ADHD Masking: The Exhausting Performance You Didn't Know You Were Giving
By Dr. Ryan Sultan, Assistant Professor of Clinical Psychiatry, Columbia University | Updated February 2026
ADHD masking is the conscious or unconscious suppression of ADHD symptoms to appear "normal" - it's exhausting, delays diagnosis (especially in women), causes burnout, and prevents people from getting the support they need. Learning to unmask is essential for mental health.
You look fine on the outside.
You show up on time (barely). You smile. You nod attentively. You write everything down. You apologize when you forget anyway.
Nobody knows that inside your head, there's chaos. Racing thoughts. Constant self-monitoring. A running script: "Don't interrupt. Make eye contact. Don't fidget. Remember what they just said. Look interested. Stop daydreaming."
By the end of the day, you're exhausted. Not from your actual work - from the performance of appearing normal.
This is ADHD masking. And it's costing you more than you realize.
🎭 What Is ADHD Masking?
ADHD masking (also called camouflaging) is the practice of hiding, suppressing, or compensating for ADHD symptoms to fit neurotypical expectations.
It's both:
Conscious: Deliberately controlling your behavior ("Don't blurt out your thoughts")
Unconscious: Automatic behaviors learned over years to avoid criticism
Common Masking Behaviors
Forcing eye contact even though it's uncomfortable and makes it harder to listen
Scripting conversations in your head before speaking
Over-preparing for meetings/events to compensate for working memory issues
Excessive note-taking to remember what's being said
Setting 10 alarms for everything to avoid being late
Staying rigidly still to hide physical restlessness
Constant apologizing ("Sorry, what did you say?" "Sorry I'm late")
Overthinking every interaction afterward ("Did I talk too much?" "Was I annoying?")
Avoiding challenging situations where ADHD symptoms might show
Working 3x harder than others to produce the same output
"I didn't realize I was masking until I got home from work one day and completely collapsed. My husband asked what was wrong, and I said 'I'm just tired.' But it wasn't normal tired. It was the exhaustion of performing 'productive employee' for 8 hours straight when my brain wanted to do anything but sit at a desk."
— Lisa, 38, diagnosed at 35
🔍 Why People Mask Their ADHD
Masking isn't a choice you consciously made one day. It develops gradually in response to external pressures.
1. Avoiding Shame and Criticism
When you were a child:
"Stop interrupting"
"Pay attention"
"Why can't you just sit still?"
"You're so forgetful"
"If you just tried harder..."
You learned: My natural behavior is wrong. I need to hide it.
2. Social Survival
You noticed:
People get annoyed when you interrupt
Friends stop inviting you when you're chronically late
Coworkers judge you for disorganization
Partners leave because you "don't listen"
You learned: If I show my real symptoms, I'll be rejected.
3. Professional Success
Workplace expectations don't accommodate ADHD:
Be organized
Manage time effectively
Remember meetings
Complete paperwork promptly
Sit through long meetings
You learned: I have to hide my ADHD or I'll get fired.
4. Gender Expectations
Girls and women face additional pressure:
"Girls should be quiet and polite"
"Women are naturally organized"
"Good mothers remember everything"
You learned: My ADHD makes me a failure as a woman.
Bottom Line: Masking develops as a survival mechanism. You're not weak for masking - you're adapting to a world that wasn't built for ADHD brains.
💔 The Cost of Masking
Masking isn't harmless. It has serious consequences.
1. Delayed or Missed Diagnosis
When you mask effectively:
Teachers don't notice your struggles
Doctors don't see obvious symptoms
You succeed academically despite suffering internally
People say "You can't have ADHD, you're too successful"
Diagnosis is delayed by years or decades
Result: You spend years thinking you're lazy, broken, or just not trying hard enough.
2. Burnout and Exhaustion
Masking requires enormous mental energy:
Constant self-monitoring
Suppressing natural impulses
Working 3x harder than neurotypical peers
Never able to relax or be yourself
Result: Chronic exhaustion, inability to function at home, need for extensive recovery time.
3. Mental Health Problems
Studies show masking is associated with:
Depression: From suppressing your true self
Anxiety: Constant fear of being "found out"
Low self-esteem: Feeling like an imposter
Suicidal ideation: The exhaustion becomes unbearable
4. Loss of Identity
When you mask for years:
You lose touch with who you actually are
You can't distinguish masking behaviors from authentic self
You don't know what you actually want vs. what you think you should want
Your relationships feel performative, not genuine
5. Physical Health Impact
Chronic stress from masking affects your body:
Sleep problems
Headaches and migraines
Digestive issues
Weakened immune system
Chronic pain
⚠️ Masking Burnout
Many people with ADHD experience sudden, severe burnout after years of successful masking. One day, the compensatory strategies just... stop working. You can't force yourself to perform anymore. This often leads to job loss, relationship breakdown, or mental health crisis.
If you're approaching burnout: It's not failure. It's your brain telling you that masking isn't sustainable.
👩 Why Women Mask More (And Get Diagnosed Later)
Women with ADHD mask significantly more than men. Here's why:
Social Conditioning
Girls are expected to be "good": Quiet, organized, compliant
Girls face harsher judgment: For interrupting, being messy, forgetting things
Social consequences are higher: Girls rely more on social bonds that require masking to maintain
ADHD Presentation Differences
Girls more often have inattentive type: Less disruptive, easier to hide
Internal hyperactivity: Racing thoughts, not physical bouncing
Better verbal skills: Can talk their way through missing information
The Result
Boys diagnosed at age 7
Girls diagnosed at age 12+ (if at all)
Women often not diagnosed until 30s, 40s, or 50s
Decades of unnecessary suffering
🛑 Signs You're Masking ADHD
You might be masking if:
✓ You're exhausted after social interactions even when you enjoyed them
✓ You feel like you're "performing" at work or social events
✓ You can't relax or be yourself around most people
✓ You have a long mental script of "rules" for how to act normally
✓ You're successful professionally but feel like a fraud
✓ People say "You don't seem like you have ADHD"
✓ You need significant alone time to recover after being "on"
✓ You work much harder than others for the same results
✓ Your home life is chaotic even though you seem organized at work
✓ You avoid situations where you might "mess up"
✓ You rehearse conversations extensively before having them
✓ You're constantly monitoring your own behavior
🌟 How to Stop Masking (Gradually and Safely)
Unmasking is a process, not a switch. Here's how to start:
Step 1: Identify Your Masks
Journal: What behaviors are you forcing that don't feel natural?
Notice: When do you feel most exhausted? (That's when you're masking hardest)
Reflect: What criticisms from childhood still echo in your head?
Step 2: Choose Safe Spaces to Unmask
Start small:
With close friends/family: "I have ADHD and sometimes I need to fidget while we talk"
At home: Allow yourself to be disorganized, to hyperfocus, to stim
With understanding coworkers: Gradually reveal accommodations you need
Step 3: Build Authentic Accommodations
Instead of forcing neurotypical behavior, create ADHD-friendly systems:
Use fidget tools instead of forcing stillness
Take notes instead of forcing memory
Request written summaries instead of pretending you remember meetings
Ask for flexible deadlines instead of burning out to meet arbitrary ones
Step 4: Practice Self-Compassion
Your ADHD behaviors aren't character flaws
You're allowed to need accommodations
Working harder than others doesn't make you weak
You deserve support
Step 5: Consider Medication and Therapy
Medication: Reduces the effort required to function, less need to mask
ADHD therapy: Learn strategies that work with your brain, not against it
Trauma therapy: Process years of criticism and shame
Dr. Ryan Sultan is an Assistant Professor of Clinical Psychiatry at Columbia University specializing in ADHD. He understands the exhausting toll of masking and helps patients develop authentic, sustainable ways of managing ADHD.
His NIH-funded research has been cited over 400 times, and he has presented at international conferences across Europe and Latin America.