ADHD Masking and Burnout in Adults

What masking is

Researchers who study masking describe it as the process of intentionally, or unintentionally, hiding aspects of yourself to avoid harm. It is sometimes called camouflaging. It can be a deliberate choice in one meeting, or a habit so old that you no longer notice you are doing it.

Masking was first studied in autistic people, but it is not limited to them. In one study, autistic adults, other neurodivergent adults and neurotypical adults all described masking, though some parts of it, such as holding back stimming, seemed specific to autistic people.

It also makes sense. People mask because they have been corrected, teased or left out. In a study of young adults with ADHD, participants said they masked out of a wish to fit in and to avoid rejection.

What masking can look like

No two people mask the same way. These examples come from adults and young adults who took part in research.

• Watching what other people do and copying it so you blend in
• Monitoring your own eye contact, facial expressions and gestures
• Staying quiet, or looking like you are paying attention when you are lost
• Overcompensating, such as arriving far too early so you are never late
• Not asking for help because you do not want anyone to see you struggle
• Holding in movement, fidgeting or stimming until you are alone

The cost of holding it together

Masking can get you through a school day or a job interview. The trouble is what it takes. In the study that compared autistic, other neurodivergent and neurotypical adults, every group described masking as exhausting, and every group said it left them feeling disconnected from who they really are.

A review of studies on autistic adults found that camouflaging can come with anxiety, depression and exhaustion. The young adults with ADHD said masking and compensating were harder when they had less energy, and the authors noted that masking often comes at a steep cost to the person.

Masking can also delay answers. The National Institute of Mental Health notes that there are many reasons someone may not be diagnosed with ADHD until adulthood, and that symptoms in girls and women are especially likely to have been missed in childhood. Reviewers say camouflaging may delay an autism diagnosis as well.

When masking leads to burnout

Autistic adults have long used the word burnout for a specific kind of collapse. Researchers working with autistic adults defined autistic burnout as a syndrome that results from chronic life stress and a mismatch between expectations and abilities, without adequate supports. They describe three main features: long-lasting exhaustion, loss of skills, and reduced tolerance to stimulus such as noise or light.

In that study, masking was the most prominent stressor people named. When the load keeps growing and there is no way to get relief, expectations outweigh abilities, and burnout follows.

Two cautions matter. Autistic burnout is a research definition, not a formal diagnosis, and the study that defined it was small and exploratory. Research on burnout in adults with ADHD is thinner still. If the description sounds familiar, that is worth taking seriously, and it is also worth checking with a professional, since depression and other health conditions can look similar.

What helps, and how affirming therapy fits

The autistic adults in the burnout study said what helped was acceptance and social support, time off or reduced expectations, and doing things in an autistic way, including unmasking. The researchers also warned about the possible dangers of teaching autistic people to mask.

Affirming therapy starts from the same place. Your traits are treated as part of how you are built, not as faults to cover more skillfully. These studies describe what people report; they do not test one therapy for masking. What therapy can offer is a steady relationship and room to work on things like:

• Noticing when and where you mask, and what it costs you afterward
• Deciding where the mask still serves you and where you could set it down
• Planning rest, sensory breaks and realistic expectations into your week
• Practical ADHD strategies. Psychotherapy such as cognitive behavioral therapy is a common part of ADHD care for adults.
• Working with the anxiety, low mood or shame that built up along the way

How we can help

Locascio Wellness is an all-virtual practice. Sessions are by secure video, and you need to be physically located in Pennsylvania, West Virginia or Arizona during each session. Therapists on our team work with ADHD and with neurodivergent adults, and we match you with someone licensed in your state. You do not need a diagnosis to start, and you do not need to have the right words.

You can read about ADHD therapy, anxiety therapy and depression therapy. If you are wondering about a formal assessment, our psychological evaluations page explains how that works. We do not prescribe medication; questions about medication belong with a prescriber. When you are ready, book a free 15-minute consultation.

If you are in crisis or thinking about harming yourself, call or text 988, or call 911. Locascio Wellness does not provide emergency services.