RSD is commonly associated with ADHD and sometimes seen in individuals with autism or trauma histories. It is not currently a formal diagnosis in the DSM (Diagnostic and Statistical Manual of Mental Disorders.), but it is widely recognized by clinicians and those with lived experience as a defining feature of many neurodiverse profiles.

How It Shows Up

• A seemingly minor comment or tone shift can feel devastating

• The person may replay conversations over and over, trying to find the “wrong” thing they said

• They may withdraw suddenly or lash out, not because they’re overreacting—but because they feel profoundly wounded

• Apologies, even sincere ones, may not register if the pain hasn’t subsided

• Fear of rejection can lead to perfectionism, people-pleasing, or avoiding risk altogether

• It may be hard for others to understand the scale of the reaction, especially if the “offense” seems small

Relationship Impact

In close relationships, RSD can lead to cycles of miscommunication and distance. A partner might walk on eggshells, not realizing their neutral feedback was internalized as deep criticism. Or they might feel confused when a conversation suddenly goes off the rails.

For the person with RSD, their emotional responses are often as bewildering to them as they are to others. They may feel ashamed afterward, replaying the moment obsessively, unsure how to make things right.

Over time, this can erode trust and safety unless both people learn to navigate it with awareness, compassion, and language.

What Helps

• Naming it: Simply knowing what RSD is—and that it’s real—can be a relief. It’s not “too sensitive,” it’s neurobiological.

• Time and space: When someone with RSD feels triggered, immediate repair may not be possible. Giving space without abandoning them can help restore calm.

• Preemptive reassurance: Affirmations of care, belonging, or safety (especially when no conflict is present) can buffer the fear of future rejection.

• Gentle language: Critique or feedback can be framed in collaborative terms: “Can we figure this out together?” rather than “You did this wrong.”

• Therapeutic support: Working with a therapist who understands neurodiverse relationships can help build internal tools for emotional regulation.

• Partner communication: Creating shared language—like a signal word or nonverbal cue—can help navigate moments of dysregulation without escalating conflict.

A Note of Reassurance

If you or your partner struggles with RSD, you are not alone—and you are not broken. You may simply feel more deeply than others. When handled with care, that depth can become a source of profound empathy, creativity, and connection.