Question 1

What is rejection sensitive dysphoria (RSD) and is it a real diagnosis?

Accepted Answer

RSD describes an intense, almost physical wave of pain in response to rejection, criticism, or the perception of having disappointed someone — out of proportion to the event and usually gone within an hour. It's a clinician-described pattern popularized by psychiatrist William Dodson from the ADHD world; it is not a formal diagnosis and isn't in the DSM-5. The broader science of rejection sensitivity, however, is well established. So the label is informal, but the experience is solidly real.

Question 2

Why do I know something is wrong but can't say what I'm feeling?

Accepted Answer

This is alexithymia — difficulty identifying and describing emotions — which overlaps heavily with autism. It isn't an absence of feeling; the feeling arrives at full strength while the words lag behind. It builds on interoception: when the body's inner dashboard runs dim, the raw signal of an emotion can arrive without its name attached. Naming feelings can be learned body-up: notice the sensation first, then look for the word.

Question 3

Are autistic women misdiagnosed as borderline or emotionally unstable?

Accepted Answer

Often, yes. Many autistic women are diagnosed with borderline (emotionally unstable) personality disorder years before autism is considered. Sometimes both fit, but autistic emotional intensity, masking, and meltdown are frequently misread as BPD — with real harm, because both the treatment and the story about who you are go wrong. Intensity is not the same as instability.

NEW PATH FAMILY

Big Feelings and Rejection Sensitivity

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