Toolkit: When Your Brain Turns Everything Into Rejection: DBT Meets RSD

Understanding the Storm Inside

I need to talk about something that doesn't appear in most DBT manuals but affects nearly every ADHD person I've ever met: the moment when your brain transforms a delayed text response into absolute proof that you're fundamentally unlovable. That instant when mild criticism feels like emotional annihilation. The way a cancelled plan can send you spiralling for days.

This is rejection sensitive dysphoria (RSD), and if you're reading this with a knot of recognition in your stomach, you're not alone. You're also not "too sensitive," "overreacting," or any of the other dismissive phrases you've probably heard (and that probably made the RSD worse).

What I've discovered through years of navigating this intersection is that DBT skills can be profoundly helpful for RSD – but not always in the ways the textbooks suggest. Sometimes emotion regulation isn't possible when your nervous system is convinced you're under existential threat. Sometimes distress tolerance becomes your lifeline. Sometimes the most radical act is simply surviving the storm.