ADHD and rejection sensitivity

[Anonymous]

DS is 10 and has ADHD. His main issue is emotional disregulation often triggered by rejection sensitivity. Prior to his diagnosis at age 7 he would often get upset over not understanding something/feeling like he didnt know what to do/feeling like he did something wrong. He would shut down and not talk/curl into a ball.

He got on medication and honestly things have been fantastic. He has a sport which he loves but practice is long and goes till 9pm. He has come home crying lately a few times because the coach corrected him on something. I see the interactions and the coach does this with all the kids and is kind about it , but DS feels it more.


We did start an afternoon booster dose of meds yesterday but yesterday may have been the worst, not sure if the med is right or it was just a coincidence.

Anyway, long story short I would love some tips on how you work through these moments with your kid. The internet often tells.me breathing/counting exercises and those just dont seem to work or he cant use them in the moment. Affirmations do work well with him, so I will ramp those up.

But any other tips are helpful. I worry about the transition to middle school when he is so sensitive.

I did talk to him about starting therapy again but last time didn't go so great (he just refuses to talk/interact). But now he is older and on meds so it will hopefully be different.

TIA

[Anonymous]

DH is 59. For 30 years we have been working on this issue with zero results. It is like he enjoys getting his fifis hurt for no reason at all. It is some kind of delusion that other people want to hurt him.

[Anonymous]

DBT can be helpful. Talk therapy tends not to be.

[Anonymous]

Anonymous wrote:DH is 59. For 30 years we have been working on this issue with zero results. It is like he enjoys getting his fifis hurt for no reason at all. It is some kind of delusion that other people want to hurt him.

Ugh. Well that is not giving me much hope!

[Anonymous]

The impulsivity is the issue (and the part that’s related to adhd.) rejection sensitivity is not among the characteristic symptoms in the dsm (though of course plenty if kids with adhd are, just as all sorts of kids are.)

I think you would be better served by concentrating on the impulsivity that causes problems when he’s feeling wounded-it’s more amenable to treatment and the most important thing to get a handle on. It also avoids the tricky business of policing his feelings.

When the lashing out is under better control cbt or dbt may help.

[Anonymous]

Anonymous wrote:The impulsivity is the issue (and the part that’s related to adhd.) rejection sensitivity is not among the characteristic symptoms in the dsm (though of course plenty if kids with adhd are, just as all sorts of kids are.)

I think you would be better served by concentrating on the impulsivity that causes problems when he’s feeling wounded-it’s more amenable to treatment and the most important thing to get a handle on. It also avoids the tricky business of policing his feelings.

When the lashing out is under better control cbt or dbt may help.

Following up because I forgot to mention-helping him with the impulsive lashing out is doubly helpful because those behaviors result in more criticism and rejection (which can generalize into kids keeping their distance at times when behavior is completely fine which of course feels bad.)

[Anonymous]

I had to check the date to see if I might have written this while changing the gender and sport.

Kid is now almost 12 and some maturity has kicked in. At least enough that instead of curling up and crying she can say “I feel like a 3rd wheel, can we leave” or “I know he wants to encourage me but I hate when coach tells me how to run”.

Therapy didn’t work at 7 or 8, but got was good at age 10. We lost our therapist due to insurance changes so we are on hiatus now and will likely start up again soon.

I think it’s a lifelong battle but a little maturity and some therapy didn’t go a long way. Also the meds and a lot of conversations and patience on our end.

[Anonymous]

Anonymous wrote:I had to check the date to see if I might have written this while changing the gender and sport.

Kid is now almost 12 and some maturity has kicked in. At least enough that instead of curling up and crying she can say “I feel like a 3rd wheel, can we leave” or “I know he wants to encourage me but I hate when coach tells me how to run”.

Therapy didn’t work at 7 or 8, but got was good at age 10. We lost our therapist due to insurance changes so we are on hiatus now and will likely start up again soon.

I think it’s a lifelong battle but a little maturity and some therapy didn’t go a long way. Also the meds and a lot of conversations and patience on our end.

*it DID go a long way…

[Anonymous]

First of all, 9 is way too late for anyone to be managing emotions.

I have worked with many kids like this and it just takes a lot of talking about the rejection feelings and CBT is really the best way to manage this.

[Anonymous]

Anonymous wrote:The impulsivity is the issue (and the part that’s related to adhd.) rejection sensitivity is not among the characteristic symptoms in the dsm (though of course plenty if kids with adhd are, just as all sorts of kids are.)

I think you would be better served by concentrating on the impulsivity that causes problems when he’s feeling wounded-it’s more amenable to treatment and the most important thing to get a handle on. It also avoids the tricky business of policing his feelings.

When the lashing out is under better control cbt or dbt may help.

Is it impulsivity? He isnt reacting but not reacting if that makes sense. Like he doesn't yell or get mad at other kids. He just goes silent and goes to sit by himself and wont interact with folks. Not doubting its the impulsivity that starts it just never thought about it that way.

But I dont see it as lashing out. Am I looking at it wrong?

[Anonymous]

Anonymous wrote:First of all, 9 is way too late for anyone to be managing emotions.

I have worked with many kids like this and it just takes a lot of talking about the rejection feelings and CBT is really the best way to manage this.

Thanks. We talk about it a lot but obviously I am not a pro but sounds like getting him back into therapy will be good..

[Anonymous]

Op, my DC with ADHD was like this and it has gotten better over the last year (now 12) but DC was in therapy from age 10-11 (CBT) to deal with managing thought patterns that led to the rejection sensitivity.

And DC’s impulse control got better around the same time — now thinks before being mean back to kids or getting angry.

My DH also has extreme rejection sensitivity and just started CBT for the first time this past year and it has gotten much better. He used to leap to defensiveness when he felt he www being criticized (even when he wasn’t). It’s honestly been amazing to see the progress he has made — it can really work if the person is willing to try to break patterns and change outcomes.

[Anonymous]

Anonymous wrote:First of all, 9 is way too late for anyone to be managing emotions.

I have worked with many kids like this and it just takes a lot of talking about the rejection feelings and CBT is really the best way to manage this.

Kids with ADHD are typically less emotionally mature than other kids their age. I don’t know what kind of work you do with kids, but you don’t seem to know much about ADHD-related emotional dysregulation.

[Anonymous]

Anonymous wrote:Op, my DC with ADHD was like this and it has gotten better over the last year (now 12) but DC was in therapy from age 10-11 (CBT) to deal with managing thought patterns that led to the rejection sensitivity.

And DC’s impulse control got better around the same time — now thinks before being mean back to kids or getting angry.

My DH also has extreme rejection sensitivity and just started CBT for the first time this past year and it has gotten much better. He used to leap to defensiveness when he felt he www being criticized (even when he wasn’t). It’s honestly been amazing to see the progress he has made — it can really work if the person is willing to try to break patterns and change outcomes.

This is great to hear. I will look into it for DS. Luckily (maybe?) He never lashes out physically or is never meant back, just shuts down. Before he was diagnosed with ADHD I felt it was depression because he just gets so deeply sad.

But he doesnt have many friends, which is heart breaking.

We talked a lot today and he just tells.me he doesnt understand why he gets so sad. It is so hard when your kid comes up and asks you why he has to feel the way he feels 😞

[Anonymous]

A traditional therapist might be fine but also consider a well regarded EF or ADHD therapist.

You want someone who understands the benefits of routine, the self concept issues that can come with ADHD, and how to interrupt the automatic withdrawal.

I am sorry it's so hard. I would guess interacting with peers brings up those sensitivities and he withdraws there too which likely explains why making friends is a challenge.