CHAPTERS
Bethany’s relapse after 7 years sober: the trigger
Alex opens with a personal story meant to illustrate how intense rejection sensitivity dysphoria (RSD) can be for people with ADHD. He introduces “Bethany,” who had been sober for seven years but relapsed after a single, ambiguous workplace message.
- •RSD framed as the hardest part of ADHD
- •Bethany had maintained sobriety for seven years
- •A relapse is linked to an emotional reaction, not a craving-driven scenario
- •The story is anonymized (name changed)
The ambiguous email that sparked immediate dread
Bethany receives a brief email from her boss late on a Friday asking to chat Monday morning. With no context, her brain interprets the message as a looming threat.
- •Timing intensifies the uncertainty (Friday afternoon before weekend)
- •Boss’s message is vague: “Can we have a chat Monday morning?”
- •Lack of clarity creates space for negative interpretation
- •RSD sensitivity to perceived rejection or criticism is activated
Catastrophic thinking spiral: “They’ve found out I’m useless”
Alex describes Bethany’s rapid descent into worst-case assumptions following the email. Her thoughts jump straight to rejection, failure, and being secretly disliked at work.
- •Instant catastrophizing in response to ambiguity
- •Fear of being fired becomes a certainty in her mind
- •Internal narrative of being ‘tolerated’ and hated
- •Emotional intensity and speed of the spiral emphasized
Self-medication and escalation over the weekend
Overwhelmed by the spiral, Bethany turns to alcohol on the way home and continues drinking into Saturday. By Sunday she can’t sleep, showing how the anxiety compounds when left unresolved.
- •Buys two bottles of wine and gets very drunk
- •Drinks again Saturday evening
- •Sunday marked by insomnia and mounting anxiety
- •RSD-driven distress leads to harmful coping behavior
Monday’s reveal: promotion, not punishment—and the RSD lesson
When Bethany finally meets her boss on Monday, she learns the conversation was to offer her a promotion. Alex uses the contrast to highlight how RSD fills uncertainty with the worst possible story, with real-life consequences.
- •Boss meeting outcome: promotion offer
- •Bethany’s disbelief underscores how convinced she was of rejection
- •Core takeaway: in absence of context, RSD assumes worst-case scenario
- •Spirals described as instant, catastrophic, and fast
- •Consequences can be severe enough to derail long-term progress (sobriety)
