\n<\/p>\n
J<\/span>enna Turnbull\u2019s chest is tightening. The 36-year-old civil servant, who lives in Cardiff, can picture herself as she speaks: an 11-year-old in her PE kit waiting with the other kids for her lesson to start. \u201cWe were outside by the courts waiting to play netball,\u201d she says. \u201cSomebody commented that I had hairy arms, one of the boys.\u201d Her voice wobbles. The incident was clearly juvenile; rationally, she knows that. Yet 25 years on, her embarrassment is still visceral, with the power to cause instant physical discomfort.<\/p>\n She searches for another example of her acute reaction to teasing and recalls a trip to the pub with her friends six years ago. Amid the loud conversation and laughter, a quip was made in the group about her being untidy at home. Or that\u2019s how she perceived it. \u201cAbout me not keeping on top of the house,\u201d she recalls. The person \u201cwas having a laugh. It was just something that was said off the cuff.\u201d Yet while the memory and detail is hazy, the shame she feels about it is not. \u201cThat comment still haunts me,\u201d she says. After that pub outing, she started cleaning her house obsessively \u2013 to such an extreme that it became one of the symptoms leading to her diagnosis of obsessive compulsive disorder (OCD). \u201cI\u2019ve been known to spend four or five hours cleaning my bathroom,\u201d she says.<\/p>\n She describes another incident, when she sent a work email to senior colleagues that contained an error. It was pointed out to her in a reply, into which other colleagues were copied. Her chest again became tight; she was struggling to breathe. \u201cI thought I was dying,\u201d she says. \u201cThe shame of receiving the email actually caused me to ring the GP and say, \u2018I need to come in \u2026 I\u2019m having an asthma attack.\u2019\u201d She managed to get to the surgery, breathless. \u201cThey took my oxygen reading and it was fine,\u201d she says. \u201cIt was a panic attack. It left me completely debilitated.\u201d At other times in her past, she has self-harmed when she\u2019s felt shame.<\/p>\n These reactions came to a head late one night in 2022, in the middle of divorce proceedings, when she called a mental health crisis line. \u201cThe shame of carrying that I was going to be a separated, single mum was honestly the most horrendous feeling I\u2019ve ever had in my life. I didn\u2019t think I wanted to make it through,\u201d she says. The nurse who spoke to her \u201csaved my life that night\u201d. She suggested that Turnbull, who had received an autism diagnosis in childhood, might also have attention deficit hyperactivity disorder (ADHD), and another condition that Turnbull had never heard of: rejection sensitive dysphoria (RSD \u2013 sometimes called rejection sensitivity dysphoria). Although RSD is not a formal diagnosis, those living with it frequently also have an ADHD diagnosis. The emotional dysregulatory symptoms of ADHD have only recently been given prominence in research and in the diagnosis of the condition \u2013 and many sufferers of RSD have only found out they have it through clinical treatment of their ADHD, although it is still not mentioned in official diagnostic tests. Experts stress that not everyone with ADHD will experience RSD, and it can also present in those with autism and generalised anxiety disorder, and as a separate condition, but too little is understood about it yet to explain why.<\/p>\n RSD as a term was first used in the 1960s, but has become more common in recent years. There are support groups on social media \u2013 one Facebook group has 67,000 members \u2013 and there are thousands of TikTok posts about it. It has also begun to filter into employment law. Last month, a headline in the Times read: Worker with \u2018rejection sensitivity\u2019 awarded \u00a312,000 over remark by boss. An employment tribunal agreed the employee had been diagnosed with dyslexia and had rejection sensitive dysphoria. She won the payout after the tribunal found her employer had acted unlawfully when her boss told her: \u201cno thinking outside the box\u201d when she asked them to provide a breakout area at a work party to help with feelings of overwhelm. \u201cShe is basically saying, mask, act neurotypical and don\u2019t rock the boat,\u201d the employee said at the time.<\/p>\n However, comments underneath the news story revealed a different take on the situation. \u201cRejection Sensitivity Disorder (sic) or \u2018touchy\u2019 \u2026\u201d writes one. \u201cSurely it\u2019s just human nature to not like criticism and we have to learn to cope with it!\u201d replies another. Turnbull is used to these kinds of comments and admits that even close friends and family can be scathing about RSD. Comments have ranged from \u201cyou\u2019re not alone in feeling this way\u201d and \u201cthat is not abnormal\u201d to \u201cI don\u2019t believe it, it\u2019s a modern-day excuse\u201d. She will usually internalise her upset when she hears them. \u201cThere is an outlook of people that invisible ailments can\u2019t be real,\u201d she says.<\/p>\n The psychiatrist Dr William Dodson, based in Denver, Colorado, is used to people dismissing RSD. As the leading expert in the field, he began working with people with ADHD in the mid-90s and after treating hundreds, then thousands, noticed that many patients showed the same symptoms when faced with rejection \u2013 intense and often immediate reactions to triggers or perceived triggers of rejection, teasing, criticism or self-criticism. While rejection sensitivity is a normal human experience, he says, the dysphoria \u2013 which in Greek means unbearable \u2013 is what makes rejection feel different for people with RSD. He identified the characteristics as they are understood today. \u201cThis is something that is just several orders of magnitude stronger\u201d than everyday rejection, he explains. And that unbearable pain is often disproportionate to the event.<\/p>\n Turnbull is aware that anyone would struggle with a divorce and that \u201ca lot of people experience embarrassment and shame\u201d, she says. However, it is the immensity of her reactions that marks her as someone with RSD. \u201cI will get chest pains and severe stomach pains \u2026 The amount of times I\u2019ve felt rejection and my chest feels like it\u2019s collapsing \u2026\u201d For most of her life, Turnbull says she had been labelled as someone who \u201ctook things to heart too much. I could never take a joke.\u201d When the nurse on the phone that night told her: \u201cYou\u2019re carrying something heavy, but your brain is adding 10 times the weight,\u201d it changed everything. \u201cJust putting a name to it was the big thing,\u201d she says. She has since received a diagnosis of ADHD.<\/p>\n In a paper detailing the experience and case history of four patients with ADHD and RSD, Dodson and his co-author describe episodes that \u201cbegin with the experience of perceived rejection, demonstrating rejection sensitivity, that progresses into a nearly instantaneous dysphoric mood, which causes significant distress and impairment\u201d. He believes this is not linked to other disorders, such as chronic depression, as was initially believed in the 1960s, because these may have a more gradual onset without a specific trigger and will last significantly longer.<\/p>\n Dodson says that when he raises RSD with his patients with ADHD, \u201cabout 95% will go: \u2018Oh my God, that\u2019s me.\u2019 People would burst into tears right there.\u201d He says that \u201cno patient volunteers this. They are very sensitive about the rejection,\u201d and for about 25% of them, they say that RSD is \u201cthe most impairing part of their lives\u201d.<\/p>\n Lauren O\u2019Carroll would agree with that. The 41-year-old, who lives in Cambridge and runs a coaching business, Positively Parenting, supporting parents with ADHD, was diagnosed with ADHD at 21. It was only when she was 37 and sought help from a private psychiatrist that RSD was suggested to her. In childhood, she was called \u201coversensitive\u201d, \u201cthe emotional one\u201d, a \u201cdrama queen\u201d. From as far back as she can remember, any request she received \u2013 from being asked to close a door or to do her homework \u2013 would trigger shame. \u201cI would immediately explode \u2026 I\u2019d take it as a criticism,\u201d she explains. The rage would be physical at home. \u201cI would feel super angry, super hard done by, like the world was against me \u2026 It would feel like a punch in the guts.\u201d<\/p>\n She still gets these gut punches in adulthood, too. She says she will lie to cover up mistakes, which is \u201cdeeply uncomfortable\u201d to admit. If she\u2019s booked the wrong train ticket for work, for example, she would rather pay out of her own pocket than admit it to anyone. When she was 18, she crashed her car, but told her parents a vehicle had pulled out in front of her. \u201cI was so ashamed, I kept that lie going my whole life.\u201d<\/p>\n The consultant psychiatrist Dr Shyamal Mashru is an adult ADHD specialist in north London and says he sees many patients with RSD. Some have been so affected by a trigger that they have become breathless or had palpitations. \u201cI\u2019ve even had some patients go to A&E,\u201d he says. Little is known yet about the causes of RSD, he says, but \u201cthere are different theories of what might be happening \u2026 One of them is what\u2019s called an underregulated amygdala and prefrontal cortex of the brain,\u201d he explains. \u201cSo that causes you to have strong emotional responses to situations.\u201d<\/p>\n But he also believes in the impact of nurture, stressing the trauma people with ADHD experience from childhood because of criticisms of their behaviour. \u201cThey\u2019re going through lots of mini traumas that just keep hammering away at their self-esteem \u2026 We may never really find out the true answer neurologically \u2026 but in this particular condition, your life plays a big role.\u201d<\/p>\n What is indisputable is that RSD affects lives. \u201cPeople want to protect themselves from these emotional reactions so much they change their entire approach to life,\u201d says Dodson. The most common is people-pleasing. \u201cSo people like to have them around, would not reject them, not criticise them at work,\u201d he says. Then there is perfectionism: \u201cThey\u2019re going to be above reproach.\u201d And finally, those who have \u201cgiven up\u201d because they fear rejection. \u201cVery bright, educated people who still live in their parents\u2019 basement, unemployed. They\u2019ve never asked a person out on a date. They\u2019ve never applied for a job. They\u2019re just crippled by it.\u201d<\/p>\n For Dhiren Doshi-Smith, 42, from Loughton, Essex, avoiding socialising has been a hallmark of his RSD. Diagnosed with ADHD four years ago, he found out about RSD at the same time. He spent years \u201cavoiding that sense of actually letting people in because the rejection would feel quite intense, and therefore \u2026 it\u2019s better to isolate yourself\u201d. Even emails and texts are triggers for him. \u201cPositive messages can be read as neutral, neutral ones can be negative and negative ones can be super negative,\u201d he explains. He will read a silence as catastrophe, even a friend delaying a reply by a few minutes. While dating his now husband, he would find himself unable to go about his day if a message wasn\u2019t answered swiftly. It\u2019s a \u201cbodily\u201d reaction, a \u201cchurning in the stomach\u201d, he says. Therapy has helped him catch his negative thoughts, and he has found medication for ADHD helpful.<\/p>\n Dodson has found that alongside therapy, a group of medications called Alpha-2 Agonists can be effective for RSD. Usually prescribed for high blood pressure, these are different from the medications more commonly given for ADHD, and would not be prescribed by the NHS in the UK. Mashru says he would tend towards \u201cnon-medical approaches\u201d to treat RSD, including patients working with coaches to relearn emotional responses. <\/strong>Turnbull says that taking an antidepressant, coupled with therapy for her low self-esteem, is helping \u201cmassively\u201d.<\/p>\n The difference to Turnbull\u2019s life has been huge. After 18 months in therapy, she feels increasingly able to know when and why chest tightening is happening, and to ground herself by stepping away. \u201cIt has helped me to stop escalating quite as badly \u2026\u201d Being honest about her struggles has helped too. She describes how one old friend had always joked about her being a few years older than him \u2013 and she finally asked him to stop. \u201cI know it\u2019s a joke, but it makes me feel physically tight-chested and unwell. It makes me feel a lot of shame.\u201d He understood.<\/p>\n Until a few months ago, she had spent 18 years in the same office and a decade working in the same team, pushing herself relentlessly in case she made any mistakes, too terrified to apply for promotions or other jobs in case she had to work with people she did not know and they judged her.<\/p>\n But six months ago, she applied for a promotion. \u201cEighteen months ago I couldn\u2019t have thought like that, because the idea of getting rejected after an interview was something I didn\u2019t even want to go through,\u201d she says. Quite simply, because she braved rejection and went for it, she got the job.<\/p>\n She has not overcome her RSD. \u201cI\u2019m still on that journey,\u201d she says, and may always be. But \u201cunderstanding it has helped me accept me\u201d.<\/p>\n <\/em>In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or email jo@samaritans.org or jo@samaritans.ie. In the US, you can call or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at befrienders.org<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" Jenna Turnbull\u2019s chest is tightening. The 36-year-old civil servant, who lives in Cardiff, can picture herself as she speaks: an 11-year-old in her PE kit waiting with the other kids for her lesson to start. \u201cWe were outside by the courts waiting to play netball,\u201d she says. \u201cSomebody commented that I had hairy arms, one<\/p>\n","protected":false},"author":1,"featured_media":45212,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[58],"tags":[6553,14815,23332,3919,37,16603,313,7568],"class_list":{"0":"post-45211","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-science","8":"tag-chest","9":"tag-collapsing","10":"tag-dysphoria","11":"tag-feels","12":"tag-health","13":"tag-rejection","14":"tag-rise","15":"tag-sensitive"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/45211","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=45211"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/45211\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/45212"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=45211"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=45211"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=45211"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}