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When ADHD and Anxiety Fill in the Blanks: A Lesson in Communication, Clarification, and Self-Regulation
May 10, 2025 at 4:00 AM
by Zaneb Mansha, MSW
A blurred hand reaching out against a red backdrop symbolizing isolation.

Today I experienced something small—but emotionally significant.

A message in a conversation with someone I care about disappeared.
It was there one moment, gone the next.

I assumed she had deleted it. And without warning, my thoughts filled with anxiety:

  • “She’s upset with me.”
  • “I must’ve said something wrong.”
  • “Why would she delete it unless something was off?”

My heart raced. My mind spiraled. And before I even had a chance to consider other possibilities, I was convinced something had gone wrong.

The Role of ADHD and Rejection Sensitivity

As someone with ADHD and Rejection Sensitive Dysphoria (RSD), I’ve learned that my brain is quick to jump to conclusions—especially in relationships.

ADHD involves more than distractibility or hyperactivity. It also affects emotional regulation, impulse control, and executive functioning (Barkley, 2015). When paired with RSD—a term coined by Dr. William Dodson to describe intense emotional pain from perceived rejection or criticism—the emotional response is often disproportionate but very real.

Research shows that people with ADHD experience heightened amygdala reactivity, meaning emotional parts of the brain activate faster than the rational prefrontal cortex can catch up (Arnsten, 2009). What might be a glitch to someone else feels like a rupture to us.

A message disappears—and it’s not just confusing. It feels personal. It feels like rejection.

But This Time, I Paused

Instead of spiraling, withdrawing, or masking my worry like I’ve done in the past, I grounded myself. I asked:

  • What else could be true?
  • Could this be a misunderstanding—or even just a technical issue?

And then, I made the choice to communicate.
I gently asked her if she had deleted the message and whether everything was okay.

The Outcome: Clarity, Not Catastrophe

A few hours later, she replied. Her message was kind, reassuring, and clarifying.

She hadn’t deleted anything. There had been a technical issue with the app.
She was surprised I thought anything was wrong—and affirmed our connection.

What I feared was a rupture… wasn’t one at all.

What This Moment Teaches About Thought Traps and Emotional Regulation

In therapy, we talk about cognitive distortions—automatic negative thought patterns that aren’t grounded in reality. For those with ADHD and RSD, these distortions often show up quickly and feel intensely believable:

  • Mind reading: “She’s mad at me.”
  • Catastrophizing: “This relationship is probably over.”
  • Personalization: “This is my fault.”

According to Beck’s cognitive model, these thoughts are shaped by core beliefs—often rooted in past experiences of unpredictability, invalidation, or trauma (Beck, 1976). When those wounds are left unhealed, our nervous system may become hypervigilant to perceived threat—even in calm situations.

The key isn’t to shame those thoughts. It’s to slow them down.
To separate the story from the situation.

Why This Moment Mattered

This wasn’t just about one message.
It was about choosing a new ending:

  • I didn’t let old fears dictate new behavior
  • I paused, reflected, and grounded
  • I chose curiosity over assumption
  • I gave someone a chance to clarify instead of retreating in fear

That’s what emotional regulation looks like—not perfection, but presence.

Therapeutic Takeaway: Tools for Navigating ADHD and RSD

If you resonate with this, here are a few evidence-based tools to support your process:

1. Name the thought distortion
Use cognitive restructuring techniques (Beck, 2011) to ask:
“Am I catastrophizing, mind-reading, or personalizing this?”

2. Regulate your body first
The nervous system needs grounding before problem-solving. Try:

  • Deep breathing (Box breathing: inhale for 4, hold 4, exhale 4, hold 4)
  • Cold water on wrists or face
  • Gentle movement or bilateral tapping

3. Challenge the urgency
Not every thought needs action.
Urge surfing (Linehan, 1993) helps you ride the emotional wave without reacting immediately.

4. Communicate gently
If safe, seek clarification. Use “I” statements:
“Hey, I noticed the message disappeared and wasn’t sure what happened—just checking in.”

5. Track the pattern
Journaling or therapy can help uncover when old wounds are shaping new stories.
Trauma-informed care reminds us that what looks like overreacting is often overprotecting (van der Kolk, 2014).

Final Reflection

For neurodivergent individuals, especially those with ADHD and RSD, even small misunderstandings can feel overwhelming. But you’re not broken—your brain is just doing its best to protect you.

With practice, you can learn to pause, regulate, and respond in ways that serve your current self—not your past fears.

It’s not about erasing your sensitivity.
It’s about learning to stay with it—and rewrite the story with clarity, not catastrophe.

_____

References

  • Arnsten, A. F. T. (2009). Stress signaling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience.
  • Barkley, R. A. (2015). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. Guilford Press.
  • Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. International Universities Press.
  • Beck, J. S. (2011). Cognitive Behavior Therapy: Basics and Beyond (2nd ed.). Guilford Press.
  • Dodson, W. (2017). What is Rejection Sensitive Dysphoria (RSD)? ADDitude Magazine.
  • Linehan, M. M. (1993). Skills Training Manual for Treating Borderline Personality Disorder. Guilford Press.
  • van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.

Your story matters. Let’s prioritize it.

If you’re ready to break patterns, build clarity, and feel seen— Book a free consultation or schedule your first session today!