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the adhd + anxiety wombo combo.

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And the ADHD+Anxiety+Depression trifecta?

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May not be interesting or new info (and the comments section of an ADHD meme are probably not the place for this anyway), but I just recently learned a very plausible reason why the trifecta seems to be so prevalent:

Rejection-sensitive dysphoria (RSD).

It’s essentially an abnormally strong negative emotional response to rejection or failure, and it’s very common in people with ADHD.

“Rejection sensitive dysphoria, while not a formal diagnosis, is also a common symptom of attention deficit hyperactivity disorder, estimated to affect a majority of people with ADHD.” Source (Wikipedia)

Basically, people with RSD go about their days constantly and disproportionately anxious about doing everyday things. If they make an absentminded mistake (which of course happens all the time with ADHD), they’ll feel bad about themselves for it out of fear of disapproval from those around them, which only feeds the anxiety even more. If they mess up something more serious, it can be devastating.

Here’s another link with some great info under the “Symptoms and Causes” section:

• It’s very easy for them to feel embarrassed or self-conscious.

• They show signs of low self-esteem and trouble believing in themselves.

• They have trouble containing emotions when they feel rejected. This is often noticeable in children and teenagers with this condition. Some may react with sudden shows of anger or rage, while others may burst into tears.

• Instead of losing control of their emotions outwardly, some people with RSD may turn their feelings inward. This can look like a snap onset of severe depression, and sometimes, it’s mistaken for sudden emotional shifts that can happen with bipolar disorder or borderline personality disorder.

• They’re often “people pleasers” and become intensely focused on avoiding the disapproval of others.

• They may avoid starting projects, tasks or goals where there’s a chance of failure.

• They compensate for their fear of failure or rejection by going all-out or striving for perfectionism. However, the downside of this is that they often experience intense anxiety and may not easily make self-care or downtime a priority.

So to sum it up, RSD affects a majority of people with ADHD, and can amplify anxiety due to fear of rejection/failure in many different forms, and any eventual rejections/failures that do materialise are met with a disproportionately negative emotional response.

Shit sucks.

I’ll share some anecdotes below if anyone is interested, but the TL;DR is that it has an extremely strong effect on me, and I imagine someone might be able to relate, if they care enough to read lol.

Last semester, I failed all 3 of my classes because I couldn’t keep up with the school work due to problems with my (at the time undiagnosed) ADHD. I remember falling behind and getting increasingly anxious about all the work I needed to catch up on, which only made me procrastinate my studies even more in order to hide from the anxiety and fear of failure/rejection that I knew I would feel when I became overwhelmed. I felt like an absolute idiot, especially because I recognised that logically, further procrastinating made absolutely no sense at all, and was definitely going to lead to failure in my classes. It got so bad that I could NOT make myself sit down and study, I was paralysed with anxiety every time I opened my laptop to study after working up the courage to make myself “just fucking start already”.

As the exams came closer, it became more and more apparent that failure was now the only option I had left. As that reality set in and I had to face this failure, the self-image I like to create of myself as a respectable and relatively smart person just dissolved. I felt the self-rejection engulfing me, I imagined the disappointment from my family and peers, and I became cripplingly depressed within maybe 90 seconds of reality setting in. I felt absolutely worthless for months afterwards, lower than low. This is what finally got me to make the doctor’s appointment which led to my ADHD diagnosis.

And something not so serious that happened years ago: While driving to work one day, I was running a tad late as usual, and couldn’t shake the feeling that I was forgetting something. It was really stressing me out, and anxiety was making me try frantically to remember what it was, because the longer it took me to realise what I forgot, the longer the drive back would take, and the later I would be for work. At some point I decided to just take inventory of everything I had and see if it felt off. I started with the 3 pocket check— wallet is there, phone is there, keys are… Shit, I forgot my keys.

So I took the next exit to turn around, and raced home for my keys. I didn’t realise for maybe 10 minutes that my keys weren’t in my pocket because, well, they were in the ignition of my car, which I was currently driving. That dumb little setback caused me to be late for work. I still remember the shame I felt driving back, deciding on what lie to tell my boss so I didn’t have to admit how much of a idiot I am. To make things worse, after I parked my car I discovered that I had forgotten my knife bag at home (I was working as a chef). It really made me feel absolutely worthless, and triggered a bit of depression afterwards. I can’t remember how long the depression lasted, but it definitely hit me harder than it should have.

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