Autism and Rejection-Sensitive Dysphoria: Is There a Connection?
Elizabeth Morey
A growing body of research suggests that a condition known as rejection-sensitive dysphoria may be linked to autism spectrum disorder (ASD) and the associated difficulties with interpersonal communication and social connection.
What Is Rejection-Sensitive Dysphoria?
Rejection-sensitive dysphoria (RSD) is a condition that causes an intense emotional response when the person who has it is rejected or perceives themselves as being rejected.
For people with RSD, any type of social rejection, whether it is real or perceived, is unbearable. It can cause feelings of worthlessness, embarrassment, over-sensitivity in social situations, and social anxiety. The intensity of this emotional response may cause the person to focus more than necessary on the rejection and have a hard time moving on and connecting with others in the future.
How Does Rejection-Sensitive Dysphoria Affect People?
The emotions surrounding being excluded or rejected may be overwhelming, resulting in intense anger and violent outbursts, running away, reacting to accidents as if they are someone's fault, or refusing to acknowledge the person who they feel hurt them.
RSD can cause low self-esteem and withdrawal from social situations. It may lead to an irrational fear of future rejection, which causes people with the condition to do everything they can to avoid social situations in which they might be rejected or keeps them on the lookout for cues that might suggest rejection. When they do get involved in social situations, they may tend to be people-pleasers to avoid confrontation.
RSD may also prompt a person to treat others poorly because they perceive others as having hurt them, even if they didn't actually do anything wrong. In a sense, it "forces" people to sabotage their own relationships.
The Vicious Cycle
Of course, rejection-sensitive dysphoria doesn't just affect people who suffer from it. It also causes people on the outside looking in to perceive people with RSD as bratty, childish, or rude. Their attempts to explain themselves may come off as mere excuses.
This can lead to teasing, bullying, criticism, rejection, and exclusion, which further perpetuates the cycle and continues to affect the person with RSD profoundly.
Parents, teachers, and caregivers may also be perpetuating the cycle without realizing it. Adults may tell a child he is being overly sensitive or ridiculous, not realizing how big a deal the issue is within the child's brain. Minimizing the child's feelings only serves to further ostracize him or her.
Are Autism Spectrum Disorder and Rejection-Sensitive Dysphoria Related?
And that brings us to the possible connection between RSD and ASD. Could autism be causing rejection-sensitive dysphoria? Could rejection-sensitive dysphoria be responsible for the social anxiety and difficulty forming interpersonal relationships that many people on the autism spectrum experience?
Researchers don't know the exact nature of the link between ASD and RSD. What we do know is that RSD is one of a long list of comorbid disorders associated with autism. This means it occurs more frequently in people with ASD than it does in the rest of the population. It's quite possible that RSD is responsible for some of the social struggles people with autism face, or it could even be an autism symptom itself.
Are There Treatments for Rejection-Sensitive Dysphoria?
At this time, RSD is not a recognized medical diagnosis, so treatment for it may be difficult to come by. However, it's still worth checking in with a licensed mental health professional to see if there's anything they can do to help with the difficult symptoms of RSD.
How to Help Someone with Rejection-Sensitive Dysphoria
It is important to be sensitive about the matter, but parents, teachers, or loved ones may be able to help people who have autism or RSD (or both) improve their social interaction skills. Teaching kids how to act and react to different social situations is important, and it's particularly important to work extra hard with children (or adults) who may perceive the world differently due to these conditions.
Help your child work on establishing interpersonal boundaries, restoring broken relationships, and creating trust. Talk with them about good and bad ways to interact with others, what to do about peer pressure, how to respect others' boundaries, and how to respond appropriately to perceived rejection. Use specific examples whenever possible.
It might also help to have a conversation with your child's teachers and their friends' parents. The more the adults involved in the situation know about your child's unique needs and way of viewing the world, the more they can help your child have positive experiences in their interactions with others. Talking to others about the situation can also help resolve previous misunderstandings and prevent new ones.
The last way you can help someone with RSD is to set a good example. When you experience rejection or go through any sort of negative social interaction, be a good model of constructive behavior. Take some time to explain what happened, how it made you feel, how you're choosing to react to the situation, and how your reaction makes the situation better.
All human beings have a fundamental need to connect with one another and belong to part of a group. Just because a person has ASD or RSD (or both) doesn't mean he or she doesn't want or need social connection. If anything, the connection between RSD and ASD points to a need for more people on the autism spectrum to take part in therapies that could help reduce the fear of rejection and improve emotional regulation in the face of difficult social situations.
In the end, the best thing we can all do for one another is to try to be more sensitive and compassionate. Surround yourself and your loved ones with people who genuinely care about your well-being, and do your best to be helpful and kind to others in return. We're all going through something, and we all deserve to have people in our corner who care.
