Rejection sensitivity dysphoria (RSD) is a term used to describe intense emotional distress in response to rejection — whether it is real, perceived, anticipated or unclear.

For autistic and AuDHD people, this might involve feeling criticised, misunderstood, excluded, unwanted or socially unsafe.

Rejection-related distress can feel intense, overwhelming and exhausting.

For some autistic people, these responses may be shaped by repeated experiences of exclusion, criticism, misunderstanding or invalidation.

Why can it hurt so much?

Rejection-related distress can feel intense, overwhelming and exhausting.

For some autistic people, these responses may be shaped by repeated experiences of exclusion, criticism, misunderstanding or invalidation.

What can it feel like?

Rejection-related distress can affect thoughts, emotions and behaviour.

It might involve:

sadness • fear • anger • shame • guilt • panic • self-blame

There may also be a strong need to work out what went wrong, seek reassurance or repair the relationship.

It doesn’t require obvious rejection. Sometimes the trigger is clear: criticism, conflict or exclusion. Other times, the distress comes from uncertainty — not knowing whether someone is upset, disappointed, withdrawing or rejecting you. Ambiguous social cues can leave a lot of room for worry and interpretation.

Triggers can include:

• criticism or constructive feedback

• mistakes, perceived failure or evaluation

• exclusion, teasing, conflict or disapproval

• being ignored or left out

• delayed or brief replies

• cancelled or changed plans

• a change in someone’s tone or behaviour

• unclear facial expressions or social cues

• feeling someone is angry, disappointed or pulling away