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‘Do you have the 20 bucks you promised me for gas?’ I twisted the key in the ignition. The staccato heaving of my electric blue Chrysler PT Cruiser competed with Anita’s rustling through her floppy purse.
‘Ugh, I must’ve forgotten it. Surely, that’s OK. I’ll just – ’
I started gasping for air. After weeks of forcing a state of calm collectedness, my body finally rebelled.
My voice: ‘Surely that’s OK?!’ (First, mocking.)
Then, loud, raspy and unrecognisable: ‘It’s not fucking OK.’
From my blurry periphery, Anita’s arm stretched to touch my shoulder. She often did that to ground someone.
I watched my arm swat hers and yank the cushioned steering wheel. The fuzzy purple dice hanging from the rearview mirror that my brother jokingly bought me for my 21st birthday tilted sharply.
‘I’m turning the car around right now, and we’re looking for an ATM.’ My forehead was pounding, my face burning. The fear on Anita’s face finally registered, and that oh-so-familiar acidity in my stomach was back.
(Deep breaths.) What did I just do?
I can answer that question now – 12 years later. Part of it was my late-diagnosed attention-deficit/hyperactivity disorder (ADHD) and difficulties with emotion regulation. But more was happening then, while I was still a graduate student, long before I became a clinical psychologist.
To see it clearly, step into my shoes a few weeks earlier.
You’re sitting with Anita in a shared graduate student workspace. You’ve been in this research lab for a few months, wondering whether you’d ever fit in. The other students are so smart and competitive.
Now, finally, you come up with a research idea that excites you. Your research mentor, Dr Jennings, has sent the lab a large dataset and asked each student to present a research question at the next lab meeting. At first you were nervous, but then a jolt of motivation hits. You stay up until 3 am and are shocked to discover a variable you’ve been reading about since early college. This is it.
Dr Jennings agrees. He pairs you with Anita to analyse the data for publication.
Your body shuts down, but your brain chugs along for the best course of action
In the graduate student office, Anita is effusive, slouching toward you with legs crossed, chatting while you’re pulling up the dataset. It’s 9 pm, too late to be facing statistical programs, but your adrenaline is pumping.
‘You should be the first author on this one,’ says Anita. ‘It’s your idea.’ She hesitates and points to the screen. ‘Hey, how’d you do what you just did?’
Over the next couple of weeks, while working tirelessly, you’ll prove you can be just as competent as the others. You’ll feel so good there isn’t even a word for it.
But then comes the crash. After weeks of effort, Dr Jennings announces in front of the students that Anita will be the first author. ‘Anita will be graduating soon, and she needs this right now.’ He says it as if it is generous.
At first, it feels confusing, like a slap. You turn to look at Anita, who says nothing. Your body shuts down, but your brain chugs along for the best course of action, and it comes up with this:
Pretend. Hide. Lie.
You nod. Decide to be compliant.
Maybe Anita does need this more.
You don’t need this.
You don’t deserve this.
Suck it up.
So, you keep the mask on. Until a few weeks later in your PT Cruiser, when you finally break.
Many people would have felt just as hurt, and some might have lost control after holding in their feelings. My reaction wasn’t irrational, yet still, more than a decade later, I am pained. One might argue that withholding my thoughts and feelings was wrong.
But for a neurodivergent woman like me, with ADHD (or for an autistic woman), it’s more complicated. Many of us struggle with fine-tuning our emotions in the midst of a conflagration of sensory stress, and some of us simply don’t know how to respond in social situations. For me – and for many other people with ADHD – emotions are all or nothing. When I mask, I (temporarily) suppress my emotions so I come off as cool and collected, but my strained effort to keep it together becomes a ticking time bomb.
People who are neurodivergent are well aware that we live in a world full of expectations – predetermined ‘rights’ and ‘wrongs’. So many of our daily interactions follow scripts: Here is what is and is not OK to wear to an interview. This thing is OK to say, but this is not. Those rules shift when two neurodivergent women interact with each other. When I first started seeing one of my autistic adult female clients for therapy, she ended our second session with: ‘You’re more direct than other therapists. I like that.’
It’s liberating to remove that mask – to just be ourselves. And most people mask, neurodivergent or not. But masking tends to happen more when we differ from other members of the community or when the community can’t accept our differences. Masking helps us get by, but it comes at a cost: depression, anxiety, burnout. No wonder the common strategies of ADHD and autistic masking have come under such fierce scrutiny in recent years.
Females with ADHD tend to have sharper insight into their strengths and weaknesses than males with ADHD
The central problem is this: masking – suppressing one’s natural instincts and behaviours – often feels unavoidable, even though it’s deeply harmful to mental health. Because neurodivergence takes many forms, so does masking. Those with ADHD, for instance, may know the ‘right’ social response but struggle to carry it out in real time due to executive functioning challenges such as impulsivity and emotional dysregulation. Autistic individuals, meanwhile, may study and imitate social cues to appear ‘appropriate’. Whatever the form, masking leads to years of pain and exhaustion from pretending to be someone else – usually to make others comfortable and avoid being ostracised in a world not built with them in mind.
Consider the possibility that masking was the best option for me during that lab meeting when Anita was announced as first author. Females with ADHD tend to have good insight into their symptoms, strengths and weaknesses – and these abilities are probably sharper than in males with ADHD. Given that it can be hard for me to control myself in the heat of the moment when I deeply care about an issue and feel wronged, wouldn’t it have been more likely for me to ‘mess up’ in front of someone more important than Anita (say, my research mentor) had I not waited?
The broader public still isn’t ready to fully embrace our differences – and honestly, it’s unclear whether that day will ever come. What we do have, however, is a growing sense of understanding and acceptance within the neurodivergent community itself. And in that shared awareness, there is strength – because solidarity is power. With each other, we can throw off the mask and be ourselves.
Mia was a teenage client with ADHD – someone I could relate to deeply, as I’m sure many other girls and women with ADHD could. She just couldn’t seem to get along with her school’s theatre director, though she tried hard to be respectful around him – an effort that was, at best, only partly successful. The irony was that Mia was a truly gifted actor. Despite her constant tug-of-war between masking and authenticity, she managed to make it through most of the year without any major blowups. Almost.
During the last month of school, Mia was given a writing assignment for her theatre class and was so fed up and burnt out from pretending nothing was wrong that she responded to the questions either mockingly or with one-word responses. This resulted in a full letter-grade drop and an angry email from her theatre director, and I had to work with her on regrouping – finding a way to retake the assignment and bring her grade back up to the A it was before.
It’s important to note that Mia was highly motivated to be liked. She already had close friends, both in and outside of school. But, like many people with ADHD – especially teens, whose difficulties with emotion regulation are often heightened – she struggled when someone upset or disappointed her. Once she decided she disliked someone, it was nearly impossible for her to rein in her true feelings or let go of the hurt. Mia understood how she was supposed to behave, but in the heat of the moment, those socially appropriate responses were often out of reach. This tendency can create serious challenges for people with ADHD in their most important relationships – with teachers, supervisors, bosses, teammates, colleagues, and even close friends and family.
The challenge tends to be more about understanding what’s expected than actually doing it in the moment
Mia’s struggles had less to do with not knowing how to act and more to do with rejection sensitivity and impulsivity. In therapy, we started by exploring her thoughts and feelings around rejection sensitivity dysphoria (RSD) – that intense sting that comes with real or perceived criticism. From there, we worked on ways she could either prevent an emotional ‘fire’ or put one out once it started. One of the most useful tools was learning to take a time-out: stepping away from the situation that set her off so she could calm down and reset before coming back to deal with it. This approach helps because most people with ADHD do know the right or socially acceptable way to respond – it’s just that, in the moment, executive functioning challenges make it hard to follow through.
By contrast, autistic people often don’t instinctively know what to do in certain social situations – but once they’re taught, they can usually perform those learned behaviours quite well. For autistic individuals without co-occurring ADHD, the challenge tends to be more about knowledge – understanding what’s expected – than about performance – actually doing it in the moment. With enough guidance and practice, many autistic people become highly skilled at masking; their social responses can appear polished, even strategic, because they’ve learned and rehearsed what’s considered the ‘socially acceptable’ or neurotypical way to act.
As a psychologist specialising in neurodiversity, it is often rewarding to work on building social skills with autistic individuals when that is one of their goals for therapy. As long as the autistic person is motivated to socialise, to make friends, get a job or date, and as long as they have at least average intelligence, I am fairly confident they will meet their therapy goals.
Jasmine’s parents brought her in to therapy because they believed her challenges emerged from ‘social anxiety’. Jasmine had a history of avoiding other children on the playground and had few friends. With this clinical history reported by her parents, I was prepared to see an anxious girl enter my office.
Far from it. Jasmine had no problem separating from her parents. She calmly sat on the corner of my navy therapy couch and independently reached for a fidget toy from a basket nearby. She chose the Rubik’s Cube (a fine choice). Then she proceeded to examine every detail of my office except, well, me. Her speech was monotonous, though eloquent. Jasmine seemed to have a good amount of insight into her difficulties, so I asked her why she preferred to not engage with other kids her age.
Her eyes rested on the corner of the ceiling. ‘It’s hard for me to understand others. But if I really wanted to talk to someone else, I would. There’s just no one I’ve really wanted to talk to.’
She insisted that social anxiety wasn’t the issue – and an evaluation for autism, which came back positive, confirmed it. Once autism, rather than social anxiety, was identified as the root cause, she began making real progress in therapy.
During sessions, Jasmine and I focused on identifying motivators to socialise with her classmates and make friends. We discussed reasons to talk to peers (eg, for social support or for help with classwork) and addressed some of Jasmine’s concerns about socialising. Jasmine was worried that she would become overstimulated if she ever did get to the point where she was making plans with a classmate outside of school. I validated her feelings and explained how these experiences are common for autistic kids and adults. We problem-solved to identify solutions. For example, Jasmine could explain to that person in advance that she would be free for an hour and could also agree on the location and activity to ensure she felt comfortable with the plans.
Intelligence alone isn’t enough to make someone socially adept – you also need the desire to connect
Her parents were already in the process of transferring Jasmine to a different school for the following year. This turned out to be extremely helpful because Jasmine then had the opportunity to start fresh in a new group of kids, who (thankfully) happened to be more accepting of and interesting to Jasmine than the students in her previous school. Because of this advantage, I was able to coach Jasmine and help her accomplish her personal social goals: make at least one good friend and get to know at least one person in every class. Jasmine ended up fitting perfectly into a small group of girls in her grade. She did great at reaching out to students she knew in class whenever she needed help with an assignment.
When it comes to autism, motivation plays a key role in both social skills and masking. Intelligence alone isn’t enough to make someone socially adept – you also need the desire to connect and the willingness to practise. With a child like Jasmine, therapists and parents first need to explore what might motivate her to want to socialise before introducing any structured social-skills training or planning get-togethers with peers her age.
We can’t assume that everyone feels equally drawn to social interaction, or that social motivation comes naturally to all. Likewise, just because someone isn’t motivated to socialise right now doesn’t mean they’ll never be. Not everything fits neatly into the category of ‘common sense’ – in fact, neurodiversity challenges what’s ‘common’ about it. With Jasmine, as with many autistic individuals, the most effective starting point was simply a conversation – not a lecture – about why connecting with classmates might be worthwhile.
A big part of that dialogue involved unpacking the unhelpful thinking patterns she’d developed after years of feeling rejected, hurt or misunderstood. For kids and adults with a history of bullying or exclusion, this can be the hardest part of therapy. But without helping a client glimpse the light at the end of what has been a dark social tunnel, any effort to build social skills risks hitting a dead end.
As long as the autistic person is motivated to learn social skills and engage with others, has some level of social awareness, and as long as their autism symptoms are not too severe, I typically see people succeed at learning the ropes and making friends.
Conversely, teaching social skills to someone with only ADHD can feel almost pointless. It’s not that people with ADHD don’t know what to do in social situations – they usually do. The real challenge lies in actually doing it. That’s why the work I do with ADHDers around social functioning and relationships focuses less on teaching specific behaviours and more on helping them create strategies for putting those behaviours into practice.
I sometimes feel hypocritical, even ashamed, working on these types of skills with neurodivergent clients just so that they can fit societal norms. There needs to be a bigger reason for learning how to mesh with the neurotypical world. I often start by asking them why it might be helpful to learn these skills. This leads to a discussion about how people need people for support and for forward movement in life. If no one likes us and if others disapprove of our behaviour, then we are setting ourselves up for failure. I often add parenthetical statements such as: ‘I know it’s annoying that the world is like this, but alas.’
Alas: we must assimilate so the environment doesn’t spit us out. And sometimes that fit requires a mask.
The general sense I’ve been getting from my neurodivergent clients is that they are sick and tired of masking. It appears that many of us are frantically running back to the dumpster to reclaim our hidden-gem personalities. Or we’re at least expressing a desire to do it while feeling torn between a fear of potential rejection and a longing to tear off the mask that has been suffocating us for too damn long. This is unsurprising, considering that neurodivergent individuals who report engaging in masking also report struggling with trauma histories, lower self-esteem, a poorer sense of authenticity, depression, anxiety, burnout, and exhaustion.
In a recent online survey, the British team of Danielle Miller, Jon Rees and Amy Pearson found that masking isn’t unique to autism – both autistic and non-autistic adults do it. But the more people masked, the more they felt disconnected from their true selves and drained by the effort it took to keep up the act. For autistic adults, masking often went a step further. They were more likely to suppress sensory behaviours – like fidgeting or stimming – and more likely to report thoughts of suicide, underscoring just how heavy the toll of constant self-suppression can be.
In a world that expects girls to be composed and compliant, masking becomes a survival skill
When Julia Morgan, a social scientist at the University of Greenwich in London, set out to interview 52 women diagnosed with ADHD in adulthood, she expected stories of frustration. What she found instead were narratives of revelation and loss – lives divided into before and after. For many participants, the diagnosis arrived as a moment of self-recognition: an explanation that reframed a lifetime of confusion, self-blame, and perceived failure. Yet the relief came tinged with grief. They had spent years being mislabelled or ignored, and when the diagnosis finally came, professional support often stopped at a prescription pad. Therapy was scarce. Follow-up care was minimal. The women were left to rebuild their understanding of themselves largely on their own.
The reasons for that delay, Morgan discovered, were rooted as much in medicine as in the culture of masking. Many of the women had learned early to hide their symptoms – to mask the impulsivity, restlessness and emotional overflow that drew negative attention. In a world that expects girls to be composed and compliant, masking becomes a survival skill. ‘Girls are always expected to be perfect and not a problem,’ one participant said, ‘and boys making mistakes is fine. Girls are better at hiding things to fit in with this idea. I spent so much time hiding my true self to not disappoint people or be judged … It took all my effort to do this. I became an expert at it.’ That effort took a psychic toll. Years of self-suppression left women exhausted, alienated, and unsure where the performance ended and the real self began. In the end, Morgan’s work reminds us that the hardest part of living with an invisible condition isn’t the difference itself – it’s the years spent pretending to be someone else.
Masking creates a kind of chicken-and-egg dilemma: does stigma cause masking, or does masking itself reinforce stigma by making neurodiversity less visible? The two are bound together, feeding each other in quiet loops. On one hand, society exerts its pressure through subtle cues and unspoken rules about how we should look, act and feel. On the other, our most ancient instinct is to adapt – to shape ourselves to the world so we can survive in it. The tragedy is that this adaptation often comes at a cost. The harder someone works to appear ‘normal’, the more their difference disappears from view – and the less the world learns to make room for it. In hiding to belong, they only deepen the loneliness that made them hide in the first place.
Stigma, and the instinct to divide the world into ‘us’ and ‘them’, is woven deep into human behaviour. Across history, those who fall outside the perceived norm have borne the weight of exclusion – whether for their race, gender, religion or mind. Social psychology has long shown that people naturally favour those within their own group and grow wary of those who seem ‘different’. This bias may have once served an evolutionary purpose, helping groups survive by fostering cohesion, but today it feeds alienation and shame. For anyone who stands apart, the message is clear: blend in if you can. And so, many learn to mimic the customs of the larger group – to mask their difference in exchange for belonging. Yet the longer acceptance depends on performance, the harder it becomes to show who you really are.
Maybe the first step toward change is accepting that we can’t erase the human impulse to mistrust difference. I wish I could say the answer to masking was simple – that those of us who are different could just decide to own our differences and be done with it. I wish I could say I’d simply turned down the volume on the anger and sadness that surged through me after Dr Jennings’s announcement, and Anita’s complicit silence. But my internal thermostat has no dimmer switch. It’s all or nothing – and in that moment, ‘nothing’ felt like the wiser choice. I don’t think I was wrong.
In a perfect world, of course, I would lean toward unmasking. And I know many of you who are neurodivergent – and just as tired of pretending – would agree. It would be a relief to move through the world as our full selves, without apology. But the truth is, that kind of openness comes with risk. We still live among people who judge and criticise, who prefer – often unconsciously – those who resemble themselves.
Yet here lies the hope: in addition to educating others on how to make neurotypical settings more inclusive, those of us who are different can find each other. We can build spaces where the mask isn’t necessary, where authenticity feels safe. Maybe the key to easing the strain of masking is twofold – advocating for inclusion in schools and workplaces, while also seeking out the company of other neurodivergent minds. To see and be seen by one another is its own kind of freedom. We are, after all, a growing and self-advocating community. And there is no circle I’d rather belong to – or learn from – than this one.
Some names have been changed to protect privacy.
