What does it mean to mask ADHD and autism?

Masking is either the conscious effort, or ingrained unconscious suppression of traits of ADHD or autism. It’s a survival mechanism that develops in an attempt to assimilate into a society which is set up for neurotypical people. However, this adaptation can cause more harm than good to mental health.

Masking starts young when neurodivergent people notice that they don’t fit into the unwritten social code that others seem to magically understand. It develops when you experience repercussions for your neurodivergent traits.

ADHDers might have been told off by parents or teachers for being loud, defiant, fidgety or daydreaming. Autistic children might be told they’re overly sensitive, or be bullied by classmates for being ‘weird’. They might struggle to make friends, or be excluded from playground games.

What neurodivergent people often learn through their interactions with others is that it is not safe to be their authentic selves. Autistic and ADHD people learn to mask by being hyper vigilant of what others feel – whether explicit – verbal reprimands, or implicit - like facial expressions or not being invited to social events.

Studies show that masking - which is when neurodivergent people hide their autistic or ADHD traits - is related to a history of trauma in relationships. When neurodivergent people suppress the behaviours which come naturally to them, it can lead to ADHD or autistic burnout.

Examples of masking in ADHD and autism

Autistic people might mirror what they notice works for others in social situations – including on TV or film. They might script conversations before having them – even interactions that may seem simple for neurotypicals, like meeting a friend for coffee.

Autistic people might continue to make eye contact, even when it’s uncomfortable for them, because they’ve been told that this is how you know someone is paying attention. They might practice facial expressions to make sure they’re emoting the ‘right’ way.

At work, masking ADHD may look like taking extra time to make your work tidy or comparable to others, or working extra hours to keep up with your tasks because reasonable adjustments haven’t been made.

While people with ADHD have a reputation for being messy or disorganised – masking may mean they’re overly fixated on keeping a clean house. They may have a militant colour-coded calendar, make lots of lists to keep up with their tasks, or have endless alarms to make sure they don’t miss appointments.

Both autistic and ADHD people use stimming as a way to self-soothe – this may look like jigging your leg, hand flapping or vocal stimming like repeating certain noises, humming or singing. In situations where it’s not deemed socially acceptable, ADHD and autistic people may suppress their stims – even when they’re needed to help self-regulate.

Masking ADHD and autism frequently means squashing intense feelings, which can have negative consequences for both your physical and emotional health.

It’s important to note that though we’re discussing ADHD and autism in this article, there are other forms of neurodivergence, like dyslexia, dyspraxia, dyscalculia and dysgraphia. People with these forms of neurodivergence may also mask and experience the adverse effects of masking on their mental health.

How does masking affect mental health?

The effects of masking on mental health are significant – masking can take neurodiverse individuals further and further away from their true self.

Rates of mental health conditions like anxiety and depression are already higher among individuals with ADHD and autism. Studies show that masking exacerbates mental health problems, leading to lower self-esteem, higher rates of anxiety, depression, self-harm and in some cases, suicide.

Masking reinforces the neurodivergent person’s belief that they are not enough as they are. That in order to be accepted by others, they must be a different version of themselves.

It can also lead to disconnection from their own emotions, as the focus is placed on how they are being perceived by others. This can lead to social interactions becoming a performance, rather than being able to know and embody who they really are.

Masking is hard work. Mental health conditions can intensify symptoms of neurodiversity - meaning that masking symptoms becomes a more difficult challenge - draining limited resources. In autism and ADHD, masking can lead to burnout – extreme physical, emotional and mental fatigue which makes it hard to function day to day.

Masking, gender, race and queerness

Women, BIPOC (black, indigenous, people of colour) and queer people may be more likely to mask as people in these groups have usually experienced discrimination based on other factors of their identity. They have been conditioned by society to hide differences out of fear of being mistreated, abused or discriminated against. Masking is used by these people as a tool to be safe in a world which is often traumatic.

This is reflected in the results of the CAT-Q test – a survey which analyses how highly masking individuals are. A score of 100 and above indicates that you’re camouflaging autistic traits.

Autistic women average a total score of 124.35. For non-binary people it’s 122, and for men it’s 109.64.
For many, masking is a necessity to survive in a world which hasn’t always been kind to them, but the effects on mental health beg the question – is it worth it?

Unmasking is a personal choice, and we recognise not everyone will feel safe enough to do so. We don’t yet live in a world that normalises and accepts neurodivergent traits – and those with ADHD and autism still experience mistreatment for being their authentic selves.

How do you unmask autism and ADHD?

The effects of masking on mental health are clear – and unmasking, even if only around people you feel safe with, can help you feel more at peace with your authentic self-expression.

But, this can be a tricky process, and additional barriers like being part of a marginalised group, being late-diagnosed or undiagnosed can complicate the process.

For some, diagnosis may be the first step - for others, knowing internally who they are may be enough.. Our clinical psychologists and psychotherapists can help you bring awareness to the ways in which you’re masking, and together, you can explore how masking may be affecting your mental health and sense of identity. During sessions, you can practice unmasking in real-time, within a safe, therapeutic relationship.

References
The Transmitter, Largest study to date confirms overlap between autism and gender diversity, 2020
J A Evans et al, What you are hiding could be hurting you: autistic masking in relation to mental health, interpersonal trauma, authenticity and self-esteem, 2024
Neurodivergent Insights, What is Masking in Autism? Autistic Masking Explained
ADDitude, Why ADHD masking is a form of self-sabotage, 2025
Re:think dyslexia, Unmasking dyslexia: understanding the impact of masking on mental health and advocacy.
Reframing autism, Friendship, loneliness and belonging in autistic people.
Embrace Autism, The CAT-Q, 2020.
J Alagbhand-rad et al, Camouflage and masking behaviour in adult autism, 2023.
Mental health America, Unmasking as a late-diagnosed autistic person, 2024.
Very well mind, What does ADHD masking look like? 2024.