Rejection Sensitive Dysphoria and ADHD

[@cosmosprincess20]

Thank you for informing us about RSD. It isnt talked about enough

[@markmuller7962]

I've been misdiagnosed with NPD, I've misdiagnosed my mom with BPD and my dad with NPD. In reality we're all undiagnosed and late-diagnosed ADHDers with (clearly) severe psychological comorbidities

[@markmuller7962]

I personally feel like RSD is composed both of psychological and neurological factors. It's true that we love emotions in an amplified manner but it's also true that we go through a lot of failures, umiliations and masking

[@broccoli-dev]

Thank you as always, Dr Kruse

[@OrafuDa]

It is illuminating to hear more about RSD, emotional control problems, and how they can be treated. Thank you! Just to add, I have now heard several times that for some people a combination of a stimulant with atomoxetine (Strattera) or, less often, guanfancine (Intuniv) can not only help tolerating the stimulant better, but also improve emotional control considerably. I have also met at least one person in a self-help group who had exactly this experience. He could not tolerate stimulants unless paired with atomoxetine, and that combo also allowed him to stay much calmer.

[@DrJohnKruse]

Yes, I have information on that in my video on guanfacine. kzbin.info/www/bejne/lXTXgKN9mN2Dna8

[@verymuchgerman]

Thank you

[@michaeljames4904]

This was tremendously detailed and instructive, thank-you! Before wishing you a very Happy New Year, Dr Kruse, I'd like to say that, I'd immensely value just such an intensive video, on the time blindness that goes hand in hand with ADHD. While I've sought out your videos from long ago on the topic, I'm curious as to whether there have been any developments in the literature, in relation to this aspect. Because in terms of effective treatment modalities, for what many count the most disabling aspect of the disorder, there seems to be a dearth of available options. (at least within my own knowledge base)

[@DrJohnKruse]

From what I've seen, CBT approaches to help teach people how much time tasks take, and learning to set alarms (that won't be ignored) are the most helpful approaches to time blindness.

[@michaeljames4904]

@DrJohnKruse Smashing, thank-you. It is to me at least the most debilitating aspect of what I am pessimistic and opinionated enough to self-refer to, as a "mental handicap." (Though having now consumed a lot of your KZbin content, your own natural kindness would eschew the use of such loaded language!) 'Adrift in time,' as Barkley writes, as a description is nonetheless right on the money.

[@kenhaze5230]

Interesting to me is that triiodothyronine specifically is said to improve atypical depression/RSD in some cases. I have a personal anecdote involving kelp and waving motorists that is consistent with this, but I hesitate to suspect it's generalizable.

[@DrJohnKruse]

It sounds like that might be an interesting one to study to see if it does generalize. Can kelp help or should we just wave this one off?

[@kenhaze5230]

​@@DrJohnKruse Thanks for the encouragement. I'm wary of overfitting to my deliberate actions, and also that nutritional deficiencies are relatively rare with sufficient food energy. That said, my overall experience after starting to eat kelp was consistent with increased thyroid hormone levels pretty much across the board, most conspicuously drastically increased cold tolerance. But finally, and this is the punchline, and one should be most wary of the absurdity, before eating kelp (and for my whole life), I would Midwesternly wave at motorists while running, but also feel irrational resentment that I was fully aware was irrational when they didn't wave back. After a few weeks eating kelp, for the first time in my life, I noticed I didn't really care. Both before and after, I told myself the same things: they didn't see, or if they did, what does it matter? There's no possible way their declining to wave could in any way implicate any judgment on anything about me. But I didn't need to engage in all the self-talk after consuming more iodine for a while. I'll bookend by saying even with a nontrivial perusal of the literature on thyroid hormone effects on cognition, emotion, and adrenergic receptor density and function, I couldn't come up with an actual explanation, even propose one, as to why normal thyroid function would ameliorate RSD/low thyroid function would reduce it. Of course, maybe it's another physiological effect of iodide, but those are even more startlingly poorly characterized. And hey, I'd love to run a trial. For now, I'll keep eating kelp.

[@kenhaze5230]

P.S.-I first started taking lower dose potassium iodide (nutritional dose, not nuclear apocalypse dose), so it's iodide, not something else in kelp, and, waving motorists weren't domain/interaction where I long experienced RSD (if not by that name) and experienced relief after putatively repleting iodine, just the one where the mismatch between the mundanity of the event and the intensity of my automatic reaction was most conspicuous.

[@DrJohnKruse]

@@kenhaze5230 that sounds like a pretty dramatic self discovery even if we don't know the mechanism.

[@cowboycarl69]

Your points about psychotherapy vs pharmaceuticals match up with my personal experience. Dodson arguing that RSD can only be treated by one and not the other sort of assumes a strict boundary between brain chemistry and consciousness, like the brain is a computer with hardware and software. Seems pretty clearly untrue! Do you have a link or DOI number for the parent/child ADHD treatment study you mentioned? Sounds pretty interesting.

[@OrafuDa]

I am glad that both medication and psychotherapy seem to help with RSD and emotional dysregulation. Of course, more studies exploring this would be good to have as well. On the computer analogy: while I am not usually using this analogy when conceptualizing psychological phenomena, mainly because it is just not necessary and it has many limits, I do think that it is not the worst analogy, as far as analogies go. Because even for computers, a good chunk of hardware problems can be addressed in software, and vice versa. (Although the latter requires exchanging hardware, rather than something analogous to medication, which is one way how the analogy breaks down and becomes useless - and one of the reasons why I am not using it. Relying on this analogy means asking for problems.)

[@DrJohnKruse]

This video is a few years old, but a few articles on parental emotional regulation and ADHD kids are here: pubmed.ncbi.nlm.nih.gov/32929486/#:~:text=Results%3A%20When%20compared%20with%20controls,self%2Dregulation%20in%20both%20groups. pubmed.ncbi.nlm.nih.gov/28890229/

[@JWdotnet]

Please can you stop using the seemingly random jump zoom cuts? I am aware other KZbin presenters use these to hold attention, or for dramatic emphasis. But this needs to be used with a certain level of editing skill that you channel doesn't currently demonstrate. I wish I didn't need to be critical in this way (ironic given the video subject, and my own RSD 😅), but as it stands, your current implementation of this is so distracting I have to listen audio only ☹

[@DrJohnKruse]

I appreciate the feedback, and Max, who is helping me with sound editing may have a more thorough explanation. The sound quality on many of the older videos is poor, both because of the microphone and recording equipment I used as well as the lag based on recording many of these without a great internet connection. Max has been improving the sound but some of this includes editing out moments due to the lags.

[@FlynnaYoutube]

Hey, this is the video editor, thanks for the feedback! As Dr. Kruse explained, some of these older videos suffer from a lot of audio issues and quite a bit of lag. They therefore require a lot of work to make them audible, and there are even some videos that I'm not able to fix because of the condition of the original recording despite my best efforts. I actually never make cuts willingly, they are always a solution of last resort when I'm not able to fix an audio glitch/artifact or lag spike by any other means. But know that I spend a lot of time agonizing about each of these cuts, and looking for solutions to make them as seamless as possible. Dr. Kruse is currently working hard to ameliorate the general quality of his videos, but in the meantime you can check out his weekly newly released videos which have better audio, or his weekly livestreams every Tuesday! Have a good one!

[@DrJohnKruse]

@@FlynnaKZbin thank you Max!

[@MT-tg4bt]

Dr. Kruse, you note that 1/3 of folks with adhd are impervious to negative feedback and criticism, that it slides off of our backs - please consider the possibility that dissociation is employed.