Paris Hilton
Extremely painful, “like a demon in our mind”, it is not a clinical condition recognized in diagnostic manuals, but two distinct, closely related psychological concepts: emotional regulation and rejection sensitivity.
The American celebrity Paris Hilton recently on a podcast, who suffers from Rejection Sensitive Dysphoria, or RSD. Hilton, who was diagnosed with ADHD, says that this condition is common in people with this disorder.
He also spoke of the impact RSD has had on his mental health over the years, describing it as being “like a demon in our mind” and saying it has been “extremely painful”.
It is important to emphasize that the DSR is not, in fact, a clinical condition recognized in diagnostic manuals. What Hilton may be referring to when he talks about DSR are two distinct psychological conceptsbut closely related: emotional regulation and sensitivity to rejection.
A emotional regulation is an umbrella term that designates a person’s general ability to manage their emotional reactions in any situation. THE sensitivity to rejection falls within this scope.
It is a intense emotional reaction to rejectioneven when it is only perceived by other people. Those who suffer from this condition may feel anger, shame, emotional blockage and a defensive posture when criticized by others.
People with a good emotional regulation ability They can keep their emotions under control, even when a situation becomes stressful or tense. They also have less likely to develop sensitivity to rejection, explains Georgia Chronicleneuroscientist at the University of Lancashire, in an article in .
Although difficulties in emotional regulation are part of the human condition, each person’s life experiences shape the way we perceive and manage emotions in a given situation.
Rejection sensitivity and ADHD
Between 25% and 45% of children with ADHDand between 30% and 70% of adults with ADHD have difficulties in emotional regulation.
These difficulties often manifest themselves in the form of catastrophizing (assuming the worst will happen), tendency to blame others and a greater vulnerability to perceived rejection from others.
Perceived rejection or criticism often ends up causing emotional discomfort.
While some people with ADHD try to hide their emotions when they feel rejected, others may become overwhelmed and react impulsively or shut down completely. These difficulties can contribute to emotional distress and affect interpersonal relationshipseducational trajectory and professional life.
Although the causes of emotion regulation difficulties in ADHD are not yet fully understood, research has explored several possible mechanisms.
In one published in 2014, Chronaki and colleagues compared the brain waves of boys between the ages of 6 and 11, with and without ADHD. Both groups heard, through headphones, a series of voices with tones of anger, joy or neutrality.
The study demonstrated that, in boys with ADHD, the brain had a increased activity when hearing threatening voices (angry). These results suggested a automatic hypervigilance to the threat in people with ADHD.
A similar one, in 2018, showed that young people with ADHD not only had a more intense brain reaction when rejected by their peers, but they also exhibited a weaker brain reaction when they were accepted by them.
Past experiences of threat or rejection can deeply mark us and alter brain development. Although the exact mechanisms are not yet fully understood, research has also demonstrated that experiences of rejection can shape brain development na Phda.
A PhD is not the only condition associated with sensitivity to rejection. Disturbances such as autism, borderline personality disorderdepression and anxiety are also related to rejection sensitivity.
However, how rejection sensitivity manifests itself differs depending on the condition. For example, people with ADHD who are sensitive to rejection may have very intense emotional reactions to difficult situations. As for autistic people tend to isolate themselves.
How to manage rejection sensitivity
Some of the pharmacological treatments used to manage ADHD symptoms may provide temporary relief from the emotional distress associated with rejection sensitivity. However, they do not eliminate it.
A more effective approach could be create environments that promote well-being, instead of trying to resolve biological issues. Guide people with ADHD to areas where they can take party to your strengths and interests can better prepare them to deal with difficult or challenging situations.
As therapeutic approaches Person-centered approaches do precisely that. Its goal is to provide an environment, through a safe therapeutic relationship, in which the person feels seen as a whole — and not just for the difficulties they may have.
The experience of feeling seen and accepted strengthens self-esteem and offers a corrective emotional experience to anyone who has felt criticized or judged in the past.
When people feel accepted, they begin to feel more confident and resort less to negative self-talk. Recent research shows that this approach can be effective for people with ADHD.
Therapies like play therapy Child-centered approaches can be effective for children with ADHD in reducing emotion regulation difficulties—including sensitivity to rejection.
This therapy uses play to allow children to express their thoughts and feelings. A recent 2024 demonstrated that this type of therapy is effective in improving emotional well-being in childhood ADHD.
In contrast, the cognitive-behavioral therapy focuses more on teaching coping strategies to modify so-called problematic behaviors. This type of treatment can be effective in reducing ADHD symptoms, but not necessarily in improving emotional regulation in this disorder.
Thanks to people like Paris Hilton, rejection sensitivity is now being publicly debated. This could help reduce stigma and, hopefully, pave the way for a more welcoming and compassionate world for people with ADHD, concludes Chronaki.
