ADHD AWARENESS MONTH: LOOKING BEYOND THE SYMPTOMS WE SEEThe RSD Loop: When Your Body Reacts Before You Know What Happened
Blog written by Michelle Oppermann, BSW, RSW (SK)
October is ADHD Awareness Month, a time to increase understanding of ADHD, challenge stereotypes, and bring attention to some of the less visible ways ADHD can affect everyday life.
In the first article, we looked at rejection sensitive dysphoria, or RSD, as a term used to describe intense distress around actual or perceived rejection, criticism, exclusion, disappointment, or failure. This time, I want to slow the experience down and look at what may happen between the trigger and the reaction.
When the Body Reacts First
Imagine receiving a message from your supervisor:
Can you come see me when you have a minute?
Your stomach drops. Your chest tightens. Within seconds, your mind may be telling you: I did something wrong. They are unhappy with me. I am going to get in trouble.
You might start reviewing everything you did that week or preparing an explanation before you even know what the conversation is about.
This is one reason I find it useful to look at rejection sensitivity through the lens of dysregulation rather than simply calling it “overthinking.”
Understanding the RSD Loop
Dr. James Kustow describes a sequence in which a trigger can lead to a body response, followed by an interpretation or meaning, emotion, and behaviour. Protective behaviours can then reinforce the original fear. (Kustow, 2026)
Something happens → Your body reacts → Your mind creates a meaning → An emotion follows → You feel an urge → You do something to protect yourself.
A friend has not replied. Your body becomes tense. Your mind says that she is upset with me. You feel anxious and send several follow-up messages. Your friend feels pressured and pulls back. The distance now feels like proof that your original fear was right.
This does not mean someone is deliberately creating drama or choosing to misread the situation. Once the system is highly activated, uncertainty can become harder to tolerate.
Checking the loop also does not mean assuming the rejection is imaginary. Sometimes criticism is unfair. Sometimes exclusion is real. The goal is to create enough regulation to respond to what is actually happening.
Regulation Before Investigation
When we are highly activated, the first task does not always need to be deciding whether a thought is true.
A more useful first question may be: What does my system need so that I can think about this more clearly?
That might mean pausing, moving your body, orienting to the room, using a sensory strategy, breathing, or reminding yourself: I am activated right now. I do not have to respond immediately.
Kustow and ADHD clinician Sharon Saline both emphasize practicing regulation skills outside moments of crisis so they are easier to access when emotions become intense. (Kustow, 2026; Saline, 2025)
Notice → Regulate → Check → Choose → Repair
In counselling, I like to use five simple steps to slow the pattern down. This is not a diagnostic tool or standardized RSD treatment. It is a practical framework for creating more room for choice.
1. Notice
What happened, and what happened inside you? Notice body signals, racing thoughts, defensiveness, or the urge to disappear. Naming the activation can create a little distance from it.
2. Regulate
Ask what would help you come down enough to respond rather than react. That may be movement, quiet, sensory input, breathing, temporary distance, or connection with a safe person. The goal is to regain access to more choices, not force the feeling away.
3. Check
Once the intensity shifts, separate what you know from what your mind has filled in. What actually happened? What am I assuming? Is there another explanation? Do I need clarification?
Checking the story does not mean deciding you were wrong. It means gathering enough information to respond to the situation in front of you.
4. Choose
Ask: How do I want to respond? Your first urge may be to apologize, lash out, withdraw, or explain yourself repeatedly. A more regulated response might be: Can you tell me what you meant by that? Or I need a little time to think before I respond.
The goal is not perfect behaviour. It is increasing the space in which you can choose.
5. Repair
Sometimes we catch the loop early. Sometimes we do not. Repair might mean apologizing, clarifying, restating a boundary, or returning to a conversation after regulating. Stepping away can help but returning matters too.
Practice Before You Need It
One of the hardest times to learn a regulation skill is when you are already overwhelmed. Practice during ordinary moments. Experiment with grounding, movement, sensory tools, or simple phrases such as: Let me think about that. Can I get back to you? Can you clarify what you mean?
Over time, the goal is not to make rejection sensitivity disappear. It is to recognize the loop sooner, know your own signs, and have more than one possible response available.
A strong feeling does not have to make the next decision for you.
In the next article, we will look at what can happen when avoiding rejection becomes a way of life: people-pleasing, perfectionism, and self-abandonment.
Sources
Kustow, J. (2026). “RSD Coming Into Focus: Rejection Sensitive Dysphoria in ADHD Brains.” ADDitude ADHD Experts Webinar Transcript.
Saline, S. (2025). “How to Control Your Emotions and RSD in Real Time.” ADDitude.
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