10 Features of Rejection Sensitive Dysphoria and Vulnerable Narcissism

Rejection Sensitive Dysphoria (RSD – a common symptom or an aspect of ADHD) in which someone experiences extreme emotional pain due to feeling shame and experiencing perceived or real rejection. Once the rejection is experienced or conceptualized, this is where the disproportionate response comes in. There can be big, intense, and debilitating responses to the pain. There is a sensitivity to criticism and an overarching fear of failure and not living up to expectations. Intense bouts of rage can occur when their feelings are hurt. Individuals with RSD are their own harshest critics, believe that no one likes them, are people pleasers to gain acceptance and approval, avoid harder tasks for fear of failure, and dedicate their time to be a perfectionist. Those with RSD may hide their feelings from others and feel ashamed of their vulnerability, sensitive sides, and emotional dysregulation, which is one of the executive functions. There is this shying away from friendships and romantic relationships because they won’t be liked if the person knows the real them. There is this constant rumination about things ending badly and catastrophizing is a big sign of RSD. 


Often we see overlap between Vulnerable Narcissism (VN) and RSD within ADHD. I’m excluding Grandiose Narcissism because it is not correlated with Neuroticism. Vulnerable narcissism and RSD are correlated with Neuroticism, although RSD is not a clinical construct so it’s not empirically correlated with neuroticism.  So we are looking closer at emotional instability and specifically neuroticism, shame, anxiety and depression. 


There are of course similarities and differences, and slight variations. Here is a list of 10 variations that I discuss on my channel:


  1. Rejection – Both can feel rejected or not valued by others and experience internalizing emotions that include low self-esteem, can mimic a mood disorder, and result in suicidal ideation. When it is externalized, the RSD individual will lash out in anger directly, and the VN will use passive aggressive tactics as well as antagonistic methods like being petty and spiteful. 


  1. Criticism – Both can feel slighted easily and can be hypersensitive to feedback of any kind that doesn’t match positivity or their self-view. The RSD individual is their own worst critic where the VN will criticize others for not recognizing how unique they are. Narcissism is more about a defense of I’m angry and outraged that you don’t recognize how special and amazing I am.


  1. Anxious and Insecure in social situations – Both can be shy, reserved, and insecure when being social. The RSD individual is anxious about not being able to keep up and do what neurotypicals are capable of doing. A difference may be that the RSD individual is anxious about someone not liking them (they just want to be part of the group or accepted by someone) and the VN is anxious that the person won’t recognize how great they are and what talents they have. Or, they don’t like me because they are too stupid to recognize my unique abilities. 


  1. Feel like Failures – The RSD individual feels like a failure in that they exaggerate even the slightest of negative things happening to them. More like an all or nothing view on something. The VN feels like a failure in knowing that they can’t directly get their narcissistic supply and have to rely on manipulative and passive aggressive ways of attaining success. They have high envy of others but think they deserve what others have without even earning it. 


  1. Rumination – the RSD individual will have negative thought loops obsessing over what they did wrong or how broken they are for hours, days and sometimes weeks. The VN will ruminate through complaining, blame shifting, talking and acting like a victim, and tricking people into misery loves company. 


  1. Shame – The RSD individual is ashamed of their lack of emotional control. That pain is actually physical and they feel like they should be able to weather the storm much better than they do. The VN suffered abuse or mistreatment in childhood and that was turned inward as being inherently unworthy of love. They invest a great deal of effort trying to push away their inner critic and to numb their pain and shame. 


  1. Distrustful of others – The RSD individual doesn’t trust others due to likely contributing factors of having negative events accompanied by intense and overwhelming emotions and cognitive distortions that move most incidents from a molehill to a mountain. They view it as much bigger than it probably was. The VN is distrustful of others because they couldn’t reach the unrealistic or high expectations from their parents in childhood and believe that people have this agenda for them that is based on getting something from them or trying to exploit them in some way. Paranoia can set in. 


  1. People Pleasers – People pleasers because they want to gain acceptance and get on people’s good side. Narcissism is more about using the acceptance of others to prop up their self-esteem. People are a tool.


  1. Interrupting – RSD interrupts because they’re going to forget what they’re thinking about and are anxious about essentially falling behind in conversation or not being able to communicate clearly. VN is more about interrupting because they aren’t listening to you anyway and couldn’t care less about what you’re saying unless it’s about them. 

Being Late – RSD Individuals are more likely to be apologetic and explain in great detail why they were late and take some accountability for their lack of time management.VN is more about blame shifting and saying something like wow there was this idiot driver in front of me going so slow for 3 miles. Blaming others for being late and can’t take accountability.

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