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Picture this: you text your romantic partner in the middle of the day, inquiring about dinner and after-work plans, but the message goes unanswered for an hour. Or your manager pulls you aside to offer some constructive criticism on a project or task you thought you were doing well with. If these or similar situations would leave you feeling anxious, incredibly unsettled, or angry, you may have high rejection sensitivity.

According to board certified behavioral analyst Reena Patel, high rejection sensitivity is an emotional response pattern characterized by an intense fear of rejection and an excessive need for approval from others. In less-clinical terms, it causes people to interpret uncertain or ambiguous social cues as signs of humiliation. As a result, rejection is not just a temporary sting or setback, but a devastating blow that affects self-confidence and can lead to social anxiety.

Who can have high rejection sensitivity?

Though high rejection sensitivity can manifest in anyone, significantly affecting their sense of self and social functioning, Patel says it is typically found in people with attention-deficit hyperactivity disorder (ADHD). “It’s hard to measure rejection, but individuals with ADHD have difficulty with attention, understanding social cues, impulse control, perspective sharing, and thus don’t have insight to interpret unclear conversations, being teased, or criticism,” Patel says. Besides ADHD, rejection sensitivity is also associated with psychological trauma and post-traumatic stress disorder.

Importantly, high rejection sensitivity is not a diagnosable condition, but a pattern of thoughts, feelings, and behaviors that can be observed and acknowledged by medical professionals, according to Darren Aboyoun, a clinical psychologist.

“It is more commonly observed in individuals who have experienced significant rejections or who have a history of interpersonal difficulties, such as those with insecure attachment styles,” Aboyoun explains. “Sensitivity to rejection can trigger physiological changes, including the fight-or-flight response, and heightened activity in areas of the brain that influence blood pressure, decision-making, and emotions.”

Aboyoun emphasizes that people who exhibit this trait aren’t just feeling bad about a situation they can easily “move on” from, but rather their feelings toward rejection are so deeply ingrained and overwhelming that they can lead to social withdrawal and isolation.

How sensitivity to rejection can affect your personal and professional life

High rejection sensitivity can cause a person to have a more insular and reserved outlook regarding their personal and professional lives, Aboyoun says. For instance, they may not want to ask for a raise for the fear of being denied, or may not be able to function properly at work if their ideas are challenged or rejected. Meanwhile, within romantic and other interpersonal relationships, they may overanalyze interactions and distance themselves from loved ones, especially if they have experienced an unsuccessful romantic relationship. As a result, they may hide aspects of themselves to avoid rejection or a breakup, though in doing so they risk appearing aloof, shy, or disinterested. 

“In professional settings, high rejection sensitivity can disrupt one’s ability to collaborate with others, concentrate effectively, and ultimately hinder productivity and career advancement,” Aboyoun says. “In family and interpersonal relationships, it can contribute to miscommunication, difficulties in cultivating open, supportive relationships.”

Coping mechanisms and steps to move forward 

High rejection sensitivity is not currently categorized as a mental condition or illness, but as a behavioral trait. There is no proven cure or medication to manage it on its own, though certain types of therapy and coping mechanisms can help.

[Related: How to keep your anxiety from spiraling out of control]

Cognitive restructuring is one effective strategy that can help you challenge and reframe negative thoughts related to rejection. You may have noticed that you can’t just “shake off the feeling” or say an affirmation to turn your feelings around. Instead, you must consciously restructure your thoughts and gain a balanced perspective on the situation to reduce the intensity of your emotional response. 

If you’re feeling up to it, you can also try to be clear with the people in your life about what you need from them. For instance, if you need validation or acknowledgment of your emotions and experiences without judgment, consider asking for it. Aboyoun suggests working with others to help them choose their words carefully when speaking with you and to ask others for reassurance when appropriate. The idea is to foster open lines of communication so that others can understand your perspective without minimizing your experiences.

Practicing mindfulness and relaxation techniques such as deep breathing exercises or meditation may also help manage anxiety and emotional reactivity triggered by perceived rejection, but Aboyoun suggests other coping strategies too.

For one, it’s important to acknowledge and accept that high rejection sensitivity is a vulnerability. If you are exhibiting a chronic heightened reaction to certain feelings or interactions, it’s good to self-reflect, Aboyoun says. Self reflection will require a deeper insight into why you reacted a certain way and whether that feeling is limited to something you said or did, or something else, he explains. 

“High rejection sensitivity is a very treatable condition,” Aboyoun says. “Effective treatment can positively change one’s life by increasing confidence and developing improved social skills that will cultivate more fulfilling relationships.”

This access to treatment is why he recommends therapy or counseling and working with a trained therapist to identify your patterns of rejection and increase your capacity to adapt to your thoughts and feelings.

Rejection sensitivity can be a challenging behavioral pattern to overcome, and unfortunately it has been the subject of very limited research. Until more studies can be done, learning to cope may involve a fair amount of trial and error. But once you find an approach that works, you should see improvement in previously troublesome areas of your life.