Glorious freedom and long, sunny days stretching out ahead. For most, the end of summer term used to signify nothing but a high point in the year, but for Amy Cocksedge, now 24, thinking back to the school holidays conjures up the beginning of an agonising emotional spiral. Something that later carried through to her university days, too.
If messages from friends grew quieter – something that tends to accompany the natural ebb and flow of a busy break – a sensation would wrap itself around Amy's body. Chest pains. Racing thoughts. Hot tears. Every day without a text "would feel like a direct, personal attack," she explains. For Amy, any ambiguity would see her leap to a devastating conclusion: that everyone secretly hates her. Tormenting thoughts of being disliked, or having failed in some way, would override everything.
And Amy isn't the only one to experience these intense, derailing emotions around rejection; as of 2026, 37% of UK adults report that social media has a direct negative impact on their mental health, while nearly half of Gen Z (47%) attest to feeling frequently lonely, despite being the most digitally connected generation in history.
But given we live in a hyper-digital world, where it’s now possible to be rejected hundreds of times in a single week (thanks to dating apps, ghosting and AI algorithms auto-deeming your CV irrelevant in seconds), how do we know if our downbeat feelings are a mere sign of the times or something deeper? Something like Rejection Sensitive Dysphoria (RSD), a term increasingly gaining traction despite not being a formally recognised diagnosis.
THE MOST REJECTED GENERATION YET
To understand RSD (also sometimes referred to as Rejection Sensitivity Dysphoria), you have to look at its top associate: ADHD (Attention Deficit Hyperactivity Disorder). While ADHD – which is a clinically recognised diagnosis – tends to be associated with making concentration and focus a challenge, experts (and those with the disorder) are becoming more vocal about its lesser-recognised sidekick: RSD.
It's all linked back to emotional dysregulation. This could mean being quicker to anger than the average, or seeming more 'dramatic' in the face of an argument, explains Dr Shyamal Mashru, an experienced consultant psychiatrist at The ADHD Health Clinic.
He shares that while growing up, children with ADHD are thought to be criticised 20,000 more times – ranging from "you’re so overly emotional!" to "stop fidgeting, it’s annoying!" – than their neurotypical peers. Now, it's thought the lifetime barrage of negative feedback has primed some brains to anticipate failure and massively fear rejection to such an extent it can stop you from having a relationship, working or putting yourself forward for new experiences. Many say they live their lives feeling misunderstood.
Some mental health professionals have labelled this bundle of experiences and entrenched thinking patterns as RSD – but given RSD isn't a standalone diagnosis, and lacks a fixed criteria against which it can be measured, Dr Mashru says those who aren't evaluated by a neurodiversity specialist can sometimes be misdiagnosed with a personality disorder (something RSD can also be an indicator of, although it can present differently). RSD can also be a feature of an anxiety disorder, or depression, he adds.
Over time, toxic relationships, criticism and unhealthy levels of people-pleasing to try and avoid pain (all RSD traits) can inflict micro-traumas and lead to devastatingly low self-esteem, which Dr Mashru stresses is "what really kills people." The relief of finally having those intense feelings validated in a clinical setting is so profound, he says, his patients frequently break down into tears when they learn about Rejection Sensitivity Dysphoria. He tells them "the word dysphoria stems from the Greek word for unbearable pain", which like in the case of Body Dysmorphic Disorder, can be magnified and distorted beyond reality.
"RSD is difficult to measure in a lab, as oftentimes people don’t realise they have it. They just think 'well, this is just me and my personality'," Dr Mashru notes. Yet, he sees RSD in about 90% of his ADHD patients, three-quarters of whom are women. "In about a third, RSD is their most debilitating feature and impacts their life more than any other ADHD symptom."
While the core pain of RSD is universal, it can present drastically differently depending on gender, observes podcast host and LadBible co-founder, Alex Partridge, 37, whose new book, Why Does Everybody Hate Me? Living and Loving with Rejection Sensitivity Dysphoria, explores RSD.
"Women are incredible at masking," Alex says, recalling some of the hundreds of guests he's interviewed for his ADHD Chatter series, noting women tend to say they internalise pain or socially withdraw. "With men, it can often come out in rage," Alex explains. "There are theories to suggest that our prison population is full of men who have, in the moment of an RSD episode, impulsively broken the law, say by punching someone in a pub or something. I'm obviously not saying every male prisoner is there because of RSD, but [it can show up as violence].”
In Alex's own life, RSD has presented in the form of extreme people-pleasing, which he says led him to ignore his own "bullshit detector" in a business meeting some years ago. Fearing he might upset the other two men sat at the table, he blocked out his intuition "because it felt like the path of least resistance in that moment" and panic-signed a disastrous contract that led to a five-year legal battle (which he eventually won). The emotional toll drove Alex to alcoholism. On a less extreme end of the RSD scale, a simple text from a friend saying they're too busy to hang out can render him immobile on the sofa, feeling that a "bull is charging at [his] chest".
Speaking about meeting Bethany*, a fellow RSD sufferer who also used alcohol to try and numb her intense feelings, Alex recalls how after seven years of sobriety, Bethany received a Friday afternoon email from her boss: 'Have a lovely weekend, can we have a chat on Monday morning?' While semi-ominous for anyone, for a person with RSD, it was apocalyptic.
"She instantly catastrophized with thoughts of, 'Everyone in the office has figured out I'm useless, everyone hates me and I'm definitely going to get fired'," Alex explains. The spiral was so all-consuming Bethany relapsed over the weekend. On Monday morning, she went to work and was offered a promotion.
"I truly believe RSD is the hardest part of ADHD," Alex reflects. "The co-morbidities with ADHD are tragic, at best you see heightened rates of anxiety and depression. At worst, people with ADHD are five times more likely to attempt suicide.
"Why? What is it about living with ADHD that can be so unbearable? It's RSD. It's the exhausting nature of tiptoeing through your life, constantly wondering when the next gut punch is going to hit."
THE MORE YOU KNOW?
For 38-year-old Lou Woods, navigating the modern digital workplace before her ADHD diagnosis (paired with RSD) felt like traversing a similar minefield of perceived slights – so much so, she eventually quit her career in events management and became an ADHD coach. With so much communication happening over email, there was huge room for misinterpretation. "We're not getting the full picture [that way]," Lou explains. "If someone sent a blunt message with no emojis or kisses, I'd think, 'God, what have I done wrong?' It's a sense of paranoia, you always think you've let this person down."
If an event wasn't a success, including for reasons entirely beyond her control, Lou would feel it deeply personally and that she had let people down – and RSD didn’t clock off at 5PM either. It also bled into romantic relationships. "One thing that would trigger my RSD was if my partner was on his phone during quality time," she shares. "I felt so rejected. But knowing that it's RSD amplifying how I feel, rather than him rejecting or abandoning me, we've been able to work at it together. Communication is so important. Feeling accepted makes us feel safer and when we feel safe, rejection lessens."
This inability to safely process feedback without adjustments is exactly why RSD needs to be taken seriously by society at large, says Henry Shelford, CEO of charity ADHD UK, "RSD is more debilitating than most people realise. We know psychiatrists who think RSD should be discussed with every patient with ADHD."
"We [hear of] multiple examples where RSD has ruined lives," he continues. "If you can't [process] negative feedback, then you can't know where problems lie. You can't know what needs work, and that can mean doom for your relationship or your career. This is a siren call for the importance of understanding and managing RSD in ADHD."
While speaking out and social media is brilliant for building awareness for RSD, Dr Mashru highlights it can also be a double-edged sword. The algorithm's echo chamber can easily lead to incorrect self-diagnoses for some, who could be experiencing a proportionate response to a tough situation, or a toxic, anxiety-inducing cycle of constant comparison. And as for whether or not our current hyper-rejection culture is making RSD worse? Dr Mashru flips the narrative, explaining that severe RSD often means a person will just avoid a trigger entirely to stay safe. He cites many patients who hold back from applying for jobs, promotions, having necessary conversations or from dating completely.
If you're spiralling over whether your own feelings cross the line into a medical issue, Dr Mashru suggests asking 'How extreme are my reactions to being rejected?', 'Am I actively holding myself back in work or relationships to feel safe?' and 'How much is this actually affecting my daily functioning?'
According to Lou, the secret to managing RSD is creating a toolbox to break the shame spiral. "Make space between the rejection (perceived or real) and your reaction," she advises. Before you fire off an impulsive, defensive email, which could cause longer-term harm, step away. "Change your state completely. Listen to music, text a friend, hug your dog," Lou suggests. "Just break the cycle. Usually, if it's an irrational trigger, taking five or ten minutes can make all the difference."
She also champions the power of self-advocacy, especially in the workplace. If blunt emails are sending your nervous system into overdrive, you have the right to ask your manager for a different approach. "Ask for flexible adjustments," Lou urges. "Instead of via email or instant messaging, you can ask for feedback to be done verbally or face-to-face. Your voice should be heard."
For Amy, requesting workplace adjustments has made her life infinitely easier; "If someone says can we have an unspecified chat, I'll say 'I find this really challenging, can you tell me what it'll be about?'." Since learning more about RSD, she’s also more comfortable navigating the ups and downs of relationships. "Often people hold back [on raising any issues] because they're worried about how it's going to go down, but then it builds and can turn into an argument. [My partner and I now] agree not to raise our voices and he understands my RSD, and how it can make me sometimes respond."
So, while texts might still arrive late and the emails can still sound blunt, with the right tools it's clear there's a positive path forwards by adjusting your mindset and having a plan in place to deal with difficult emotions as and when they arise – and perhaps that's something that could benefit us all, not only those with RSD.
To learn more about ADHD and to get support, visit ADHD UK
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Jennifer Savin is Cosmopolitan UK's multiple award-winning Features Editor, who was crowned Digital Journalist of the Year for her work tackling the issues most important to young women. She regularly covers breaking news, cultural trends, health, the royals and more, using her esteemed connections to access the best experts along the way. She's grilled everyone from high-profile politicians to A-list celebrities, and has sensitively interviewed hundreds of people about their real life stories. In addition to this, Jennifer is widely known for her own undercover investigations and campaign work, which includes successfully petitioning the government for change around topics like abortion rights and image-based sexual abuse. Jennifer is also a published author, documentary consultant (helping to create BBC’s Deepfake Porn: Could You Be Next?) and a patron for Y.E.S. (a youth services charity). Alongside Cosmopolitan, Jennifer has written for The Times, Women’s Health, ELLE and numerous other publications, appeared on podcasts, and spoken on (and hosted) panels for the Women of the World Festival, the University of Manchester and more. In her spare time, Jennifer is a big fan of lipstick, leopard print and over-ordering at dinner. Follow Jennifer on Instagram, X or LinkedIn.
