Highlights
- 89% of people with ADHD expect discrimination based on their diagnosis and, therefore, mask their symptoms to keep social interactions positive.
- More frequent ADHD masking in females might be a contributing factor to the higher rate of undiagnosed ADHD in girls and women versus boys and men.
- ADHD masking is often emotionally difficult to maintain, resulting in ADHD masking fatigue, which can have serious consequences.
- The ADHD unmasking process should be done slowly so that the person and their companions and coworkers can adjust. It should ideally also be supervised by a health professional to prevent a rebound of ADHD symptoms.
It is estimated about 7 out of every 100 adults worldwide have ADHD, which means that most people are likely to interact with a person with ADHD at some time. However, it may not be obvious, as people with attention deficit hyperactivity disorder often mask their symptoms from those around them. So, let’s learn more about masking, its causes, effects, and possible ways to stop it.
What Is ADHD Masking?
Understanding ADHD, its symptoms, and its impact on daily life and functioning is essential before the term masking makes any sense.
Attention deficit hyperactivity disorder is a common neurodevelopmental condition characterized by the following basic symptoms:
- Low attention span, which results in trouble focusing.
- High energy, which leads to being restless, hyperactive, and impulsive.
Other common issues associated with ADHD are weak decision-making abilities and difficulty regulating emotions, which are thought to be due to the ADHD brain’s poor working memory and reduced function of dopamine receptors.
The signs of inattention in people with ADHD present as:
- Making careless mistakes
- Overlooking details
- Being easily distracted in conversations or meetings
- Daydreaming or not being ‘present’
- Not completing tasks and getting sidetracked
- Having poor time management
- Missing or being late to appointments
- Losing important things
- Avoiding tedious or complicated tasks
- Not completing essential daily activities
Hyperactivity and impulsivity manifest as:
- Not being able to sit still when remaining seated is expected
- Being restless and agitated
- Being loud, overbearing, and talking excessively
- Interrupting conversations
- Not being able to wait their turn in queues
- Being ‘on the go,’ and others are unable to keep up
- Using other people’s things without asking permission
- Engaging in irresponsible behavior
- Saying inappropriate things at inappropriate times
- Being accident prone
According to the American Psychiatric Association, these patterns must be present in
If ADHD symptoms are causing problems in the individual’s life, they develop compensatory behaviors, masking symptoms and disguising their diagnosis. In fact, nearly all individuals with ADHD report that they expect to be discriminated against because of their diagnosis.
Why Do People Mask ADHD Symptoms?
As mentioned, people with ADHD may use masking trying to avoid potential discrimination. Some of the associated stigmas that people with this condition may face include:
- “Adult ADHD is not a valid diagnosis”
- “People with ADHD are unreliable and dangerous”
- Distrust of medications
Addressing stigma takes time, so ADHD masking behaviors become a kind of survival mechanism in a neurotypical world; they help people meet social expectations, avoid judgment, and function better at school and work. However, this benefit is often temporary and followed by negative consequences.
Let’s take a closer look at why people mask their symptoms.
Societal Expectations
ADHD is not a choice but a developmental disorder, and the person with ADHD has challenges controlling their symptoms. It is difficult to fit in socially when you battle to control emotions, interrupt conversations, and are loud and disruptive. Importantly, even when others know about the diagnosis, it might still be difficult to be compassionate and understanding for some people, so a person with ADHD may prefer masking in such cases.
Fear of Judgment
Most classic symptoms and behaviors associated with ADHD are viewed as negative by the general population. It may sound unbelievable, but even adults with high-functioning ADHD who are successful are judged.
Survival Mechanism in Education and Work Environments
It makes sense that it will be tricky to keep your job if you miss deadlines and appointments, do not listen to your supervisor, and make careless mistakes. For those people with ADHD who are on a treatment plan, it is easier to cope, but those who have not consulted with a healthcare professional often choose to mask.
What ADHD Symptoms Are Masked?
As a result, people with ADHD tend to hide their inattentive and hyperactive symptoms to make their behavior more socially acceptable. Let’s look at a few ADHD masking examples that get people over these hurdles.
Common Signs of ADHD Masking for Inattention
- Making excuses for being late or distracted
- Working longer hours
- Putting more effort into researching
- Double-checking their work
- Doing too much preparation
- Having abnormally intense focus on conversations
- Pretending they’re listening by making eye contact and nodding
- Arriving early at appointments and events
- Setting multiple alarms
ADHD Masking Behaviors for Hyperactivity and Poor Social Skills
- Avoiding situations like social interactions
- Mimicking other people’s behaviors in social settings
- Not saying anything
- Holding in energy and urges
- Self-stimulating behavior (stimming) consists of repeated behaviors, such as humming, grinding teeth, rocking, twirling hair, and rubbing or picking skin, that suppress energy and emotions.
What Are the Cons of Masking?
In some situations, although temporarily helpful, ADHD masking ends with self-sabotage and other negative consequences. Let’s explore some of them below.
ADHD Masking Fatigue
Many people communicated that hiding their genuine selves takes so much energy; this can ultimately lead to ‘dropping their mask’ due to exhaustion and burnout. The after-effects of this can be serious:
- Severe emotional instability, such as crying or shouting in the workplace
- Poor performance at work and failing interpersonal relationships due to low self-esteem and self-doubt
- Turning to alcohol and illicit substance abuse
Predisposition to Other Mental Health Conditions
Another consequence of the mental load resulting from ADHD masking is developing other mental health conditions. The most common co-existing (comorbid) disorders in adults with ADHD are depression and anxiety.
Missed Diagnosis
Clinical implications of masking behaviors may result in a hidden diagnosis of ADHD, mainly when individuals mask their symptoms successfully. This might result in the incorrect diagnosis of another mental health disorder, and the person with hidden ADHD may not receive the treatment they need.
Not Being Authentic
For some individuals with ADHD, masking affects personality. This happens when people mask to an extreme that flips the ADHD symptom. For example:
- From being overly emotional to being numb.
- From being a chatterbox to being silent.
- From being high-energy and spontaneous to being indecisive.
- From being the life of the party to becoming the wallflower.
- From not thinking things through enough to overthinking decisions.
Adult-Onset ADHD
- a high IQ,
- strong social adaptation ability,
- good family support and
- stable school environment.
The undiagnosed ADHD presents as later in life because when the adult goes into the world on their own, family and environmental support dissolves, and they can no longer rely on their intelligence to pull them through. This causes a boomerang effect that could have been avoided if they had been on an effective ADHD management plan since childhood.
High-Functioning ADHD
High-functioning ADHD is an informal term used to describe people with ADHD who manage to maintain normal function or achieve success in their lives. A theory might be that successful masking helps adults with high-functioning ADHD to progress.
What Are the Pros of Masking?
ADHD Masking vs. Coping Strategies
Some of the compensatory behaviors of ADHD masking are valid coping mechanisms and not harmful. Here are a few examples:
- Certain types of low-profile stimming, such as fidgeting, help the person with ADHD to cope while not being obvious to others.
- Active listening is great for relationships at work and home.
- Setting reminders and alarms helps to stay organized and complete tasks, which can only be beneficial.
However, individuals with ADHD need to distinguish between unhealthy masking behaviors and beneficial coping strategies. This will allow them to function at maximum, live a low-stress, fulfilling life, and be themselves.
Healthy Coping Mechanisms
Here are a few tips to help people with ADHD cope better with daily life:
- Break up tasks and goals: Achieving shorter, step-by-step goals is more manageable than one overwhelming project.
- Practice brain dumping: Writing all your thoughts down helps to process emotions and deal with them.
- Use stress balls: Squeezing a stress ball can take the place of more noticeable stimming behaviors like humming or rocking.
- Exercise: Exercising might improve attention and focus.
- Sleep enough: Being tired decreases focus and increases mood swings.
- Limit distractions: Keeping your desk neat, working in a quiet, private space, and putting your mobile devices away will help you focus.
- Use lists and calendars: Staying organized is better if you make notes and have a schedule.
Gender Differences in ADHD Masking
It is known that the rate of ADHD is higher in males than females; in fact,
One theory for this difference is that the rate of undiagnosed ADHD is thought to be higher in girls and women. Importantly, undiagnosed attention deficit hyperactivity disorder in girls has profound long-term social and mental health implications for adult women; examples are social anxiety and isolation, other anxiety disorders, and depression.
ADHD masking in women happens more commonly than in men in the form of adaptive social behavior. Females with ADHD also generally have better coping strategies and, therefore, more effectively mask their symptoms. One example is that girls tend to put in extra work to stay on top of classwork, so good grades do not rule out ADHD. By more effectively hiding their condition, girls and women are less likely to be referred to a professional, so they go undiagnosed.
The lifespan approach to ADHD in females recognizes that their presentation might not be classic and that women who try to mask ADHD might only manifest inattentive or hyperactive symptoms during periods of life change and vulnerability.
How to Identify and Unmask ADHD
Practice Self-Acceptance and Self-Reflection
In order to stop masking ADHD, people need to realize that sometimes, masking is harmful; it is exhausting trying to fit in and, eventually, affects self-esteem and mental health.
- Practice self-compassion by reflecting and recognizing their ‘disguise.’
- Accept their ADHD diagnosis.
- Realize that they are in control.
- Let the mask drop slowly, giving others time to adjust.
- Surround themselves with people who are accepting.
Peer Support Systems
Many people with ADHD feel that they can be themselves around other neurodivergent people (those with ADHD and autism spectrum disorder (ASD)) because they don’t take offense and make friends more easily.
The participants of one study who were neurodivergent shared the following:
“We tend to be more direct and say exactly what we mean, whereas neurotypical people say things in a kind of doublespeak. That’s why neurodivergent people tend to have a lot of neurodivergent friends, because we can communicate more easily if we know that person’s neurodivergent.”
It makes sense that in-person ADHD support groups will be helpful for companionship and advice. Additionally, online communities have been found to benefit people with ASD. For example, Facebook use increased the happiness of this group, and social media connections might prove helpful. These platforms might be a great source of information needed to unlearn ADHD masking.
Professional Help
Lastly, unmasking ADHD in adulthood often requires professional treatment.
Without therapy and medication, if appropriate, the unmasking process may result in serious dysfunction at work and in social life due to rebounding symptoms.
An accurate diagnosis of ADHD is the needed first step. Above all, a healthcare professional should consider possible co-existing mental health conditions such as anxiety and depression to decide on a personalized ADHD management plan.
To go through an assessment and get a proper diagnosis and help for ADHD online, book an appointment at MEDvidi today.
