PostedDecember 22, 2025

UpdatedDecember 30, 2025

ByMy Patient Advice

Author: Victoria Rowe, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

If you find that even gentle criticism or feeling left out hits harder than expected, you may be experiencing rejection sensitivity, sometimes known as rejection sensitive dysphoria (RSD). According to NHS guidance, this intense emotional response is common in ADHD and can make relationships and self-confidence harder to manage.

What causes rejection sensitivity in ADHD?

RSD happens when the brain’s emotional regulation systems react strongly to perceived rejection, criticism, or exclusion. People with ADHD are more prone to it due to differences in brain regions linked to emotion and self-control (PubMed, 2024). NICE guidance (NG87) and Mind UK explain that these reactions often overlap with emotional dysregulation, intense feelings that arise quickly and take longer to calm down. Repeated rejection experiences can also lower self-esteem and increase anxiety around social feedback (NHS Dorset, 2024).

Ways to manage rejection sensitivity

Try CBT to challenge negative thoughts

Cognitive behavioural therapy (CBT) can help people with ADHD reframe critical feedback, separate emotion from interpretation, and practise problem-solving steps that reduce the intensity of rejection.

Build emotional balance through DBT and mindfulness Dialectical behaviour therapy (DBT)

teaches distress tolerance, mindfulness, and self-compassion, helping reduce the emotional surge that follows rejection. Mind UK and recent PubMed reviews (2025) show DBT, and mindfulness-based training can improve tolerance for uncomfortable emotions and rebuild confidence over time.

Strengthen self-esteem and connection

NHS and RCPsych guidance recommend focusing on self-esteem building, peer support, and psychoeducation to understand how rejection sensitivity works and reduce shame. Learning communication and self-advocacy skills helps soften the impact of negative feedback and maintain perspective (NHS GM ADHD Report, 2025).

Combine professional support with structure

Therapy-based coaching programmes like Theara Change can reinforce emotional regulation techniques, while assessment services such as ADHD Certify provide medication and treatment reviews in line with NICE recommendations.

Takeaway

Coping with rejection sensitivity in ADHD starts with understanding that it is not overreacting; it is a valid emotional response tied to how ADHD affects the brain. According to the NHS and NICE, combining CBT, mindfulness, DBT, and self-esteem support can help you process criticism more calmly and strengthen your confidence over time.

Victoria Rowe, MSc

Author

Victoria Rowe is a health psychologist with a Master’s in Health Psychology and a BS in Applied Psychology. She has experience as a school psychologist, conducting behavioural assessments, developing individualized education plans (IEPs), and supporting children’s mental health. Dr. Rowe has contributed to peer-reviewed research on mental health, including studies on anxiety disorders and the impact of COVID-19 on healthcare systems. Skilled in SPSS, Minitab, and academic writing, she is committed to advancing psychological knowledge and promoting well-being through evidence-based practice.

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.

Dr. Rebecca Fernandez, MBBS

Reviewer

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 reviewer's privacy.