                Therapist Rant · Vol. 06
            

The “Thin Skin” Myth: Why One Wrong Look Ruins Your Week

You aren’t dramatic. You are experiencing RSD.

The Short Answer

**Rejection Sensitive Dysphoria (RSD)** is an extreme emotional response to real or perceived rejection, criticism, or failure. It is extremely common in ADHD and Neurodivergent brains. It is not a mood disorder; it is a neurological reaction where rejection is processed as actual physical pain.

Here is a scenario I hear in my office every single week.

You send a text to a friend. They don’t reply for three hours.

A neurotypical brain thinks: “Oh, they are probably busy.”

Your brain thinks: “They hate me. I was too much. I am annoying. Our friendship is over. I should block them before they block me.”

And then, when they finally reply with “Sorry! Was in a meeting!”, you feel a wash of relief so strong it makes you dizzy. But you are also exhausted. You just lived through a whole breakup that never actually happened.

This isn’t insecurity. It is Rejection Sensitive Dysphoria.

The Text Message Autopsy

RSD makes you an unreliable narrator of your own life. It takes neutral data and translates it into a catastrophe.

The Actual Message

“Hey, can we talk later?”

How Your Brain Read It

“YOU ARE IN TROUBLE. I AM LEAVING YOU.”

Why It Hurts Physically

For people with ADHD or high sensitivity, the brain lacks the mechanism to filter out emotional impulses. When you perceive rejection, your nervous system triggers the same area of the brain that handles **physical pain**.

That punch in the gut you feel? That chest tightness? That is real. You are not “being dramatic.” You are in pain.

How to Manage an RSD Spiral

1. Name It to Tame It: The moment you feel that stab of panic, say out loud: “This is an RSD flare.” Labeling it separates the biology from the reality.

2. The 24-Hour Rule: Do not respond to the text while you are spiraling. Your brain is in fight-or-flight. Wait until your heart rate comes down.

3. Ask for Clarification: It is okay to ask for safety. Try texting: “My brain is making up a story that you are mad at me. Can you just confirm we are good?”

Common Questions

Is RSD the same as Social Anxiety?

Not exactly. Social Anxiety is the fear of *future* embarrassment. RSD is an intense, unbearable reaction to a *current* perception of rejection. It hits faster and harder.

Can therapy fix this?

You can’t “cure” the way your brain is wired, but you can build a buffer. We work on building your “Internal Safety” so that one person’s opinion doesn’t have the power to destroy your entire sense of self.

Your sensitivity is real. But it doesn’t have to rule you.

Get Help with RSD

Maria