Basics What Is Masking in Mental Health? By Amy Marschall, PsyD Amy Marschall, PsyD Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health. Learn about our editorial process Updated on December 22, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Morsa Images / Getty Images “Masking” refers to when an individual hides or suppresses symptoms, behaviors, or difficulties they are experiencing. While it can happen intentionally, it often occurs unconsciously over time as an individual receives negative feedback for their authentic presentation. While many think of masking as a neurodivergent behavior, particularly for autistic people or those with ADHD, people with various diagnoses mask for a variety of reasons. Learn how masking manifests for people with various mental health concerns, the problems it can cause, and how to overcome this habit. What Is Masking? Masking, sometimes referred to as “camouflaging,” occurs when someone attempts to hide their mental health symptoms in an effort to blend in with people around them. They may copy other people’s demeanor or actions or engage in compensatory behaviors. The goal of masking is to appear as though you are not experiencing mental health symptoms or struggling even when this is not true. Masking can be compared to writing with your non-dominant hand. Up until the mid-20th century, children who are naturally left-handed were punished and forced to use their right hand instead because this was considered “correct.” These children grew into adults who used their right hand even though this is not what came naturally to them. They were forced to mask which hand they favored, and even if they learned to write this way, it took extra effort to learn and maintain. Neurodivergent children and those with mental health issues learn to present in the way they think adults consider “correct,” much like writing with their non-dominant hand. While they might be able to look convincingly like their neurotypical peers, the act takes additional effort and resources to pull off. What Does Masking Look Like? Masking can present in different ways, all of which can be stressful and require the individual to suppress or hide who they really are in order to fit in: Social Masking. This refers to when someone engages in social behaviors that do not come naturally to them, such as making eye contact even when it is uncomfortable or mirroring body language to avoid standing out. Behavioral Masking. This can mean hiding fidgeting or stimming behavior. Compensation. An individual might compensate by spending more time and energy on tasks than their peers in order to hide that they are struggling. People with ADHD often mask by compensating. Why Do People Mask? In short, people mask to protect themselves from backlash that occurs when they are not masking or to be accepted by other people. Stigma about mental health and neurodivergence, as well as fear of ableism and discrimination, lead to masking among various populations. People may also mask because they simply want to fit in or be like their peers. A person may not realize that they are masking. From a young age, the people around us communicate expectations for behavior. Neurodivergent children, or those with any mental health difficulty, may realize that they do not live up to these expectations as naturally or easily as many of their peers, and this realization causes stress. In an effort to fit in and meet these standards, they may begin to mask their symptoms and behave in ways that are not natural to them. When masking happens unintentionally, the person might not recognize that it is happening and could continue masking even when their natural behaviors are not harmful, or when no one is around to judge them or take issue with their behavior. Signs of Masking Since masking can occur unconsciously, you might not realize that you are doing it or the impact it is having on your mental health. It takes time to realize that you are masking and to unlearn the behavior. If you notice that you tend to look to others before deciding what to do in various situations, you might be masking by mimicking their behavior. If you do not feel like these choices come naturally to you, and you instead try to copy what you see, you might be masking your social behavior. If you find that you suppress certain body movements because you are worried that they will look strange or people will comment on them, you may be masking your behavior in order to fit in. You might notice that there are certain movements or actions that you find calming, but you do not feel comfortable with anyone seeing them. This can be a sign of behavioral masking. You may feel exhausted after social engagements, like you need to spend time alone in order to decompress and “feel like yourself.” This might be a sign that you are masking in those settings. The Impact of Masking Feeling like you must behave in a way that is inauthentic to your true self is exhausting, especially when you believe that others will not accept you or punish you for showing your true self. Masking has been shown to increase mental health issues and stress, and for autistic people in particular, long-term masking increases the risk of suicidal thoughts and behaviors. In the long term, masking can lead to burnout, especially in autistic people. Behaving in ways that do not come naturally over a long enough period of time wears the person out in unsustainable ways. In addition to the mental health concerns of masking, individuals who mask may struggle to receive appropriate support for their difficulties because they do not show symptoms in a way that others can recognize. Masking can prevent people from receiving an accurate diagnosis, as professionals do not recognize masked traits. This is particularly prevalent in autistic women, who are often not diagnosed with autism because their behavior mimics that of their neurotypical peers. Even if the behavior or trait being masked does not harm the individual, someone else, or cause irreparable damage, masking can still cause more harm than good. Unmasking As you begin to recognize your masking behavior, you might not feel comfortable or safe fully unmasking in every situation. Stigma and discrimination are valid concerns, and everyone is sometimes in a setting where they cannot fully be their authentic self (for example, many people have a “work face”). At the same time, learning who you are and how you behave when you are unmasked can help you recognize when it is safe to unmask. Find spaces where you feel safe unmasking, and try out different social interaction styles or stimming behaviors. As you get to know your authentic self, you might feel less burned out or worn down by masking. What Is ADHD Masking? 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. History Extra. A history of left-handed writing. Masking and mental health. Masking and Mental Health | Nebraska Autism Spectrum Disorders Network | Nebraska. https://www.unl.edu/asdnetwork/masking-and-mental-health. Accessed December 18, 2022. Miller D, Rees J, Pearson A. “Masking is life”: experiences of masking in autistic and nonautistic adults. Autism in Adulthood. 2021;3(4):330-338. Chapman L, Rose K, Hull L, Mandy W. “I want to fit in… but I don’t want to change myself fundamentally”: A qualitative exploration of the relationship between masking and mental health for autistic teenagers. Research in Autism Spectrum Disorders. 2022;99:102069. Raymaker DM, Teo AR, Steckler NA, et al. “Having all of your internal resources exhausted beyond measure and being left with no clean-up crew”: defining autistic burnout. Autism in Adulthood. 2020;2(2):132-143. Belcher HL, Morein-Zamir S, Stagg SD, Ford RM. Shining a light on a hidden population: social functioning and mental health in women reporting autistic traits but lacking diagnosis. J Autism Dev Disord. Published online May 20, 2022. By Amy Marschall, PsyD Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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