By Tim Aiello, MA, LPC, NCC, ADHD-CCSP, ASDCS
Clinical Director, Myndset Therapeutics
What Is Masking?
Masking is a natural human behavior. We all do it to some extent—adjusting our tone, body language, or expressions depending on the social context. It’s a form of camouflage that helps us navigate different environments. For example, we might suppress frustration in a professional setting or feign confidence in a nerve-wracking situation.
For neurodivergent individuals, particularly those with ADHD, Autism, or AuDHD (the co-occurrence of ADHD and Autism), masking isn’t just an occasional adjustment—it’s a full-time survival strategy. It’s the act of suppressing or mimicking behaviors to fit into neurotypical expectations, often at great personal cost.
Why Do ADHD and Autistic Adults Mask?
Masking in neurodivergent individuals develops as a response to social pressures, learned over time through trial and error. As children, many of us receive subtle (or not-so-subtle) messages that our natural ways of thinking, moving, and interacting are "wrong" or "too much." To avoid social rejection, bullying, or exclusion, we learn to camouflage.
For Autistic individuals, this often means forcing eye contact, suppressing stimming (repetitive movements like rocking or hand-flapping), or memorizing social scripts to navigate conversations (Hull et al., 2017).
For ADHD individuals, masking may involve overcompensating for impulsivity, forcing themselves to sit still, or mimicking organizational strategies of neurotypical peers to appear more "put together" (Kirkovski et al., 2019).
For AuDHD individuals, masking becomes a particularly complex juggling act, as they navigate both ADHD-related difficulties with impulse control and Autism-related struggles with social communication (Mandy, 2019).
This constant performance isn't just exhausting—it has significant psychological and physiological consequences.
Examples of Masking in ADHD, Autism, and AuDHD Adults
Autistic Masking
Practicing conversations in advance to mimic neurotypical speech patterns.
Forcing themselves to maintain eye contact even when it feels overwhelming.
Memorizing and mimicking social cues like smiling at the “right” time or nodding to show interest.
Suppressing stimming behaviors (e.g., tapping fingers, fidgeting, rocking) to appear more “normal.”
Using excessive politeness to avoid conflict, even when boundaries are crossed.
ADHD Masking
Writing out scripts for meetings or social interactions to avoid impulsively interrupting.
Over-apologizing for things like being late, fidgeting, or forgetting details.
Forcing themselves to appear “calm” and “focused” in situations where they are internally overwhelmed.
Relying heavily on lists, alarms, or apps to mask executive dysfunction while appearing organized.
Suppressing emotions or downplaying struggles to avoid being labeled as "lazy" or "irresponsible."
AuDHD Masking (A Combination of Both)
Constantly monitoring tone and facial expressions to avoid seeming “too much” or “too blunt.”
Alternating between fidgeting (ADHD side) and suppressing fidgeting (Autistic side) to appear controlled.
Overanalyzing every social interaction afterward, worrying about what was said or how they were perceived.
Mimicking behaviors of neurotypical coworkers or friends to avoid standing out.
Feeling exhausted after social interactions due to the mental effort required to “perform” neurotypicality.
The Hidden Dangers of Masking
1. Increased Anxiety and Depression
Research shows that chronic masking is strongly correlated with mental health struggles. The ongoing pressure to suppress authentic behaviors can lead to anxiety, depression, and even suicidal ideation (Cage et al., 2018). The more an individual masks, the more disconnected they may feel from their true self, leading to a deep sense of alienation.
2. Autistic Burnout and Emotional Exhaustion
Autistic burnout is a state of intense mental, physical, and emotional exhaustion caused by prolonged social masking and sensory overload (Raymaker et al., 2020). Unlike general burnout, which improves with rest, autistic burnout is deeply tied to identity suppression, making recovery much harder without intentional unmasking.
3. Loss of Self-Identity
Many neurodivergent adults, including myself, reach a point where we realize we don’t actually know who we are. After years—sometimes decades—of performing a version of ourselves that’s palatable to society, we have to unlearn the mask and reconnect with our authentic identity. This process can be disorienting, even painful, as we sift through years of conditioned behaviors to uncover what truly feels natural.
4. Delayed or Missed Diagnosis
Masking can also prevent individuals from receiving a formal ADHD or Autism diagnosis. Many high-masking adults, particularly those assigned female at birth, have gone undiagnosed for years because their symptoms don’t present in the stereotypical way clinicians expect (Lai et al., 2017). This often leads to misdiagnosis with anxiety, depression, or personality disorders instead.
Unmasking: The Journey Back to Authenticity
Unmasking is a deeply personal and often nonlinear process. It doesn’t mean we stop adapting to situations entirely—some level of social camouflage is normal and necessary. However, for neurodivergent individuals, unmasking means shedding the parts of ourselves that we’ve hidden out of fear and embracing who we really are.
Ways to Start Unmasking Safely
Self-Reflection: Journaling or talking with a trusted therapist can help identify which behaviors feel natural versus which ones are performative.
Safe Spaces: Surrounding yourself with neurodivergent-friendly communities where you can be yourself without judgment.
Mindful Stimming: Reintroducing natural stimming behaviors (e.g., fidgeting, rocking) in safe environments to rebuild sensory regulation.
Setting Boundaries: Learning to say no to social interactions that require excessive masking.
Therapeutic Support: Working with professionals who understand neurodivergence (like those at Myndset Therapeutics) can provide guidance on balancing social adaptation with authenticity.
Final Thoughts
Masking is a survival skill, but long-term, it comes at a high cost. For those of us who are neurodivergent, unmasking isn’t just about comfort—it’s about reclaiming our true selves. The journey back to authenticity takes time, patience, and self-compassion, but it is possible.
At Myndset Therapeutics, we understand the struggle of masking firsthand, and we’re here to help neurodivergent adults navigate their path toward self-acceptance. You deserve to be seen, understood, and valued—exactly as you are.
References
Cage, E., Troxell-Whitman, Z., & Monteith, J. L. (2018). "Understanding the relationships between social camouflaging, mental health, and well-being in autistic adults." Journal of Autism and Developmental Disorders, 48(6), 1974-1986.
Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M. C., & Mandy, W. (2017). "Putting on my best normal: Social camouflaging in adults with autism spectrum conditions." Journal of Autism and Developmental Disorders, 47(8), 2519-2534.
Kirkovski, M., Enticott, P. G., & Fitzgerald, P. B. (2019). "A review of the role of female gender in autism spectrum disorders." Journal of Autism and Developmental Disorders, 49(4), 1357-1371.
Lai, M. C., Lombardo, M. V., Auyeung, B., Chakrabarti, B., & Baron-Cohen, S. (2017). "Sex/gender differences and autism: Setting the scene for future research." Journal of the American Academy of Child & Adolescent Psychiatry, 56(1), 95-103.
Mandy, W. (2019). "Social camouflaging in autism: Is it time to lose the mask?" Autism, 23(8), 1879-1881.
Raymaker, D. M., McDonald, K. E., Ashkenazy, E., Gerrity, M., Baggs, A. M. B., Kripke, C., & Nicolaidis, C. (2020). "Barriers to healthcare: Instrument development and comparison between autistic adults and adults with and without other disabilities." Autism, 24(4), 879-892.
Comments