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Masking, also called camouflaging or compensating, is when individuals repress or hide signs of a mental health condition to blend in or adapt to the neurotypical world.
The concept is primarily used in the context of autism, but it can apply to ADHD and other mental health conditions as well.
While this technique can be advantageous in some ways, by creating greater integration in settings such as education or employment, it can come with heavy psychological costs, such as stress, exhaustion, burnout, and loss of identity.
For neurotypical people, it can be difficult to imagine a world in which your natural way of being is constantly at odds with societal norms. But this is the reality for many individuals with autism—as a result, they may use strategies to compensate and conform. Masking is the observable discrepancy between underlying preferences and outward behavior; it may be prompted by wanting to avoid judgment, rejection, and bullying, to make friends or find a romantic partner, or to succeed in their career.
In practice, camouflaging behaviors may look like someone with autism forcing themselves to make eye contact at work, using memory techniques to remember appropriate conversation topics, mimicking other people’s gestures or facial expressions, attending social gatherings when they don’t want to, or suppressing the desire to engage in repetitive behaviors such as stimming. Masking behaviors can occur consciously or unconsciously.
To some degree, masking can be beneficial. It can help individuals form necessary relationships, succeed in a job interview, and more. However, camouflaging consistently can be extremely damaging. As one woman with autism describes, “I worked relentlessly to keep up with my mask. I tried to hide my stims and my preferences. I pretended to eat food I hated and to drink alcohol and poured glasses of wine down the drain when no one was looking. I worked hard not to info-dump or say anything weird. I tried to limit my social interactions to less than three hours because I knew that after three hours, the mask would slip and the real me would come out, and I lived in constant fear of this.”
Masking has negative repercussions. It can be stressful and exhausting, and lead to burnout over time. Research has found that camouflaging is linked to heightened levels of anxiety and depression. The more an individual engages in camouflaging, the greater the emotional regulation difficulty and perceived stress they experience. This, in turn, increases their symptoms of depression and anxiety. These effects are more pronounced among women.
Yes, research shows that women tend to utilize masking more than men. This may be because autism can manifest differently among girls and boys, girls may be more motivated to form friendships, and social skills may be prioritized more in girls’ development than boys. Many women with autism become so skilled at masking they later don’t realize that they’re doing it. It may not be until later in life that women’s social difficulties become too great to manage with their usual camouflaging strategies. The “success” of masking can lead autism to be underdiagnosed or misdiagnosed among women.
The time of diagnosis can influence people’s experience of masking. People who receive a diagnosis in adulthood have often struggled with confusion and frustration in childhood, where they didn’t fit in and likely sought to try and hide or change themselves. Those who were diagnosed in childhood, however, often have a different experience; their autism was recognized, accepted, and they hopefully had supportive caretakers who encouraged them to be themselves.
Recent research used functional magnetic resonance imaging (fMRI) to investigate how atypical functional brain connectivity in autism affects behavior in social settings. The findings suggest that some atypical brain connectivity patterns, such as increased recruitment of the right hemisphere during language production, may serve a compensatory function, aiding conversational abilities for individuals with autism.
Autistic burnout is not a psychiatric diagnosis but rather a phrase coined by those with autism to describe the often draining effects of interacting in the neurotypical world. It involves the accumulation of several factors including masking, sensory overload, changes to routine, mean behavior from others, and more. Externally, it may manifest as withdrawal, fatalistic thinking, exhaustion, frustration, and disorganization. Internally, it may manifest as a mixture of depression, anxiety, numbness, and an inability to keep up.
Coping with the challenges of masking, and exploring how to unmask, is a difficult process. This path forward will look different for everyone.
One way of approaching this challenge is by exploring what one’s “mask” looks like and if there are safe places to take it off. This might take the form of deciding to disclose one's neurodivergence to more people or allowing oneself coping skills, such as fidgeting or stimming, that are being suppressed. Feeling safe to unmask and be one’s true self can promote resilience. Kindness and understanding from neurotypical people in response can also go a long way.
However, the burden of change shouldn’t all be on the individual. Society has a role to play—to be more inclusive and accepting, and to create environments in which people with autism can thrive without hiding their authentic selves.
Unmasking can be deeply challenging yet worthwhile. The experience differs for everyone. It may require the courage to behave atypically and authentically. It may take time to rediscover one’s true self and live authentically. Some may find that their family, friends, or employer are accepting, while others may lose relationships.
One woman with autism describes this process as follows: “Unmasking is critical work I do with many of my autistic clients. The saddest part of this process is that most of them have been masking for so long that they don’t even remember who they are anymore. They don’t remember what they enjoy. They only know that it’s their job to try to figure out what others want and do it to avoid rejection. Unmasking can be a miraculous thing—because once you figure out who you really are and live an authentic life, almost everything becomes better.”
Yes, a therapist can help by exploring the reasons for masking, such as underlying shame, and conquering those challenges. A therapist can help identify masking behaviors, assess what easy steps the person can take to unmask, and then the harder steps, as well as implications for their relationships, career, and daily life. They can help brainstorm and implement changes in the person’s home and workplace that allow them to flourish.
