What surprises clinicians in ADHD assessments

In this episode, Ben sits down with Dr Shyamal Mashru, Consultant Psychiatrist and Medical Lead for Adult ADHD, for a clear and compassionate deep dive into Rejection Sensitive Dysphoria (RSD).

Often misunderstood or dismissed as being “too sensitive,” RSD is explored here as a real, neurological experience - one that can hijack rational thought, flood the body with emotional pain, and quietly shape relationships, work, and self-worth. Dr Shyamal explains what RSD is (and isn’t), how it shows up differently across people, and why ADHD brains may be especially vulnerable.

They unpack the science, the role of trauma and hormones, why RSD isn’t currently in the DSM, and what actually helps when rejection hits hard.

If rejection feels overwhelming, confusing, or deeply personal - this conversation offers clarity, relief, and language for what you may have been carrying alone.

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Host: Ben Branson

Production Manager: Phoebe De Leiburné

Video Editor: James Scriven

Social Media Manager: Charlie Young

Music: Jackson Greenberg

Head of Marketing: Kristen Fuller

00:00 Introduction

01:00 Dr Shyamal Mashru’s ADHD Background & Clinical Work

03:15 What Surprises Clinicians About ADHD Assessments

04:41 Rejection Sensitive Dysphoria Explained: What RSD Is & Why It Hurts

09:16 RSD Coping Mechanisms: Shutdown, People-Pleasing & Avoidance

11:44 Is It RSD or Something Else? How to Tell the Difference

15:05 The Neuroscience of RSD: Why Rational Thinking Switches Off

17:27 RSD in Romantic Relationships & Attachment

21:33 How to Support a Partner With Rejection Sensitive Dysphoria

22:50 How Aware Is Society of RSD?

24:38 RSD, Hormones & ADHD: Menstrual Cycle, Perimenopause & Menopause

26:33 Is There an Upside to RSD? Emotional Depth & Sensitivity

29:56 Can Non-ADHD People Experience RSD?

31:55 RSD vs Trauma & Fear of Failure

34:46 Why RSD Is More Than “Not Handling Rejection”

36:15 Why Rejection Sensitive Dysphoria Isn’t in the DSM

40:00 How RSD Shows Up in Children

41:29 Early Signs & Patterns Clinicians Look For

42:59 How Common Is RSD in ADHD — and When It Appears

46:20 Treating RSD: Therapy, Medication & Regulation

56:18 The One Thing Dr Shyamal Would Change About RSD Awareness

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Ben Branson @seedlip_ben

Dr Shymal Mashru @adhdhealthclinic

www.adhdhealthclinic.co.uk

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