Behind the ADHD Mask: What Research Tells Us
Picture someone who's never late for a meeting because they set four alarms and show up 30 minutes early. They take detailed notes, so nobody sees their mind wander. They practice conversations ahead of time, sit on their hands so they won't fidget, and stay up past midnight redoing work that should have taken an hour. To colleagues they seem capable and put-together. But inside, they're exhausted.
That's ADHD masking, also called ADHD camouflaging. It's one reason ADHD often goes unrecognized for years, especially in women, high-achieving adults, and anyone who learned early that their natural way of being was "too much" or "not enough."
What is ADHD masking?
Masking means hiding, suppressing, or making up for ADHD traits so that you blend in with neurotypical expectations. The idea first became widely known through autism research. In recent years researchers have started asking whether people with ADHD do something similar, and they found the answer is yes.
In a 2026 study published in Research in Neurodiversity, researchers at Simon Fraser University asked 202 adults with ADHD about their experiences. 91.6% said they camouflaged their ADHD traits in social situations, at work, or in close relationships. Common strategies that people used included pretending, mimicking others, overpreparing, avoiding social situations, suppressing impulses like fidgeting or interrupting, and self-medicating.
Why people mask
Masking is rarely a conscious decision in the moment. It usually builds up over time, in response to stigma, criticism, and wanting to belong. In the SFU study, people's reasons included fitting in socially, gaining acceptance, avoiding negative experiences, and adapting to environments built for neurotypical brains.
A large 2026 Australian study of more than 5,600 adults with autism and/or ADHD found that higher ADHD symptoms and higher perceived stigma were both linked to more camouflaging. It's an understandable pattern: the more people's differences draw negative attention, the harder they work to hide them.
Many coping strategies start out as healthy adaptations. A qualitative study of adults with ADHD found that people had developed a wide range of strategies before they were ever diagnosed: checklists and reminders, strict routines, physical activity, seeking low-distraction environments, and social strategies. The authors pointed out that these same skills can hide symptoms from clinicians and contribute to underdiagnosis in high-functioning adults. The study also found that some participants had been self-medicating with substances such as caffeine and nicotine.
The hidden cost
Masking can help in the short term. As lead researcher Marisa Mylett put it, masking strategies "may help you get your foot in the door socially... but they often leave people feeling exhausted." Participants in the SFU study described:
Exhaustion and burnout. Some needed days to recover after long stretches of masking.
Anxiety and depression
Identity confusion and a sense of being inauthentic ("I wish I could just be myself").
Weaker connection with others, because relationships felt built on a performance.
Worse ADHD symptoms. The mental effort of monitoring yourself uses up the same attention and working memory ADHD already strains.
That last point matters. Masking doesn't just coexist with ADHD. It can make ADHD harder to manage.
Why women and girls are often missed
Masking helps explain why ADHD in girls and women has long been under-recognized. A review in The Primary Care Companion for CNS Disorders found that girls more often have the inattentive presentation and tend to show internalizing symptoms rather than disruptive behavior (2014). They're less likely to be referred by teachers and more likely to have their symptoms called "subthreshold." They often get treated for anxiety or depression before anyone considers ADHD. In one dataset the review cites, 14% of girls versus 5% of boys received antidepressants before ADHD treatment.
Stephen Hinshaw and colleagues reach a similar conclusion in their 2022 Journal of Child Psychology and Psychiatry review. Girls and women remain underrepresented in ADHD research and diagnosis, even though ADHD in females is linked to real and lasting impairment into adulthood.
The practical takeaway: doing well in school or at work does not rule out ADHD. Sometimes that success is the mask.
An honest side note: The science is still young and there’s more to be done.
Most of this research is new, and scientists are still debating how to define and measure ADHD masking. In a 2024 study, Van Der Putten and colleagues found that adults with ADHD camouflaged more than people without a diagnosis but less than autistic adults. They also found that autistic traits, not ADHD traits, predicted camouflaging scores. That may partly be because the questionnaire they used was designed for autism.
The lived experience of hiding, compensating, and burning out is real and well documented, and researchers are still working out how best to describe and measure it.
Moving toward unmasking
Unmasking doesn't mean dropping every coping strategy or ignoring social context. It means shifting from hiding who you are to supporting who you are. Some places to start:
Notice your patterns. Where do you perform the most? What does it cost you afterward?
Separate helpful strategies from harmful ones. A calendar that reduces stress is support. Staying up until 2 a.m. so nobody sees you struggle is a mask.
Build in recovery time after high-demand social or work situations.
Find safe spaces where you can fidget, pace, interrupt yourself, or say, "I lost track, can you repeat that?" without shame.
I once had a supervisor who would openly admit when she got distracted and ask me to repeat what I'd just said. I appreciated that honesty. It was far better than pretending she'd been following along. Her openness didn't make her seem less capable; it made her easier to trust.
Consider an evaluation if this sounds familiar to you, you've never been assessed, and especially if you've been treated for anxiety or depression without much relief.
What does an ADHD evaluation involve? No single test diagnoses ADHD, so a licensed psychologist does a comprehensive assessment. It usually includes a clinical interview, your developmental history, standardized rating scales, and screening for conditions that can look like ADHD, such as anxiety or depression. For adults who have masked for years, a careful evaluation looks past how well you seem to be functioning and asks how hard you're working to get there.
Work with a clinician who understands adult ADHD. Therapy can help you reduce shame, build sustainable systems, and choose when and where masking is worth the effort.
You shouldn't have to spend your life running two programs at once: the one you're living and the one you're performing. Understanding the mask is the first step toward setting some of it down.
Masks are great for Halloween, but for everyday life, you deserve to show up as yourself!
References
Adamou, M. (2026). Camouflaging in ADHD: The need for construct validation before clinical adoption. The British Journal of Psychiatry. Link
Canela, C., Buadze, A., Dube, A., Eich, D., & Liebrenz, M. (2017). Skills and compensation strategies in adult ADHD: A qualitative study. PLOS ONE, 12(9), e0184964. Link
Giblett, M. J., Lind, P. A., & Medland, S. E. (2026). Autism traits, ADHD symptoms, and stigma as predictors of social camouflaging in adults from the Australian ASD and ADHD study. Research in Neurodiversity. Link
Hinshaw, S. P., Nguyen, P. T., O'Grady, S. M., & Rosenthal, E. A. (2022). Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: Underrepresentation, longitudinal processes, and key directions. Journal of Child Psychology and Psychiatry, 63(4), 484–496. Link
Madhoo, M., & Quinn, P. O. (2014). A review of attention-deficit/hyperactivity disorder in women and girls: Uncovering this hidden diagnosis. The Primary Care Companion for CNS Disorders, 16(3). Link
Mylett, M. L., Boucher, T. Q., & Iarocci, G. (2026). "I wish I could just be myself": Experiences of social camouflaging in adults with ADHD. Research in Neurodiversity. Link
van der Putten, W. J., et al. (2024). Is camouflaging unique for autism? A comparison of camouflaging between adults with autism and ADHD. Autism Research. Link
