ADHD & Rejection Sensitive Dysphoria: The Emotional Pain No One Explains
The Hidden 20%
Defining Rejection Sensitive Dysphoria (RSD)
Dr Shyamal defines RSD as intense emotional pain tied to real or perceived rejection and its roots.
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.
Join us at hidden20.org/donate.
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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
The Hidden 20% is a charity founded by AuDHD entrepreneur, Ben Branson.
Our mission is simple: To change how the world sees neurodivergence.
No more stigma. No more shame. No more silence.
1 in 5 people are neurodivergent. That’s 1.6 billion of us - yet too many are still excluded, misunderstood, or left without support.
To break the cycle, we amplify voices, challenge myths, and keep showing up. Spotlighting stories, stats and hard truths. Smashing stereotypes through honest voices, creative campaigns and research that can’t be ignored.Every month, over 50,000 people turn to The Hidden 20% to feel safe, seen and to learn about brilliant brains.
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Ben Branson @seedlip_ben
Dr Shymal Mashru @adhdhealthclinic
www.adhdhealthclinic.co.uk
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