Rejection Sensitive Dysphoria: AKA Richard, The Dick Who Lives In My Head

Just one of the many areas where I relate to Boyle. So fucking much,

Once, several years ago, an ex-girlfriend and I were on a road trip. We were chatting, as you do to pass the time in that situation, when I mispronounced a word. She immediately pointed out my mistake and corrected me. And, not in a way that was harsh or mean-spirited; it was nice and easy, gentle even. But, it didn’t feel that way to me. I was crushed and wanted nothing more than to pull over and find a hole to crawl into, dragging the earth in over me. This wasn’t a quick flash thing, like you feel it and move on. No, it stuck with me, a nagging presence in the back of my head for the rest of a 10-hour trip. And that, my friends, is what Rejection Sensitive Dysphoria feels like. And, yeah, it’s a motherfucker.

Hello World. Meet “Richard”

I’ve told you about this asshole several times over the course of this blog, but today I thought I give him the spotlight he so richly deserves. To kick this off, I should probably start with a little background, like maybe a definition. Psychology Today says that rejection sensitive dysphoria is “a strong emotional reaction to negative judgments, exclusion, or criticism from others that it sends them into a mental tailspin, leading to rumination and the pit-of-the-stomach malaise that won’t let them move forward with their day.” That tracks rather well with the shitastrophe related in the preceding paragraph and is one of the better descriptions/definitions I’ve seen of the condition. As I said, it’s a motherfucker.

Why “Richard”?

Right about now, you’re probably wondering why I refer to RSD as “Richard”. There are a couple of reasons. One, “Rejection Sensitive Dysphoria” is a kind of a mouthful. Well, really, it’s a lot to type. And, what with me being slightly lazy, I’m always looking for shortcuts. Now, I could–and occasionally do–use the acronym, RSD. While that would be a good fit with the aforementioned laziness, it doesn’t really… sing. It’s just kind of flat. So, I tried to think of a name that, for me, represented a true asshole. I settled on “Richard” because it’s the name of a guy who made life hell for my kids. I won’t go any deeper than that. It’s not important. Just know that the name “Richard” represents a total fucking shitshow of a human being and is the perfect representation of my RSD.

So, How Does Rejection Sensitive Dysphoria Work?

We don’t really know that much about RSD other than it fucking sucks. When you read up on it, you see a lot of “doctors believe” and “may” or “could be” language around the subject when it comes to what causes it. That’s because it’s a relatively new label that’s only beginning to see in-depth research. It doesn’t help that RSD gets misdiagnosed because, often, it looks like other mental illness-related shit. With me, when things stay internal, I basically shut down and start looking for a way to get out of what has become a shitty situation. Basically, it looks like I’m sad or scared. If it becomes an external thing, it can come off as a rage disorder because I’ll blow the fuck up over some shit that seems utterly trivial. And, like anyone else who’s experienced any trauma, I try to do anything possible to avoid the pain that comes with it. Then, it looks like I have social anxiety/phobia (I do but that’s another story). All in all, it’s a fucked up situation.

What It Looks Like For Me

Okay, remember how I said in the story at the beginning of this post that mispronouncing a single word stuck with me for 10 hours? Yeah, it’s really so much fucking worse than that. Because that incident occurred years ago. And, I still remember it. Vividly. Well, kind of vividly. I can’t recall what the conversation was about or the word I fucked up. But I do remember feeling like a goddamn moron and beating myself up for mispronouncing a relatively simple word. I also remember thinking, “Oh shit, I’ve been saying it this way for years. And, nobody said anything. They’ve probably all been laughing and talking about how stupid I am.” And, that’s part of what makes Richard such a goddamn bastard. He replays shit from the past that has absolutely no bearing on the present, just to make me feel like a total garbage person.

What To Do About it?

Okay, there’s good news and bad here. First, the bad: there’s not really a “cure” because it looks like this shit is genetic. It’s fucking hardwired into your brain. And childhood trauma, something every neurodivergent person is intimately familiar with, makes it worse. Oh, it gets better, since psychotherapy doesn’t do much good either because of the way it hits so suddenly. I fucking told you it was bad. But, as I said a second ago, there’s good news, too. Like, sometimes, just knowing that RSD is a thing helps. It tells you that none of this is your fault and you’re not a total garbage person. If that’s not enough, there are medications that can help, like alpha agonists and MAOI’s (monoamine oxidase inhibitors). MAOI’s, those lovely little bastards, are also effective in treating ADHD symptoms. So, as bad as it sounds, it’s not a complete fucking loss.
(All info in this paragraph pulled from ADDitude and Psychology Today)

Richard and I

So, what does all this mean for me and the asshole in my head? It’s hard to say, really, because things are little fucking cloudy where Richard is concerned. Partly because this stuff is so new, to me and the mental health folks, and partly because I’ve spent 60-odd years dealing with this shit on my own and developed a shit ton of coping skills. I don’t think I need meds because, while it’s not exactly great having some dick inside your head saying you suck, I can function. To a degree at least. But, I also feel like the whole “just knowing” thing isn’t really cutting it, either. I mean, it worked for a while, but now? Not so much. I’m going to have to find a middle way with this and I have no earthly fucking idea what it might look like. If I ever come up with something, I’ll let you know. Until then, I guess I just keep telling Richard to shut the fuck up.