ADHD and RSD: Why Your ADHD Child May Be Sensitive to Criticism

Oct 02, 2023
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Have you ever noticed your child becoming unusually upset by criticism or feedback? It could be a connection between ADHD and a lesser-known phenomenon called RSD (rejection-sensitive dysphoria). Here’s what you need to know.

Have you ever wondered why your child with attention-deficit/hyperactivity disorder (ADHD) seems particularly hurt or upset after receiving even the most minor criticism? This sensitivity has a reason, and it goes beyond their emotional reactions. 

Rejection-sensitive dysphoria (RSD) is a little-known issue related to ADHD, and it can make life extra challenging for those with the condition. The board-certified pediatric providers at The Center for Advanced Pediatrics in Darien and Norwalk, Connecticut, specialize in helping kids with ADHD and their families succeed.  

Take a moment to dive deeper into your understanding of ADHD and RSD so you can better navigate this complex issue. 

A quick review of ADHD

Attention-deficit/hyperactivity disorder is a neurodevelopmental disorder often appearing in early childhood. It stems from a combination of genetic, environmental, and neurological factors. 

Research has shown that people with ADHD often have differences in brain structure and activity, particularly in areas responsible for attention and impulse control. Keep in mind that ADHD is not a one-size-fits-all diagnosis. There are three primary types of ADHD:

Inattentive type

Formerly referred to as ADD, children with this type mainly show signs of inattention and are easily distracted, often forgetting tasks and finding it challenging to organize their thoughts or tasks.

Hyperactive-impulsive type

Children with this type display hyperactivity and impulsiveness symptoms, including constant movement, excessive talking, and difficulty waiting their turn.

Combined type

This is the most common type of ADHD. Children with combined-type ADHD exhibit both inattentive and hyperactive-impulsive symptoms.

RSD and why it makes your child extra sensitive

Rejection-sensitive dysphoria is an intense emotional response caused by the perception — not necessarily the reality — of being rejected or criticized by important people in one's life. Many individuals with ADHD experience RSD, making them hypersensitive to perceived criticism or rejection. 

This response can lead to overwhelming feelings of shame, guilt, or anger. The heart of RSD isn’t just the fear of rejection — it’s the severe emotional pain that feels almost unbearable when perceived rejection occurs. 

For a child with ADHD, what may seem like a minor comment or feedback can trigger an intense RSD episode, making them feel devastated. But as overwhelming as RSD and ADHD might sound, it's essential to know that children can manage and even thrive with the right guidance and care. 

Navigating ADHD and RSD

Your provider at The Center for Advanced Pediatrics assists you and your child through this journey and creates a personalized treatment plan. Here’s a look at ways our team can help you and your family navigate ADHD and RSD:


This talk therapy can be invaluable in teaching your child coping strategies to manage and cope with their symptoms. Not only can your child benefit, but your entire family can undergo therapy sessions to better understand and support the child with ADHD's unique needs.

Cognitive-behavioral therapy (CBT)

Through CBT, children can recognize the negative beliefs, thought patterns, and behaviors associated with ADHD. This therapy empowers them to shift toward healthier thinking patterns and actions.


For some children, therapy might not suffice in managing the intense symptoms. In such cases, our team can prescribe medications that help reduce hyperactivity and boost focus at home and school.

In addition, The Center for Advanced Pediatrics team can actively collaborate with your child's teachers and caregivers. This collaborative approach ensures they have the tools and resources to help your child succeed academically and emotionally.

Navigating the challenges of ADHD and RSD might seem daunting, but with specialized care and understanding, your child can lead a fulfilling and thriving life. With the right support, knowledge, and coping strategies, you and your child can face these challenges head-on.

If you believe your child might be struggling with ADHD or RSD, or if you need further guidance, reach out to our team of experts who are here to guide and assist by scheduling an appointment online or over the phone at The Center for Advanced Pediatrics today.