The Impact of Masking on Women with ADHD
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Masking might be the norm for many people with ADHD, perhaps especially women
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Dr Janina Maschke explores the different types of masking and their impact, and offers advice on how to begin unmasking
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We have therapists who specialise in working with ADHD – find them here
ADHD’ers have a unique way of thinking, but unfortunately society isn’t set up for unique or different. That’s where masking comes in.
What is masking?
Masking, something many women can relate to, is all about hiding your true self to meet societal expectations. It’s that feeling of trying to be “normal” when you feel anything but.
Masking can be a conscious or subconscious camouflaging of yourself to make your differences less noticeable to the world around you, so you feel more accepted and able to fit in. When you feel different from the rest of society, it can be a struggle to find where you belong. While society sometimes celebrates uniqueness, history has shown that in many situations, conforming to the group was necessary for survival. Masking may provide a short-term sense of safety, but it can leave lasting scars.
The reality is that as humans we’ve been mastering the art of masking from the very beginning. Even infants instinctively mirror the facial expressions of those around them, like a smile. Throughout our existence, our survival has consistently relied on forming connections with others and building communities, rather than remaining in solitude. We all fear, whether we are neurodivergent or not, being rejected or not fitting in, so we have all mastered the art of “fitting in” to an extent. But for someone who is neurodivergent, the amount of masking needed to fit in is often far greater than for someone who is neurotypical.
If you’re a woman who’s been masking your true self, you probably know what it feels like to be an outsider. Perhaps you tend to find yourself on the edge of social gatherings, watching others and trying to imitate their moves so you fit in, feeling like you never quite get it right. This urge to fit in taps into a basic human instinct – the desire for acceptance and connection.
Masking can look different from woman to woman, influenced by various factors, including their specific type of ADHD:
Inattentive ADHD
People with this type may exert extra effort to focus and appear attentive, even though they struggle to maintain attention. They may also hide their difficulties with organising and completing tasks, often leading to procrastination or missed deadlines.
Hyperactive ADHD
Those with this type may suppress their restlessness and present themselves as calm and collected, concealing their constant need for movement. They may also work to control impulsivity, refraining from interrupting others or making inappropriate comments.
Combined type ADHD
Individuals with this type experience symptoms from both categories and may use a combination of the above masking strategies. Additionally, they may hide feelings of overwhelm or anxiety and avoid engaging in repetitive behaviours or movements (known as stimming), even if it helps them self-regulate.
If we mask over and over again, we can turn the masking into a learned behaviour, a conditioned response. This is true for many neurodivergent individuals and especially neurodivergent women. Masking can start as early as preschool, but for most people it begins during school years, when girls in particular face added social pressures. Once we enter school there is often a strong emphasis on fitting in and conforming to societal norms, which can make us want to conceal our true self to avoid any form of judgement or social stigma.
Why do we mask?
To conform to gender stereotypes
Girls and women tend to internalise symptoms more than boys and men, who are more likely to externalise their behaviours. This does not necessarily mean that the core symptoms are always different, but just that how we show them and how others perceive them can be very different.
But why is it that girls or women are more prone to internalising their behaviours? Some research suggests that women are better at masking, meaning that they have a better memory of social scripts and might be able to inhibit undesirable behaviour.
Also, how the different genders are perceived socially has an impact on our behaviour, even though we are slowly growing away from the traditional gender norms and what we have been led to perceive as “feminine” and “masculine”. The feminine stereotype is to be shy, compassionate, sensitive or sympathetic versus the masculine stereotype of being rather independent, dominant and aggressive. Despite the fact that we have become aware of these gender stereotypes and have started to actively break them down, they are still engrained in our society.
And this of course shapes everyone, as well as females with ADHD. It might make us more prone to be quieter and turn inwards in order to be considered “socially acceptable”.
Fear of judgement and stigma
Being neurodivergent makes you different in a variety of ways. As we have already established, standing out as someone who is different isn’t always a good thing in society, or at least isn’t perceived as something good. This makes many ADHD’ers fear judgement, so we try to fit in even though we were kind of made to stand out. Due to the fear of judgement and a reluctance to be conspicuous and seen as different, many females with ADHD still feel the pressure to conform to social pressures.
Are there different types of masking?
While there is a wide range of ways in which masking can manifest, they can generally be grouped into one of the four categories outlined below, particularly relevant to women.
Behavioural masking
This involves modifying behaviour to hide or suppress symptoms. For example, someone might avoid eye contact or engage in deep-breathing exercises to manage their symptoms during social interactions. Similarly, a woman with ADHD may create task lists or use timers to better manage her responsibilities and prevent herself from feeling overwhelmed.
Emotional masking
Emotional masking is used to hide emotions or feelings from others. For instance, a woman dealing with depression might force herself to smile or laugh in social situations to avoid any conversations about her depression. Likewise, a woman with ADHD may employ distraction techniques, such as exercise or work, to divert her attention from the intensity of her emotions.
Social masking
Social masking involves adapting behaviour to conform to societal norms and expectations, often to fit in with others. For example, a woman with ADHD might consciously mimic the facial expressions and body language of those around her to avoid standing out in social settings.
Self-masking
This is the act of hiding or downplaying one’s symptoms or mental health condition from oneself. For instance, a woman with ADHD might dismiss her symptoms of distraction, forgetfulness and impulsivity as laziness, a lack of motivation or even a personal character flaw rather than recognising these as indicative of ADHD.
Why is masking a bad idea?
Now you might wonder why it’s a bad thing if it helps you to fit in with others and hold it all together, but the reality is that masking takes a toll that goes beyond the surface and can lead to all of the following issues.
Exhaustion and burnout
Masking necessitates the constant monitoring and regulation of your own behaviour, which can be mentally and emotionally draining. This perpetual self-regulation often results in a pervasive sense of exhaustion and fatigue, making it challenging for women to effectively manage their daily lives while coping with their symptoms. Those who mask may find themselves repeatedly prioritising fitting in over their own wellbeing, ultimately leading to an enduring state of burnout and frustration.
Loneliness
Masking compels women to conceal their authentic selves and adopt a persona that aligns with societal expectations. This facade can hinder the formation of genuine connections with others, making it difficult for them to establish authentic relationships. Living a life devoid of these genuine connections can be emotionally isolating, resulting in profound feelings of loneliness. Furthermore, masking may prevent women from receiving the necessary support and understanding they deserve, as their true condition often remains unnoticed both by others and themselves.
Self-doubt and lack of self-understanding
Masking can cause women to internalise their symptoms, making it more challenging for them to acknowledge and address their unique challenges. By attributing these difficulties solely to themselves, women may inadvertently invalidate their own experiences, leading to feelings of shame, self-doubt and disconnection from their genuine selves. This self-doubt can hinder their ability to form healthy relationships with both themselves and others.
What can I do to start unmasking?
With the right support and understanding, you can learn to differentiate between healthy and unhealthy coping mechanisms, enabling you to adapt your responses and ultimately cultivate healthier connections with yourself and those around you.
Reflect on your history
Take some time to delve into your personal history and assess if there are any recurring patterns of masking. By tracing back through your experiences, you can gain a deeper understanding of your unique journey and begin formulating coping strategies tailored to your needs.
Seek input from loved ones
Don’t hesitate to reach out to those closest to you and ask for their insights regarding your behaviour and traits. Their perspective can provide valuable observations that you might not have been aware of, plus they can offer support and encouragement as you navigate the process of unmasking.
Consult a professional
If you suspect that an undiagnosed mental health condition may be contributing to your masking tendencies, it’s crucial to seek guidance from a qualified medical professional. They can assess your symptoms, provide an accurate diagnosis and recommend a personalised treatment plan designed to address your specific needs.
Unmasking isn’t something that will happen overnight. It involves peeling away the layers of adaptation and camouflage that you have developed over time to conform to societal expectations. This process will allow you to reclaim your genuine identity and recognise that your unique traits, quirks and struggles are all valid and deserve acknowledgment. So, let’s start peeling away the layers of your mask.
Dr Janina Maschke is the author of The Feminist's Guide to ADHD