Masking in Autism and ADHD: Why So Many Adults Don’t Realize They’re Neurodivergent
Masking often means hiding your true self to feel safe or accepted. For many autistic and ADHD adults, this survival strategy can delay self-understanding and lead to chronic exhaustion.
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Many adults don’t discover they’re autistic, have ADHD, or have both until their late 20s, 30s, or beyond. Often, it’s not because the signs “weren’t there.” It’s because those signs were hidden—sometimes even from the person themselves—through a process called masking (also called camouflaging).
Masking can look like “doing fine” on the outside while feeling chronically exhausted, anxious, or disconnected on the inside. And for many high-achieving adults—especially women and people socialized to be agreeable, emotionally attuned, or “easy to be around”—masking can become so automatic that it feels like personality rather than a survival strategy.
This article explains what masking is, why it happens, how it shows up in both autism and ADHD, and what the research says about its mental health impact.
Important note: This post is educational and not a diagnosis. If you suspect autism and/or ADHD, consider seeking a formal evaluation with a qualified professional.
What is “masking” (camouflaging)?
Masking refers to strategies people use to hide, suppress, or compensate for neurodivergent traits in order to “fit in.” In autism research, this is often called social camouflaging—and it can include consciously copying social behaviors (like facial expressions, tone, or conversational timing) or unconsciously monitoring oneself to avoid being judged (Khudiakova et al., 2024; Lei et al., 2024).
Researchers commonly describe camouflaging as involving processes like:
Compensation: using learned strategies to navigate social situations
Masking/suppression: hiding traits that might be seen as “odd”
Assimilation: blending in by matching social expectations, sometimes at the expense of comfort or authenticity (Lei et al., 2024; van der Putten et al., 2024)
Masking isn’t “fake.” It’s often an adaptive response to real social knowledge: If I act like myself, I might be rejected, misunderstood, punished, or excluded.
Why masking is so common in adults
Masking tends to develop when a person repeatedly learns that their natural way of being is “too much,” “not enough,” “weird,” “rude,” or “lazy.” Over time, they may become highly skilled at predicting expectations and editing themselves—especially in school, workplaces, or family systems where performance and social ease are rewarded.
Research reviews suggest that camouflaging is influenced by a mix of social pressure, stigma, identity development, and context (Khudiakova et al., 2025; Summerill, 2025). It can be more common in environments that prioritize social conformity, emotional labor, or appearance of competence.
Masking isn’t just autism — it shows up in ADHD too
While “masking” is most studied in autism, evidence increasingly shows that adults with ADHD also camouflage, even if the pattern can differ (van der Putten et al., 2024). In one study comparing autistic adults, adults with ADHD, and non-autistic/non-ADHD adults, those with ADHD reported more camouflaging than the comparison group, though generally less than autistic adults (van der Putten et al., 2024).
This matters because many adults who suspect ADHD—or who are diagnosed with anxiety or depression—may not realize the daily effort they spend compensating:
rehearsing what to say before a conversation
over-preparing to avoid being seen as “messy” or “inconsistent”
using perfectionism to cover executive functioning challenges
working twice as hard to stay organized, on time, and “together”
Camouflaging can also complicate identification when autism and ADHD overlap (often called AuDHD in online communities), because strengths in one area can obscure needs in another, and vice versa (Waldren et al., 2024).
Why late diagnosis is especially common in women and high achievers
Many adults—especially women—report that they “looked fine” growing up because they were:
compliant
high-performing academically
socially “pleasant”
internally struggling but externally functional
Research indicates camouflaging can be particularly relevant when social expectations are more intense or gendered, contributing to missed or delayed recognition (Khudiakova et al., 2024; McKinney et al., 2024). More recent measurement work also finds patterns of camouflaging that differ across groups, including sex-related differences in camouflaging scores (Cancino-Barros et al., 2025).
In other words: it’s not that autism/ADHD suddenly appears in adulthood. Often, adults become aware because their coping system finally becomes too expensive—especially during major life transitions:
college or graduate school
starting a demanding job
parenthood
relationship stress
burnout
health changes
Signs masking may be part of your experience
Not everyone who masks is neurodivergent—but if these resonate strongly and consistently, they can be worth exploring:
After socializing, you feel depleted
You may “perform well” socially and still need significant recovery time.
You script conversations
You rehearse what to say, study social dynamics, or mentally review interactions afterward.
You’ve been told you’re “intense,” “too sensitive,” or “hard to read”
Or you learned early to hide emotional reactions to avoid criticism.
You feel like you have multiple versions of yourself
Work self. Social self. Family self. “Real” self (only when alone).
You’re successful—but feel chronically stressed or like you’re barely holding it together
You may be using anxiety, perfectionism, or people-pleasing as scaffolding.
These experiences are common in clinical discussions of camouflaging and its consequences (Lei et al., 2024; Summerill, 2025).
The hidden cost: what science says masking can do to mental health
Masking can help someone navigate a world that doesn’t accommodate neurodivergence—but research consistently links higher camouflaging to worse mental health outcomes.
A 2024 systematic review and meta-analysis found camouflaging is associated with higher anxiety and depression and lower mental wellbeing in autistic people (Khudiakova et al., 2024). Additional research suggests links between camouflaging, internalized stigma, and mental health strain across groups, highlighting that camouflaging can carry psychological costs even when it “works” socially (Ai et al., 2024).
Other reviews focused on adults describe both potential short-term benefits (like social access or safety) and significant downsides, including exhaustion, identity strain, and reduced wellbeing (Summerill, 2025).
A core theme across the literature is this:
When your nervous system is constantly monitoring for mistakes, it can look like competence—and feel like chronic threat.
“Unmasking” doesn’t mean dropping everything at once
Unmasking is not about forcing yourself to be different overnight, or putting yourself in unsafe situations. For many adults, unmasking is more like reconnecting with internal cues—needs, boundaries, sensory preferences, pacing, and identity.
A science-based approach is often gradual and contextual:
noticing where you mask the most (and why)
identifying which environments are truly safe
experimenting with small, low-risk changes
developing supports that reduce the need to compensate constantly (Summerill, 2025)
For some, a formal assessment is helpful because it provides a framework for self-understanding and accommodations. For others, therapy is the first step: building clarity, self-trust, and a language for what they’ve lived.
When to consider an evaluation (or therapy)
You might consider seeking assessment or neurodiversity-informed therapy if:
you’ve been treated for anxiety/depression for years but still feel “different”
you relate strongly to autism/ADHD lived experience
you feel exhausted from constant self-monitoring
your functioning drops during transitions or stress
you suspect you’ve built your life around coping rather than thriving
A supportive next step
If you’re questioning whether masking has shaped your life, you don’t have to figure it out alone. Therapy can help you:
identify patterns without pathologizing you
reduce shame and self-blame
explore whether autism, ADHD, trauma, or anxiety best explains your experience
build practical supports that fit your real life
If you’d like, I offer a consultation to help you sort through what you’re experiencing and decide what kind of support would be most helpful.
References
Ai, W., et al. (2024). Camouflaging, internalized stigma, and mental health in autistic and non-autistic people. [Journal name]. https://pmc.ncbi.nlm.nih.gov/articles/PMC11528950/
Cancino-Barros, I., et al. (2025). A meta-analytic review of quantification methods for camouflaging. Scientific Reports. https://www.nature.com/articles/s41598-025-06137-z
Khudiakova, V., et al. (2024). A systematic review and meta-analysis of mental health correlates of camouflaging. [Journal name]. https://www.sciencedirect.com/science/article/pii/S1750946724001673
Khudiakova, V., et al. (2025). What we know and do not know about camouflaging. Autism Research. https://onlinelibrary.wiley.com/doi/full/10.1002/aur.3299
Lei, J., et al. (2024). Exploring the association between social camouflaging and mental health. Autism. https://journals.sagepub.com/doi/10.1177/13623613241238251
McKinney, A., et al. (2024). Camouflaging in neurodivergent and neurotypical girls at the transition to secondary school. [Journal name]. https://acamh.onlinelibrary.wiley.com/doi/10.1002/jcv2.12294
Summerill, J., et al. (2025). The consequences of social camouflaging in autistic adults: A systematic review. [Journal name]. https://www.sciencedirect.com/science/article/pii/S3050656525000288
van der Putten, W. J., et al. (2024). Is camouflaging unique for autism? A comparison of camouflaging between adults with autism and ADHD. Autism Research. https://onlinelibrary.wiley.com/doi/full/10.1002/aur.3099
Waldren, L. H., Leung, F. Y. N., Hargitai, L. D., et al. (2024). Unpacking the overlap between autism and ADHD in adults: A multi-method approach. Cortex. https://www.sciencedirect.com/science/article/pii/S0010945224000145
