Dr. Yath Ramesh

for both men and women again, the experience of complex physical health challenges as you age, and again, going through retirement.

At all of these life stages, you're experiencing things that you never may have experienced before.

And one of the most difficult challenges with this, and I'll give you an example of this, okay?

One of the things that people in their later stage of life tell me is that they look back at a certain period, it's around middle adulthood, where everyone is caught up in the thick of things.

And during that time, what happens is that you don't have as many interactions with your friends and family around you, but those interactions can be detrimental depending on how they play out.

And so something that I've heard time and time again is,

I never really had that good a relationship with my brother, but that one Christmas in 1998 just completely ruined our relationship.

And they link it back to their experience of RSD that might have happened during that moment.

And what it does is it reinforces to their RSD and to their ADHD brain that...

this is not a safe space and that you need to be careful with your social interactions so as you go through the life stages things can become more complicated but also your rsd can become more sensitive to those situations from happening what is rsd how would you describe it so rsd stands for rejection sensitive dysphoria

It is a concept and a term coined by the American psychiatrist William Dodson, who I know that you know very well.

You've interviewed him here.

And essentially what it describes is an intense physical and an emotional experience.

a symptom or pain that you experience in the context of actual or perceived threats and it's disproportionate to what other people may presume to be a normal reaction to a situation and this is important because in the moment when you're experiencing rsd it's very possible that

your emotions and experience are completely logical and justified for that situation based on what's going on in your brain.

You might regret it later, yes, but in the moment, it will make complete sense to you.

And...

One of the most painful things about RSD is that there is a self-perpetuating cycle between RSD and trauma.

So as we all know, you know, from ADHD, you're more likely to experience trauma in the context of having ADHD.

Unlike other experiences, so let's take alcohol.