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The word ‘no’ can easily be shrugged off by most – but for people living with ADHD, just the thought of hearing those two-letters can trigger fear-induced paralysis or even physical pain.
It’s a phenomenon known as rejection sensitivity disorder (RSD) and while it’s not an officially recognised medical condition or diagnostic criteria of neurodivergence, it’s commonly experienced by people with both attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).
It manifests as an extreme fear of rejection, and can see sufferers end friendships over perceived slights or fear of abandonment, decline invitations to try new things for fear of failing, avoid exploring new career opportunities or business opportunities and even stay in unhappy, toxic relationships for years too long.
It’s a concept that Alex Partridge, author of new book Why Does Everybody Hate Me? is painfully familiar with, which might come as a surprise to some people.
On paper, Partridge, 37, doesn’t seem like the sort of person who would struggle with confidence, decision-making or self-belief – and to his army of social media followers, he appears to brim with confidence.
He is undeniably successful, and his CV is impressive. He founded social media behemoths UNILAD and LADbible when he was a 21-year-old university student, and is now best known for fronting ADHD Chatter, one of the UK’s top mental health podcasts, which is listened to by millions of people across the world every week.
But appearances can be deceiving.
Speaking to the Daily Mail, he said: ‘I wasn’t aware of it at the time, but I’d go as far as to say that RSD nearly killed me.
Rejection Sensitivity Disorder can ruin friendships – sometimes over nothing
‘I drank myself into hospital on numerous occasions, and it all could have been avoided if I had known how to set boundaries – but I found saying “no” to people too scary.’
Like thousands of Britons – particularly women – Alex didn’t discover that he has ADHD until he was an adult, getting his diagnosis at the age of 34.
American psychiatrist William Dodson has theorised that between birth and the age of 12, children with ADHD receive 20,000 more negative or corrective messages than their neurotypical peers – and it creates the perfect conditions for RSD to take root.
‘Some of the negative comments ADHD children hear are “Why are you so emotional? You’re too dramatic. Stop fidgeting. You’re too sensitive. Calm down. Be normal. Why are you so weird, why are you too much?”‘ said Alex.
Alex Partridge has penned a book about rejection sensitivity disorder
‘When you are bombarded with all of these extra criticisms, your nervous system almost anticipates and expects to receive more.
‘That’s where the “dysphoria” in rejection sensitivity dysphoria comes from, because often you’re turning something that isn’t really a criticism into a big one, because you just expect it.’
It present as someone hugely overreacting to ‘small’ things – a change in a partner or friend’s tone of voice, a manager asking to have a ‘chat’ about an ambiguous topic, being given constructive feedback, or someone replying to a long text with a short answer or a thumbs-up emoji all have the power to make someone with RSD fall into a blind panic or lash out.
People with RSD often fall into people pleasing – putting others’ needs and wants ahead of their own – as they do not want to be rejected or to be caught up in any sort of interpersonal friction. It can make them vulnerable to being taken advantage of by unscrupulous ‘friends’ and ending up trapped in abusive romantic relationships.
And, as the title of Alex’s new book perfectly describes, RSD often causes a low level hum in the back of your mind that everyone you meet thinks you’re an idiot and doesn’t really want you around.
Alex isn’t the only person in the public eye who has spoken about struggling with a pathological fear of rejection.
In January, Paris Hilton, 44, spoke about how being diagnosed with ADHD in her late twenties had affected her life and that she had no idea that some of the symptoms she had been experiencing were classic signs of RSD.
Speaking on the Skinny Confidential Him and Her show podcast, she described it as ‘almost like a demon in your mind that is like saying negative self-talk to you.’
Frustratingly for people with RSD – and especially for the people close to them who want to see them thrive – these negative messages and their harsh, critical internal dialogue can stop them from fulfilling their potential or enjoy all that life has to offer.
‘RSD will suck the potential out of people, because over the years, you’ve learned that it feels safer not to try,’ said Alex.
‘It’s tragic because you don’t start that business, or you don’t apply for that promotion. We avoid the conversations we should have with a partner to get out of a relationship that isn’t making us happy anymore.
‘It can look like not doing things that you’re capable of doing, including projects, hobbies and fun things, because you’re scared of the feedback that the world will give you if you try.’
But this isn’t to say that RSD causes people to hide away in the shadows for fear of being noticed – when it is triggered, it can cause explosive behaviour.
‘RSD can cause an instant reaction,’ Alex explained. ‘When it is triggered, the logical part of the brain just completely shuts down.
‘I think it is the hardest part of having ADHD and why so many people struggle to maintain friendships, jobs and sabotage and break up their relationships.
‘Sometimes you say stuff you can’t come back from, or you are too embarrassed to address the outburst when you’ve calmed down. That’s the most heartbreaking thing about it.’
Confusingly for the people on the other side of the RSD meltdown, they often have no idea what has caused their friend or partner to act in this way, which is why Alex believes communication about potential triggers and being open about being neurodivergent and how it affects you is important.
It could be as simple as explaining that responding ‘sure’ to an invitation is too ambiguous and you need to hear more enthusiasm, or to be clearer in explaining what you want to talk about when you ask to ‘have a chat’.
Alex shares several coping strategies for navigating RSD in his book – although he admits that ‘when you are triggered, quite often you forget them because you just all you care about is the feeling and reacting to it.’
His main piece of advice is to remember that when RSD rears its (often ugly) head, you’re not really angry at the situation or person in front of you.
‘Remind yourself “this is me responding to 20,000 horrible comments that weren’t my fault, and therefore, the big feelings I’m feeling today are also not my fault”,’ he said,
‘It will help reduce some of the internal shame and be kinder to yourself.’
Why Does Everybody Hate Me? by Alex Partridge is out now.