It’s natural for someone with attention-deficit/hyperactivity disorder (ADHD) to feel ashamed of their condition. However, it’s not natural to try to hide the condition through ADHD masking.

Simply put, ADHD masking is when someone with ADHD presents themselves in a manner to appear as if they don’t struggle with the condition. ¹ Sometimes it’s called “impression management” or “camouflaging.” Such terms came about when psychologist Russell Barkley noticed about one-third of people with ADHD attempt to mask their condition.

ADHD Masking Defined

Since people who attempt to mask ADHD are trying to hide their symptoms, this phenomenon makes its appearance in some behaviors.

More specifically, masking ADHD is hiding the shame that appears with symptoms. For example, people with ADHD are likely to talk more. Therefore, someone masking ADHD may actively attempt to talk less.

This is a coping mechanism and how some handle their condition. ² With that, once masking becomes a habit, it can be difficult to manage.

Examples

• Being overly careful about what you say or remaining quiet. This is to avoid talking too much and interrupting others.

• Obsessively checking to make sure you don’t lose your personal belongings.

• Offering specific reactions in a group setting that you believe are expected, rather than reacting as you feel.

• Hiding the fact that you struggle with ADHD symptoms, appearing “fine.”

• Obsessive cleaning even when it feels overwhelming.

• Trying to remain calm as a means of hiding hyperactivity (may cause you to have trouble focusing).

• Avoiding “time blindness” by always showing up to appointments or events early.

• Attempting to listen more closely. This is to miss what another person is saying.

• Excessive writing so as not to forget something due to memory issues caused by ADHD.

• Obsessive organization to ensure you don’t lose anything.

• Bottling up emotions without knowing why (this may lead to depression).

• Avoiding stress and anxiety-inducing situations (i.e. calling out sick).

• Experiencing irritability when you attempt to concentrate on things that don’t interest you.

• Overdoing things to prove to others that you’re capable and reliable.

• Hiding negative emotions caused by responsibilities (i.e. shame or guilt).

• Masking your struggles to appear as though you’re in control.

• Suppression of stimming behaviors (i.e. leg bouncing) to avoid disturbing others.

• Mimicking other people to feel accepted in social situations.

Effects of ADHD Masking

As mentioned, masking is a way for people to cope with ADHD. Therefore, it may seem like a good trait to have. However, ADHD masking has several downsides that should be taken into consideration:

• Masking tends to lead to undiagnosed ADHD. As a result, people continue to struggle with symptoms when they could receive treatment. ³

• If masking goes untreated, it can lead to other mental health disorders, such as anxiety and depression, as similarly observed in people who struggle with autism. ⁴ Furthermore, undiagnosed ADHD can lead to a substance use disorder. ⁵

• Some research suggests that people who mask autistic symptoms may struggle with their own identity. ⁶

Do Girls Struggle More?

Research from 2019 found that women are more likely to be diagnosed with ADHD than men. In turn, they’re also more likely to camouflage ADHD symptoms. ⁷

These effects tend to compound one another. When a person hides ADHD symptoms, they’re less likely to be diagnosed. Vice versa, a person is more likely to struggle with masking without a proper diagnosis.

Some research suggests these gender differences may also have to do with other conditions existing alongside ADHD. For example, men with ADHD are more likely to struggle with oppositional defiant disorder. This condition causes very outward behaviors (i.e. aggression) and makes masking more difficult.

On the other hand, women with ADHD are more likely to struggle with internalizing disorders, such as anxiety. In turn, they have a better chance of masking these symptoms. ⁸

How to Cope with ADHD Masking

If you’re aware that you mask ADHD, you’re already one step ahead of the problem. From here, you’ll want to:

• Identify which type of ADHD you struggle with and find the proper treatment. Since ADHD can appear in different ways, there are a few paths to take based on the type of ADHD you struggle with.

• Learn how to cope with your emotions in healthier behaviors. The best way to do this is through psychotherapy, where you’ll learn exactly how ADHD impacts your life and develop proper coping mechanisms.

• Find a support system. It’s important to understand that you’re not alone in your struggle. There are several support groups (both online and in-person) for others struggling with ADHD.

Final Word

While ADHD masking may not appear harmful on the surface, it can have long-lasting negative impacts not initially considered. For this reason, if you do struggle with masking ADHD, it’s important to find help as soon as possible.

With psychotherapies, you can properly identify which ADHD symptoms you struggle with most. From there, you can develop healthier coping mechanisms.

References

¹ Williams OC, Prasad S, McCrary A, Jordan E, Sachdeva V, Deva S, Kumar H, Mehta J, Neupane P, Gupta A. Adult attention deficit hyperactivity disorder: a comprehensive review. Ann Med Surg (Lond). 2023 Apr 12;85(5):1802-1810. doi: 10.1097/MS9.0000000000000631. PMID: 37228994; PMCID: PMC10205222.

² Kosaka H, Fujioka T, Jung M. Symptoms in individuals with adult-onset ADHD are masked during childhood. Eur Arch Psychiatry Clin Neurosci. 2019 Sep;269(6):753-755. doi: 10.1007/s00406-018-0893-3. Epub 2018 Apr 6. PMID: 29626225; PMCID: PMC6689273.

³ Journal of Postsecondary Education and Disability: A Descriptive Review of ADHD Coaching Research: Implications for College Students

⁴ Attoe DE, Climie EA. Miss. Diagnosis: A Systematic Review of ADHD in Adult Women. J Atten Disord. 2023 May;27(7):645-657. doi: 10.1177/10870547231161533. Epub 2023 Mar 30. PMID: 36995125; PMCID: PMC10173330.

⁵ Hamed AM, Kauer AJ, Stevens HE. Why the Diagnosis of Attention Deficit Hyperactivity Disorder Matters. Front Psychiatry. 2015 Nov 26;6:168. doi: 10.3389/fpsyt.2015.00168. PMID: 26635643; PMCID: PMC4659921.

⁶ Miller D, Rees J, Pearson A. “Masking Is Life”: Experiences of Masking in Autistic and Nonautistic Adults. Autism Adulthood. 2021 Dec 1;3(4):330-338. doi: 10.1089/aut.2020.0083. Epub 2021 Dec 7. PMID: 36601640; PMCID: PMC8992921.

⁷ Slobodin O, Davidovitch M. Gender Differences in Objective and Subjective Measures of ADHD Among Clinic-Referred Children. Front Hum Neurosci. 2019 Dec 13;13:441. doi: 10.3389/fnhum.2019.00441. PMID: 31920599; PMCID: PMC6923191.

⁸ Quinn PO, Madhoo M. A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. Prim Care Companion CNS Disord. 2014;16(3):PCC.13r01596. doi: 10.4088/PCC.13r01596. Epub 2014 Oct 13. PMID: 25317366; PMCID: PMC4195638.