ADHD Masking: The Impact (Part 2)

This article is part 2 of a multi-part series that explores some common examples of ADHD masking behaviours and their impact. This article explores the often-unnoticed impact of ADHD masking on people with ADHD and includes some personal experiences as well as common examples I've come across as a Psychologist working with adults with ADHD. For Part 1, please click here.

The Impact of ADHD Masking

ADHD masking is a common strategy people with ADHD use to manage their ADHD symptoms and act "normal". It can involve using a mix of impression management and compensation strategies to "mask" ADHD symptoms to fit in to the situation. When we’re aware of the different masks we put on, and when we use them in moderation, ADHD masking strategies can help us effectively navigate the world around us.

But when we start to feel exhausted by them, think that we need to always act to fit in, or that we can’t take our mask off at home, it may be time to rethink whether an ADHD masking strategy is working for us.

This article is Part 2 of the ADHD masking series and will explore some common effects of ADHD masking and how they might affect people with ADHD.

If you’d like to learn more about ADHD masking and common masking behaviours, check out Part 1 here.

1. ADHD masking can cause stress, anxiety, and even burnout.

Masking uses a lot of energy to keep up, even when we don’t realise we are doing it. It takes constant energy when you’re trying to monitor everything you say, catch impulsive behaviours, or change how you act to fit in – all the while trying to hold a conversation! This constant drain uses extra mental energy and gradually leads to extra stress, anxiety, and exhaustion if pushed too long.

When our resources are high or when the masking is temporary, we might walk away feeling a bit drained but okay. But when our resources are low and we’ve been masking all day, it can leave us feeling completely exhausted and overwhelmed. When in this state, we might also start to feel angry, sad, or frustrated and we might even notice other ADHD symptoms coming up more.

This can start to form a downward spiral where we feel depleted from masking, notice elevated ADHD symptoms because we’re low on energy, and then mask even more to cope. Over time, this can put us at a higher risk of developing generalised anxiety or depression.

2. ADHD masking can reinforce the harsh judgements we hold about ourselves.

ADHD masking often stems from harsh and inaccurate beliefs we hold about ourselves. These beliefs are generally learnt from early childhood and can affect how we act as adults without us even realising it.

When we grow up being told over and over that we’re too loud, too excitable, too annoying, or too unfocused to reach our potential, we can, unfortunately, start to believe these hurtful messages and use masking strategies as a way to cope. For me, these messages turned into unhelpful self-beliefs and negative automatic thoughts that looked like:

• I’m annoying. If people realised how annoying I am… they won’t want to be my friend.

• I’m disorganised. If my boss sees how disorganised I am… I won't get that promotion.

• I’m not capable. If people saw me struggling… they will think I’m incompetent.

These internalised beliefs will be different for everyone and also affect everyone differently. But you may start to see that, from the examples above, these types of harsh self-beliefs and judgements can trigger difficult feelings and shape how we behave. Building on the messages above, this could look like:

Beliefs and Thoughts...	Triggered ​Feelings...	Masking Behaviours
I’m annoying. If people realised how annoying I am… they won’t want to be my friend.	Anxiety sadness, embarrassment, shame, loneliness, or insecurity.	Watching everything we say in a conversation and holding back with friends.
I’m disorganised. If people find out I’m disorganised… I won't get that promotion.	Anxiety, stress, frustration, disappointment, or hesitancy.	Working extra hours every day to organise your schedule at work and try to plan everything.
I’m not capable. If people saw me struggling… they will think I’m incompetent.	Anxiety, stress, fear, helplessness, or out of control.	Pretending that everything is okay and denying help even though you are struggling. Saying yes to everything to appear in control.

Over time, these masking behaviours and sometimes other people's comments can reinforce our negative automatic thoughts. For example, this could look like:

At work:

You struggled with managing distractions at work, felt frustrated and incompetent, so you stayed extra late after hours to force yourself to finish a project. Your boss thinks you're really dedicated and comments "great work!". Although objectively great feedback, only you knew how distracted you were and how incompetent you felt, so you now stay late every day to avoid being found out despite struggling daily with distractions.

With friends:

You were told growing up that you're annoying when you get too excited. With every new friend you've made after that, you've been putting on a calm and composed mask and held back from getting too excited. You start to feel inauthentic but worry that your friends will think you're annoying if they see you get too excited.

From the examples above, you might start to see how these negative automatic thoughts can trigger masking behaviours. These behaviours, in turn, can reinforce the negative automatic thoughts, trigger the feelings, and trigger more masking. And thus, a vicious self-reinforcing cycle.

The great news is that we can start to break this cycle by noticing these negative automatic thoughts and replacing them with more helpful ones. More on this in Part 3.

3. ADHD Masking can affect our self-esteem.

When we spend too much time and energy putting on a mask and acting to fit in, it puts us at risk of losing a sense of who we truly are. It may make it harder for us to separate what is real and what is an act and we can start to feel inauthentic, fake, or even like an imposter.

It’s human and completely normal to feel sad at times, to be the quiet one when you’re tired, or to be full of energy when you’re excited about something. But when we start believing we need to always be funny to fit in, or we can't get excited because we'll be annoying, it can eventually take away from our self-esteem.

Over time, we may even start to discount our strengths and look for evidence to confirm the reasons we think we need to mask. We may start to become hyper-aware of our faults and spend more and more energy trying to cover up every little flaw. This can also cause us to build higher and higher standards for ourselves to try and compensate.

4. ADHD masking can cause us to withdraw, feel isolated, and feel lonely.

The more time we spend hiding a part of ourselves, the more we can start to feel invisible to others.

When we mask a part of ourselves and hide away our true experiences, it can make it harder for us to communicate how we truly are in the moment. Do these examples sound familiar?

• You find it hard keeping your place clean, so you avoid inviting your friends over.

• You struggle with finishing your work as quickly as your colleagues, so you say no to Friday night drinks to catch up on work.

• You pretend that you're "fine", even though you're struggling deep down.

• You take on extra work and spend your nights working instead of spending time with friends or family.

• You're worried about being seen as incompetent, so you don't ask your colleagues for help when you need it.

• You're feeling overwhelmed so you cancel on plans with your friends.

• You don't want to appear too excited, so you hold back how you feel.

If we get too good at masking and hiding how we feel, we can eventually lose a sense of deeper connection with the people around us. We may not ask for help when we really need it, minimise our hurt to make others feel better, or push people away to avoid being found out.

We may minimise our sadness, anxiety, or excitement and deny ourselves our full emotional experience and connection with others. We might even convince ourselves that we don't need the support despite wanting the support and connection.

Brick by brick, we may have built a wall without even realising it.

5. ADHD masking can hide symptoms too well and delay a diagnosis and support.

It's not uncommon for people with ADHD to go years struggling through life without support. We may only start to notice symptoms years later when stress from work and life starts to feel too much, or when other people start noticing our struggle.

In fact, it's quite common for adults with ADHD to only notice symptoms when they're going through a crisis or when they're supporting a child, friend, or loved one through an ADHD diagnosis.

This delay in diagnosis can really take a toll on us over time and stop us from accessing support from our friends, loved ones, and even health professionals.

Like a duck on water, ADHD masking can make it seem like we're calm and in control on the surface. But of course, deeper down, we may be furiously paddling away and using all our energy to keep up the façade.

It's important to note; however, that not everyone with ADHD needs or has a formal diagnosis. In fact, there's a lot of examples of people with undiagnosed ADHD who have found different strategies and support networks that really work for them.

Wrapping up

Everyone's experience with ADHD and masking is different. But if you're starting to notice that it's becoming a constant and overwhelming drain on you, it may be time to reach out to your friends, loved ones, or a mental health professional for support.

Talking and reaching out to others can help create those moments where we can 'unmask', feel seen and heard, and get the support we want.

Working with an ADHD Psychologist can help you notice and break out of the cycles of unhelpful masking and find new strategies to make the ADHD brain work better for you.

Stay tuned for more on this in Part 3!