Rejection Sensitive Dysphoria (RSD) and ADHD in Leadership and Entrepreneurship

Kaitlyn Boudreault
Jan 14
6 min read

Running a business is no easy feat, especially when you have ADHD.

The constant effort of monitoring how you’re perceived, anticipating feedback, and bracing for possible rejection can make even small interactions feel emotionally charged.

Sometimes, even a brief critique or a delayed email reply can disrupt your momentum, or the fear of rejection can stop you from pitching your ideas or showing up authentically.

If this experience resonates with you, you may be experiencing rejection sensitivity dysphoria, or an intense physical and emotional response to real or perceived rejection or criticism, which is a common experience that can make emotions difficult to manage.

You might notice it showing up as thoughts like, “What if they don’t like my pitch?” “What if my client says no?” or “I’m nervous about sending this proposal.” While everyone’s experience is unique, these fears are often rooted in rejection sensitivity and how it can shape how you respond to challenges and opportunities.

RSD can have a profound impact not only on your life as an entrepreneur but also on your overall well-being. If you are looking for personalized support, an international Rejection Sensitive Dysphoria coach or neurodiversity‑affirming therapist in Ontario, Canada, can provide compassionate care tailored to neurodivergent individuals.

Whether you are an emerging founder, CEO, or creative entrepreneur, this edition of our neurodiversity-affirming blog will help you understand how RSD shows up in your professional life and what to do about it.

What Is Rejection Sensitive Dysphoria?

Rejection Sensitive Dysphoria (RSD) involves an intense emotional or physical reaction that an individual experiences in response to perceived or actual rejection, criticism, or failure.

This is more than just the typical hurt or sadness. RSD is an intense pain that can lead to despair, anger, or anxiety for weeks on end.

If you have RSD, even an ambiguous communication, such as an ‘okay’ to an email, can cause you to take it as a personal attack and trigger emotional pain.

Why Does RSD Happen?

The exact cause of RSD is not entirely known. But there is some research to indicate that it involves a combination of neurological and psychological mechanisms. Below is a breakdown of some of these causes.

Brain Wiring and the Default Mode Network: The default mode network in your brain helps with controlling your emotions. If you experience RSD, this network may be overactive when you experience and try to process rejection. As a result of the overactivity, the default mode network may amplify emotional responses and make rejection more intense.
Sensory needs: Neurodivergent individuals often experience heightened sensitivity to sensory inputs and have a difficult time filtering out stimuli that are irrelevant.
Executive Functioning and Emotional Dysregulation: Executive functioning involves the mental skills needed to control your emotions and thoughts to reach your goals. For those with ADHD, executive functioning skills may be a challenge. When you experience difficulty controlling your emotions, even minor criticisms can trigger overwhelming reactions.

How RSD Shows Up in Entrepreneurs and Leaders

As an entrepreneur, you are constantly receiving feedback loops, pitches, negotiations, and evaluations, which can inherently open you up to rejection and criticism.

While every entrepreneur will experience RSD differently, let’s explore below how RSD commonly shows up for neurodivergent business owners.

1. Heightened Sensitivity to Feedback

If you are an entrepreneur who experiences RSD, you may be more likely to read into every piece of feedback that you receive. Even constructive feedback can come across as negative, and minor suggestions can leave you feeling as if you are a failure or that rejection is imminent. These feelings of doom can lead to an increase in stress, anxiety, and self-doubt.

2. Fear of Negative Judgment

Individuals with RSD become paralyzed by the fear of judgment, which can prevent them from pitching ideas or taking risks to put their brand or business out in the eyes of the public.

3. Reluctance to Speak Up

In an effort to avoid criticism or prove that you are competent, you may overwork, skip breaks, or take on more responsibilities than you can handle. Perfectionism becomes your default in an effort to try to guarantee acceptance. This can cause physical and emotional exhaustion.

4. Misinterpreting Ambiguous Signals

Any time you receive a message that is ambiguous and not concrete, such as a neutral email, vague instruction, or delayed response to a question, you may misread this as rejection or disapproval. For entrepreneurs with RSD, ambiguity may be interpreted as a negative judgment, which can worsen anxiety or avoidance.

Common Scenarios for Entrepreneurs Experiencing RSD

Scenario 1: A Potential Client Doesn’t Respond

A delayed email or text can trigger a rejection spiral: “They must not want to work with me,” “I did something wrong,” “I’m not good enough.” Before you know it, your motivation to follow up or pitch again is gone.

Scenario 2: Low Engagement on Social Media

Not all followers like or comment on every post. Yet a lack of visible engagement can feel like rejection.

Scenario 3: Comparing Your Success to Others

Seeing another entrepreneur’s success can trigger feelings of inadequacy or self‑criticism, even if your own achievements are meaningful.

Practical Strategies for Managing RSD

If you are experiencing RSD, it may impact your daily life. Let’s explore strategies below to help you regulate your emotional responses.

Recognize Your Triggers

Overcoming RSD first starts with recognizing that rejection will occur in your day-to-day life as an entrepreneur. But not all situations will cause the same level of emotional response.

During your day, you can begin by identifying the situations that reliably activate intense emotional responses. These might include feedback from authority figures, unanswered messages, social media comparisons, client rejection, or perceived disapproval from people you care about.

Naming your triggers helps externalize the experience. Instead of “Something is wrong with me,” it becomes “My nervous system is reacting to a familiar pattern.” That shift alone can reduce shame and create space for choice.

Emotional Regulation Techniques

RSD causes physiological responses to real or perceived rejection, which can mean that regulation of the body will help to regulate RSD.

Simple practices can lower emotional intensity enough to regain perspective:

Slow, deep breathing (longer exhales help calm the nervous system)
Grounding exercises (naming things you can see, feel, or hear)
Brief movement or stretching
Stepping away from the trigger before responding

These strategies won’t necessarily get rid of the emotions. But they will support you in reducing the intensity of your emotions so that you can regulate them.

Separate Emotion from Logic

RSD often makes it difficult to understand when you are actually experiencing rejection versus when you are perceiving it.

When you are experiencing a strong emotion, gently pause and ask yourself:

What actually happened?
What story am I telling myself about it?
Is this a perception or a confirmed reality?

This technique isn’t meant to invalidate your experiences. Instead, it aims to slow the moment down so your response isn’t driven solely by fear of rejection.

Seek Balanced Feedback

People with RSD may experience a distorted interpretation of feedback. In this situation, even neutral or constructive input feels like personal rejection.

Choose a small circle of trusted people, such as mentors, colleagues, coaches, or friends, who can offer honest and compassionate perspectives.

Having someone help you reality-check feedback can prevent spirals and reinforce a more balanced self-view.

Create Clear Boundaries to Protect Your Energy

If you are low on energy, emotional reactions tend to hit harder.

How and when you receive feedback
Social media consumption
Work hours and availability
Tasks or roles that consistently drain you

Building routines and a workload that align with your capacity can significantly reduce emotional burnout.

Reconnect With Your “Why”

When you are experiencing RSD, it may be difficult to try to understand why you continue to run a business.

By sitting down and reflecting on why you do what you do, what values guide you, and what impact you want to make, this can anchor you during moments of rejection or criticism.

This reflection can help you remember that rejection is part of growth, not proof of failure.

FAQ

Is RSD a recognized medical condition?

RSD is not currently included in the DSM‑5 as a diagnostic category, but it is widely discussed in clinical and coaching contexts as part of emotional dysregulation, especially in people with ADHD.

Is RSD exclusive to ADHD?

No. While people with ADHD often experience emotional dysregulation and RSD‑like reactions, similar sensitivities can occur in autism and other neurodivergent or emotional regulation conditions.

How can I start managing RSD in my business life?

Begin with awareness of your triggers, practice separating emotions from facts, and build a support system that includes professionals and peers who understand neurodivergent experiences.