You know something is wrong. You’ve always known. But you’ve spent so long performing “fine” that you’re not sure what’s underneath it anymore. That’s what ADHD masking does. It doesn’t just hide your symptoms from other people. Eventually, it hides them from you.
There’s a particular kind of exhaustion that comes from spending your entire day managing how you come across. Not the ordinary social effort most people make. Something more fundamental. A constant background process of monitoring, adjusting, suppressing, and compensating that runs from the moment you wake up to the moment you finally stop pretending.
For people with ADHD, this process has a name. It’s called masking. And for many, it’s been running so long they’ve forgotten it’s even there. It’s one of the reasons so many adults arrive at an ADHD assessment not because they recognised their own ADHD symptoms, but because something finally broke down badly enough that the mask couldn’t hold.
What Is ADHD Masking?
ADHD masking is the conscious and unconscious suppression of ADHD-related behaviours in order to appear neurotypical. It ranges from deliberate strategies like rehearsing conversations and scripting emails, to automatic habits like suppressing fidgeting, chronic people-pleasing, and saying yes to everything because the cost of being seen as difficult feels worse than the cost of burning out.
Conscious and Unconscious ADHD Masking
The distinction between these two forms matters. Research using camouflaging scales adapted from autism studies has found that adults with ADHD score highly on both deliberate compensation (using conscious strategies to get through social situations) and automatic assimilation (the internalised compulsion to blend in). Evans, Krumrei-Mancuso, and Rouse (2024) found that higher levels of masking were associated with poorer mental health, lower self-esteem, and a reduced sense of authenticity, regardless of the specific diagnosis driving it. Most people use a mix of both. Conscious effort tends to dominate in high-stakes environments like work or new social settings. The automatic habits take over everywhere else.
Unconscious masking is often the harder form to recognise, precisely because it doesn’t feel like a strategy. It feels like who you are. Years of social punishment for being “too much” or “not enough” train the nervous system to suppress certain behaviours automatically. You might not even notice that you tense your body in meetings, mirror the energy of whoever you’re with, or default to agreeableness regardless of what you actually think. These aren’t choices being made in the moment. They’re conditioned responses, built up over years of learning that your natural way of being invites correction. For many people, this masking is so deeply embedded that unmasking feels less like removing a disguise and more like losing an identity.
ADHD masking is different from high masking in autism, though there is significant overlap, particularly for people who sit across both profiles. In ADHD, the masking tends to centre on hiding disorganisation, impulsivity, emotional intensity, and the inability to sustain attention. In autism, it’s more commonly about concealing social communication differences. Where the two overlap, the masking load compounds.
One thing that gets lost in most discussions of ADHD masking is the question that matters most. Not what are you hiding, but why is your brain doing this in the first place?
What’s Happening Underneath: The Neurology of ADHD Masking
ADHD masking isn’t a personality trait or a character flaw. It’s a compensatory neurological strategy, and it has a measurable cost.
The Prefrontal Cortex and the Effort of Appearing Normal
Research by Brennan and Arnsten (2008) established that ADHD involves alterations in prefrontal cortex circuits and their connections to the striatum and cerebellum. The prefrontal cortex governs exactly the functions masking depends on: inhibiting inappropriate responses, holding social rules in working memory, monitoring errors, and regulating attention and affect.
When these systems work differently, as they do in ADHD, the person has to recruit more prefrontal resources to reach the same behavioural outcome as someone without ADHD. Social performance that looks effortless from the outside is, neurologically, anything but.
Why Adults “Look Normal” When Children Don’t
A 2024 systematic review of social cognition in ADHD (Capuozzo et al.) found that children show clear difficulties with emotion recognition, understanding sarcasm, and reading non-verbal cues. But adults with ADHD often look more “normal” on these same measures. The authors’ explanation is compensatory processes. Adults have had years to develop workarounds. They’ve learned to read the room by working harder at it, not because the underlying difficulty has resolved.
That’s masking, described in clinical language.
A separate review in Frontiers in Psychology (2022) reinforced this. When emotional expressions were presented in richer, audiovisual formats, adults with ADHD showed significant gains in emotion recognition. They could use extra contextual cues to compensate for baseline processing inefficiencies. The difficulty wasn’t in interpreting what an expression meant. It was in picking up the cue in the first place: the clinical picture of someone who knows what’s socially appropriate but has to consciously work to notice and respond to signals that other people process automatically.
Reward, Punishment, and Why Masking Starts
Wetterling and colleagues (2015) found that adults with persistent ADHD showed reduced activation in the medial prefrontal cortex after punishment and weaker connectivity between prefrontal and reward-processing regions. People whose ADHD had remitted showed more typical connectivity, interpreted as reflecting more effective neural compensation developed over time.
In practical terms, this means ADHD masking is partly shaped by how the brain processes social reward and punishment. The approval you get for appearing organised. The criticism you get when you don’t. The rejection you experience when you’re “too much.” Over time, the brain builds control loops to avoid that punishment, and in some people, those loops become efficient enough that the ADHD looks like it’s gone. It hasn’t. The person has just become very good at hiding it.
In Short
- ADHD masking draws heavily on prefrontal cortex resources that are already working harder than typical in ADHD brains
- Children with ADHD show clearer social difficulties; adults appear to compensate, but at significant cognitive cost
- The brain’s reward and punishment systems play a central role: masking often begins as a response to social rejection and criticism
What Does ADHD Masking Actually Look Like?
ADHD masking shifts depending on context, on how depleted someone is, on who they’re with. But there are patterns that show up repeatedly.
ADHD Masking at Work
At work, it might look like someone who arrives impeccably prepared for every meeting because they spent three hours the night before compensating for the fact that they couldn’t focus during the day. They take meticulous notes not because they’re diligent, but because they know they won’t remember what was said otherwise. They volunteer for visible tasks that play to their strengths and quietly avoid anything that exposes their difficulties with sustained attention or sequential processing. Their colleagues see someone competent. What they don’t see is the ADHD paralysis that sets in the moment the office door closes.
ADHD Masking in Relationships and Social Settings
In relationships, masking can look like over-attentiveness in the early stages, driven partly by hyperfocus and partly by anxiety about getting it wrong. It can look like suppressing emotional reactions because you’ve been told too many times that you’re “overreacting.” The emotional dysregulation that accompanies ADHD doesn’t disappear because someone has learned to keep a steady face. It just goes underground.
Common Signs of ADHD Masking
Across these settings, the behaviours that tend to signal masking include:
- Over-preparing for tasks or conversations to compensate for difficulties with working memory and focus
- Scripting what to say in social situations or before phone calls
- Suppressing fidgeting, restlessness, or the urge to move
- People-pleasing or agreeing to things you don’t want to do in order to avoid conflict or judgement
- Using humour or charm to deflect attention away from unmet responsibilities
- Mimicking the organisational habits or social behaviour of colleagues and friends
- Chronic lateness followed by elaborate compensatory routines to appear punctual
- Exhaustion after social interactions that others seem to manage easily
- Avoiding situations entirely rather than risk being seen to struggle
In school, masking is often the reason ADHD gets missed entirely. ADHD masking in girls is particularly difficult to detect, and masking inattentive ADHD is harder still, because the symptoms are quiet to begin with. A child with the inattentive presentation might sit quietly, stare at the board, and appear to be paying attention while their mind is somewhere else completely. They compensate through intelligence or perfectionism, getting by on ability alone until the demands outstrip what raw capability can cover. Teachers see a “bright but inconsistent” student. ADHD masking at school becomes self-reinforcing: the better the child performs the mask, the less likely anyone is to look underneath it.
ADHD Masking in Women and Girls
If masking is common across all ADHD presentations, it’s especially prevalent and especially costly in women and girls. ADHD masking in females is not driven by a fundamentally different neurology, but by different social conditions acting on the same brain.
Why Girls Learn to Mask Earlier
Young and colleagues published an expert consensus statement on females with ADHD (2020) highlighting that girls are socialised to be compliant, relational, and emotionally contained from early childhood. Disruptive or disorganised behaviour is less tolerated in girls than in boys. The consequence is that girls with ADHD learn very quickly that overt hyperactivity, impulsivity, or emotional intensity leads to criticism, social rejection, or being labelled “dramatic” or “lazy.” They respond by camouflaging. Their self-esteem becomes contingent on how well they perform the mask rather than on anything authentic.
Research published in Frontiers in Psychology (2025) on identity work among girls with ADHD described strong pressure to conform to feminine norms of being diligent, socially smooth, and caring. The girls in the study reported “adjusting and suppressing behaviour,” “holding back energy,” and hiding their true selves in school and peer settings to avoid being seen as annoying, childish, or “too much.” This wasn’t occasional impression management. It was constant.
What Masking Costs Women Long-Term
A doctoral thesis titled “Behind Her Eyes: Masking in Women with ADHD” (2025) synthesised nine studies and conducted new interviews with ten adult women. The findings were consistent. Masking was used to fit in, reduce criticism, and maintain relationships by concealing ADHD-linked behaviours and emotions. The women described it as something that started in childhood, often before diagnosis, and became so embedded they struggled to distinguish masking from their actual personality.
The Diagnostic Gap
The same masking that allows women with ADHD to function well on the surface is the thing that delays their diagnosis, sometimes by decades. ADHD in adults is already under-recognised; ADHD in women is missed at roughly three times the rate it’s missed in men. The consensus across the research is that masking and internalisation are key reasons for this misdiagnosis pattern. Girls hide symptoms, over-comply, and their struggles get reframed as personality traits. “She’s a worrier.” “She’s a perfectionist.” “She’s just sensitive.” Many remain undiagnosed well into their thirties or forties.
By the time many women receive a diagnosis, they’ve accumulated years of anxiety, depression, and a fractured sense of identity that has nothing to do with weakness and everything to do with the cost of sustained camouflage.
The Cost: From Masking to Burnout
There is a trajectory that clinicians see repeatedly. Someone masks successfully for years. They build a life that looks functional, sometimes even impressive, from the outside. Then something changes. The demands increase, or the capacity to compensate decreases, or both happen at once. The system that held everything together starts to fail.
How ADHD Masking Burnout Happens
This is where ADHD masking and burnout converge, and ADHD masking burnout is increasingly recognised as a distinct clinical presentation. The prefrontal resources that masking depends on are finite. Every act of suppression, every rehearsed conversation, every forced period of sustained attention draws from the same cognitive budget. Sensory overwhelms it.
When that budget runs out, what follows isn’t just tiredness. It’s a collapse in the ability to do the things that used to feel manageable. Executive function deteriorates. Emotional regulation becomes harder. The mask starts to crack, and the person underneath often doesn’t recognise themselves.
The “Behind Her Eyes” thesis found that long-term masking in women was associated with chronic exhaustion, identity confusion, shame, and relationship difficulties, even when external functioning appeared high. These were high achievers falling apart privately.
Why the Real Problem Gets Missed
What often happens next is that the person presents for help. But they present with anxiety, sometimes social anxiety specifically. Or depression. Or burnout. The ADHD masking underneath goes unrecognised because the thing that brought them to a clinician is the consequence of masking, not the cause.
Years of depleted dopamine-driven reward circuits and overworked prefrontal systems produce symptoms that look like standalone mental health conditions. This diagnostic overshadowing is one of the most significant barriers to appropriate treatment, particularly for adults who’ve been masking since childhood and have no frame of reference for what unmasked functioning would even feel like.
When the Mask Starts to Crack
There’s a particular disorientation that comes with late diagnosis. You’ve spent twenty, thirty, sometimes forty years building an identity around compensation. The strategies you developed to survive became, in your mind, who you are. The people-pleasing. Over-preparation. The relentless self-monitoring. When someone tells you those aren’t personality traits but neurodivergent symptoms driven by a brain that processes information differently, it doesn’t feel like relief. Not at first. It feels like the ground is shifting.
Many adults describe this as an identity crisis, and that’s not an exaggeration. If the mask is all you’ve known, removing it means confronting a self you’ve never actually met. It means grieving for the years spent compensating. It means renegotiating relationships that were built on a version of you that was partially constructed.
This is not something that a list of coping strategies can address.
What Actually Helps
The instinct, both for the person and sometimes for the clinician, is to offer more strategies. Better organisation systems. Mindfulness techniques. Productivity hacks. But for someone who has been masking ADHD for years, more strategies can feel like more masking. Another layer of compensation on top of an already exhausted system.
What therapy can address that coping strategies alone cannot is the underlying architecture. The shame that drives the masking. The rejection sensitivity that makes it feel dangerous to be seen. The identity confusion that follows years of performing a version of yourself that was designed for other people’s comfort rather than your own.
This doesn’t mean strategies are useless. Medication, where appropriate, can reduce the baseline cognitive load and make the prefrontal compensation less effortful. Structured support can help. But without addressing why someone masks, and what it costs them, the pattern tends to reproduce itself in new forms.
Starting With an ADHD Assessment
The goal isn’t to stop masking overnight. For many people, some degree of social adaptation is both necessary and healthy. The goal is to make it a choice rather than a compulsion. To know when you’re doing it. To understand what it costs. And to have enough of a relationship with your unmasked self that the performance doesn’t become the whole of who you are.
If any of this sounds familiar, a formal ADHD assessment is often the most useful starting point. Not because a diagnosis fixes everything, but because it gives you a framework for understanding what you’ve been doing all this time, and why it’s been so exhausting.
