# New Insights Into Rejection Sensitive Dysphoria - Author: **William Dodson, M.D.** - Document Tags: [[adhd]], [[Emotional Dysregulation]], [[Health Index]], [[Sensitive dysphoria]] - [URL link](https://www.additudemag.com/rejection-sensitive-dysphoria-adhd-emotional-dysregulation/)  ## Highlights - brain-based symptom that is likely an innate feature of ADHD. ([View Highlight](https://read.readwise.io/read/01hayrq8g3kg7t9kamwban1v90)) --- - One-third of my adult patients report that RSD was the most impairing aspect of their personal experience of ADHD, in part because they never found any effective ways to manage or cope with the pain. ([View Highlight](https://read.readwise.io/read/01hayrmgeapw91f8x1gnxgz2bh)) --- - can instantaneously appear as if they have a full Major Mood Disorder syndrome complete with suicidal thinking ([View Highlight](https://read.readwise.io/read/01hayrr6asp5pphf41e5rjhssw)) --- - Avoidance of social settings in which they might fail or be criticized (for this reason, RSD is often hard to distinguish from [Social Anxiety Disorder](https://www.additudemag.com/slideshows/social-anxiety-disorder-in-adults-with-adhd/)) - Note: what is the difference? ([View Highlight](https://read.readwise.io/read/01hayrstj2ya30w0sx20fewxb8)) --- - **Mood Disorder** **RSD and ADHD** Mood changes are untriggered; out of the blue Mood changes always have a clear trigger Moods are independent of what is going on in the person’s life Moods match the perception of the trigger Mood shift is gradual over weeks Mood shift is instantaneous Offset of mood episode is gradual over a period of weeks to months Episodes end quickly in a matter of hours Duration of episode must be > 2 weeks Episodes rarely last more than a couple of hours. - Note: oh... so def RSD and ADHD ([View Highlight](https://read.readwise.io/read/01hayryety2ns20q8eddkbwvrp)) --- - For clinicians who work with later adolescents and adults, the DSM-V criteria are almost useless because they ignore so much which is vital to understanding how people with an ADHD nervous system experience their lives. ([View Highlight](https://read.readwise.io/read/01hays3t0dpyfk2w8r2r7smm5w)) --- - emotional dysregulation was consciously excluded from the diagnostic criteria for ADHD and effectively forgotten for many years ([View Highlight](https://read.readwise.io/read/01hays7mb7pbvcfm3pqvy2nmzx)) --- - more inclusive term of emotional dysregulation (ED) instead of RSD ([View Highlight](https://read.readwise.io/read/01hays8gmtjb6q3ghz7kar48y3)) --- - ADHD as being divided into only two subtypes: the well-known inattentive type and an [emotional dysregulation type](https://www.additudemag.com/adhd-and-emotions-diagnosis-criteria-study/). ([View Highlight](https://read.readwise.io/read/01haysdnrep563h9a6tj09sgjc)) ---