Masking and Adult ADHD

The example websites I showed in the video are:

The two quasi-research papers I found in journals on masking and ADHD are here:

W. J. van der Putten et al. (2024). Is camouflaging unique to autism: A comparison of camouflaging between adults with autism and ADHD. Autism Research.

[Jotto]

"Just act how you feel" is good advice for maybe 10% of the population.

[p_serdiuk]

My own study of psychology suggests that the persona (the social mask) and neurodivergent masking are different.
The persona is mostly about hiding psychological traits, opinions, and behaviors, that are considered socially unacceptable, and thus it is tied to the concept of the Jungian shadow.
Masking is about pretending that you do not have the limitations that you actually do. In the context of ADHD, it's pretending to not have executive dysfunction and emotional regulation problems.

In my experience, neurotypical people who hadn't been educated about ADHD can't readily wrap their heads around the concept of me really wanting to do something and understanding well the positive and negative consequences to myself and other people of both action and inaction, but still being unable to do that thing.

Finding out about ADHD, and then getting an official diagnosis, really helped me to unmask and stop pretending like my pattern of productivity must be the same as a neurotypical person's. It substantiates my struggles both with low motivation and hyperfocus. And now I can explain these things in simple terms, reinforcing the fact that it's my diagnosed psychiatric neurodevelopmental disorder, and not simply stupidity, laziness, or lack of caring. This made my life significantly easier even in cases when I don't get any special accommodations because of it. The ability to manage the social expectations of other people that are being placed on me, instead of just trying to conform to them, is a relief.
I, of course, still make a daily effort to overcome and manage my symptoms even though they are known to people around me. But this is not the same as pretending to not have them.

A real-world example is that at my current job, I often do my work in intense batches and allow myself long periods of rest between them, which for me is the authentic way to work. In the end, I complete the same overall amount of _weekly_ work as everyone else, even if my daily output fluctuates. If I don't have to also pretend like I'm constantly busy with something, which is expected of neurotypical employees who don't usually work as intensely, I can get more work done instead. And I don't get the anxiety associated with the possibility of being seen as a slacker despite my ability to get stuff done, or the depression that's associated with me being unaware of my authentic productivity pattern and thinking that there's something wrong with me if I need long periods of rest when I can't force myself to do anything productive. This is the main difference between masking and symptom management.

Masking that's related to emotional regulation is a different topic though. Yes, it's good for me when I behave and manage my emotions appropriately in public. But I can't do that all the time. This amount of conscious effort burns me out and leads me to avoid social situations. So my family, friends, and partner need to be informed about my ADHD and its consequences, and they have to learn to be a bit more tolerant of my outbursts of enthusiasm if spending more time around me is more important to them than not being irritated when I occasionally interrupt them, gesticulate, or fidget. They can either get more of my authentic unmasked self or less of my restrained self, and there's nothing more that I can do about this.

Similarly, at my current job, my managers are tolerant of me being occasionally overly enthusiastic about some of my tasks and see it as a good thing, even if it sometimes requires them to calm me down a bit and explain some caveats in more detail. Or of me being very sluggish at very "boring" and manual tasks. That's still better than someone who is completely passive about their job. For them the trade-off is worth it, considering that I most often get excited about the most technically difficult parts of the job that other people on my team struggle with and just can't get done as quickly, while they can do "boring" tasks as well as I can when I'm able to in the first place. With the additional synergy of me being far more motivated to automate any manual tasks, which is good for business in the long run. It's a relatively simple matter for my manager to delegate tasks appropriately within the team. Again, this means that I can mask less and achieve more by being authentic. I can cultivate a healthy persona of _the_ employee to go to if something very complicated has to be done under a tight deadline and who can explain things to new people in almost obsessive amounts of detail to ensure their success, instead of a toxic persona of a lazy slacker who nobody knows how he's still employed and who should be able to achieve far more if he could just apply himself.

[donnaw]

Dr Barkley, as someone who has just been diagnosed with ADHD at 60, masking undiagnosed ADHD fits this description better. My whole life I have been hiding my inadequacies, not just at work, but all day long.

It is exhausting, and shameful, and made me feel like something was wrong AND it was my fault, like everyone else knew some secret that I didn’t. Nothing I tried helped, and having people in my life angry or irritated with me all the time was crushing. Everyone including myself saw these problems as incompetency or laziness. It destroyed my self esteem and I had to hide that as well.

Even emotionally it was a constant struggle. Relationships felt so difficult that I sometimes wanted to stop existing. I felt judged and found to be unworthy or damaged, but with no understanding of exactly how or why. Masking was hiding the shame and pain I carried all the time. There was no time when I could stop and relax and feel okay as my actual self.

[ameleh]

When you say it’s exhausting on a daily basis, but it’s not a bad thing at all, it’s not true. It’s a necessary thing, it has benefits and places, but there are limits and we need to recover. We need places where we can just act how we feel.

[imthinkingthoughts]

My understanding is ‘adhd masking’ essentially means people trying their best not to let their executive impairments affect them in public without asking for adjustments or taking steps to reduce their symptomology (medication etc).

I think this much more aligns with autism as this literature suggests. I think that ‘masking’ is basically internalisation, which is as the literature suggests linked to all sorts of psychopathology

[DonnaMcMasterRiver]

I was diagnosed with ADHD (primarily inattentive) three years ago, at age 70. I’ve come to realize that masking became so automatic that almost none of my friends over the years have never really known me. I worked with half a dozen different psychotherapists over the years, but none of them saw anything but depression. I think in the earlier years it was because ADHD in adult women wasn’t recognized, but with the most recent practitioners I believe the problem was that I had become so adept at masking my ADHD symptoms that they didn’t see it. The shame and self-loathing built up over 70 years of never meeting expectations, feeling that I was always letting people down, and throttling my behavior so that I could appear normal. I understand that it’s important to learn how to moderate behavior in many situations, but it’s painful to always feel that you have to squash part of yourself because it is so ugly that people will be repelled by it.

[steceymorgan]

Psychedelics are just an exceptional mental health breakthrough. It's quite fascinating how effective they are against depression and anxiety. Saved my life.

[hallucynation]

Hi Dr Barkley,
I appreciate that you're referencing the available research re: masking, but my concern is that there is a focus on how those with ADHD are perceived rather than the effort and energy that go into this practice.
As you say in the video, masking is something all of us do in order to conform to social norms in different settings. By thanking us for suppressing traits associated with ADHD, I would interpret that you are acknowledging that these traits are particularly disruptive to these social norms, indeed leading to alienation and other negative outcomes. Particuarly for those who have not been diagnosed, I believe that feeling that you need to suppress these elements of yourself in the vast majority of social settings can lead to self-loathing, or feelings that there is something wrong with you. And with this effort being put into masking and limited executive function, is it not unreasonable to assume that the longer this persists without understanding, the more difficult this becomes?
I think the issue lies less in questioning whether masking is a good or bad thing for ourselves or the others around us, and moreso how and when it is healthy to allow ourselves to be unabashedly unrestrained, and to utilise opportunities to completely "unmask".
I would be interested to hear whether you believe this is a healthy practice or whether ultimately the goal with ADHD management is to suppress these traits indefinitely? I don't mean to pose this as an infammatory question and I hope it hasn't come across as such, I'm just genuinely intrigued

[dragonabsurda]

I feel like ambiguous terminology leads to some conflation of experiences when talking about masking. While I agree that everyone masks to some degree to fulfill different social roles, this also feels somewhat like the "everyone is a little ADHD" argument. This may simply be a misunderstanding on my part of the typical masking experience. Do most people mask in order to perform particular social roles or do they also mask to hide who they are regardless of the role they're in because they've learned that something about who they are is fundamentally "wrong"?

[miriam]

Masking is not asking for help when needed because others seem to manage just fine. Its not having people vist your home because you just can't seem to get on top of your cleaning (isolating). It's pretending to understand something that you've missed in conversation because you got distracted again (and getting in trouble for it later. It's not sharing your extreme trouble getting started and not finishing in fear of being called lazy. It's not getting a diagnosis and not getting the help you really need because of shame in sharing just how much difficulties you have doing 'normal' stuff. Masking can be extremely detrimental. Its very disappointing to hear it talked about as just confirming to normal social standards. This commentary absolutely misses the point (as does the article being discussed).

[freed]

I felt that this video lacked necessary context. 1) If masking for an adult with ADHD is in lieu of necessary accommodation I would not be surprised if this would increase the chances of negative outcomes for that person
2) Given that there is a not insignificant significant number of people that has both ADHD and Autism and that there was a time when you couldn’t be diagnosed with both ADHD and Autism (in earlier editions of DSM), I feel that Dr Barkley worded his conclusions less than optimal.

Since Dr Barkley is such an authority on ADHD this video might be the first ones people see while researching and since he mentioned Autism and neurotypical people I feel he opened a door that he was a bit careless with.

For Autistics I feel that it has been quite well established that masking can have a quite detrimental effect, especially in groups who has typically been underdiagnosed (such as girls, non-binary persons). Masking among those groups can delay diagnosis or prevent it which can result in poorer outcomes with less or no needed support.

3) Lastly, I have no scientific foundation for this (I am not a scientist), but I wouldn’t be surprised if excessive masking/camouflaging in some persons with ADHD could possibly delay or prevent early detection and diagnosis with the same increased risk for poorer outcomes for those persons.

[Eryniell]

I'm surprised about your view on this, yes I agree that masking in itself is not really something bad in general, it serves a purpose, it helps to keeps us safe (and others) and it's something everyone does to some degree.
What is talked about in both autistic and adult adhd communities though, is that the masking needed to perform and be acceptable for others who aren't autistic/adhd is excessive, to the point that it's incredibly difficult and taxing on us, which leads to burnout and withdrawing from social situations, low self esteem, having difficulties making friends and real connections, because you kinda have to be yourself to make genuine friends/relationships.

You mentioned examples of situations where it's preferable that people mask, things like following impulses, aka socially inappropriate behaviour, following unsafe impulses or disrupting behaviour etc. but you didn't bring up "unrealistic expectations" vague social norms, that rely on an intuitive understanding of social rules and being able to understand and notice social cues.
How for things that aren't unsafe for others or oneself, we still have to hide them, because others might find them disruptive/are disturbed by them, without being given an alternative, like as example stimming, which is something that helps emotionally regulate both adhd and autistics (and even helps focusing for some with adhd).
If we are considered developmentally disabled, we should be allowed to take more space, be allowed to do things that aren't 100% aligning with what would be expected from someone neurotypical.

And last point to make: if there is a lack of research of it, neither proving nor disproving the statements of adult people with adhd/autism, isn't that a sign that we NEED research on it? rather than making assumptions of how harmful it is or isn't?

[CarolaSiegel]

I can relate to your irritation to a certain degree but I´m afraid that in this case you jumped to the other extreme. There ist a healthy amount of compensation, but there also is a point when it becomes too much and turns into an attitude of seing oneself as a misfit and inferiour in a way that is bad for your mental health. Issues with self esteem are not a separate symptom but the logical consequence of surroundings that force you to pemanently hide your struggle from others and live behind a functional facade.

[aybikeanacali]

I wish there was a study about if masking is actually improves a person's social life and mental health.
I admire your knowledge Dr Barkley but in this topic you seem to lack empathy.

I am diagnosed at 29, and until that point masking was all I do.
And I can certainly say it didn't help even a bit.

I was lonely and miserable despite all that effort.
Because even you work really hard, people sense that you are fake.
Because it is not like a dimmer, it is a switch.

It is not like you try to talk less, it is like you completely shut up and pretend to listen all the time.

And believe me people sense that.
And that is worse than being yourself and stay lonely as a result, because you believe no matter what you do people won't like you.
And even if they like you, it is not satisfying at all because you know it's is not a real connection.

Since my diagnosis I only mask on work related occasions because I don't need my work circle to like me as a friend. I just need to get along so we all can work.

In my personal life I don't mask anymore and I have more friends than ever.
Because now I only attract people like me or people who are very emphatetic towards diffent traits and cultures.

Of course I am only talking about my personal experience and there is nothing scientific about it.
But other than me, I also observe that people with adhd who don't mask, despite that their symptoms are more severe than me, are more popular and have better mental health and confidence.

Because like I said, people feel who is fake and who is genuine.

Of course we should try to fit in.
Of course we should keep it down a little bit.
But a relationship where only 1 side puts all the effort is not a meaningful connection for neither of the parties.

And I can recommend my fellow ADHDers to learn masking, practice and be better at it, so that they can use it as a tool on environments where they need it.

And put it away when you try to build real relationships.

You can be a better version of yourself without pretending to be someone else.
You can learn to manage your emotions without pretending you don't have them.

There are people that will love you as who you are, I can promise that.

[thurstylark]

I think there's more nuance to the concept of masking (both autism and ADHD flavors) than our current language can accurately express. In this instance, I think that those advocating for unmasking are talking about a much higher (read: strenuous, restrictive, enforced punitively) degree of masking than the masking/coping mechanisms that you refer to in this video. From my perspective, finding the line between necessary masking that is productive, and excessive masking that is unproductive is something that I constantly reevaluate, and is heavily context dependent.

As a reductive illustration, questions like these help me figure that out: "Am I masking for the purpose of successfully operating the machinery of society (useful, positive, keeps me and those around me safe and sane), or am I masking in an attempt to achieve an ideal that is defined and evaluated by those who do not (or refuse to) have any understanding of the difficulties caused by my disability, thus rendering that ideal unobtainable from the start (futile, oppressive, destructive)?" "Am I being *asked* to do things that *are within my reach* if I put extra effort into it, or am I being *told* that *the way I am* is unacceptable as a whole and should be covered up for their comfort?"

The former case is for things like driving only while medicated, developing systems for keeping track of critical possessions, and increasing awareness of how my behavior negatively affects my loved ones. These things are necessary to keep driving, housed, and attached, respectively.

The latter case is for contorting myself into an "acceptable" shape, defined by a world that does not, and *refuses* to make even the smallest accommodations for its disabled population.

It's the latter case that unmasking advocates are focused on deconstructing with this discourse.

This type of masking, if left to fester without inspection, develops into maladaptive coping skills. We learn how to cover up so well that we *can't* take the mask off, which leads us to an impossible situation where fitting in will eventually fail catastrophically, leaving us at a social-skill deficit compared to our peers that is much greater than it would have been if we had instead directed that effort towards gaining a deeper understanding of how to operate the mask to our benefit.

[nyarparablepsis]

Is not tapping my foot a "coping strategy"? Well, stimming already is a coping strategy to deal with overload or overwhelm in certain situations. Is it beneficial not to do it, because someone might be annoyed by it?

I can still remember the poison and belittling I went through as a kid when I tapped my feet. It led me to internalise that stimming is BAD because it annoys others.
How about me feeling bad about not being able to do it? Nah, that was not an issue. I would prefer it if people didn't turn on all the bright lights during the day or sneeze into others' faces. But nobody thinks of accommodating me that way, to make me feel less annoyed.

The problem is that telling people with ASD and ADHD to keep masking *because that's just proper behaviour* makes the *a priori* assumption that everyone else's preferences count much more than our nervous system's need to adjust. It perpetuates the ideas that many of us have built up over the course of our lives - that we are bad, wrong, annoying, or whatever. "I can't even keep my feet from tapping! I am a failure!"

I know. ADHD is a disorder. But like with autism, some of the seemingly problematic behaviour is because society decided that it is problematic. Is it inherently problematic in itself that I have a need to stim? Nope. It is made problematic by a society who has decided that everyone needs to act a certain way, and everyone who acts differently is misbehaving or ill.

I know that cultural history and semiotics aren't typically things that are part of the discourse on ADHD, but it might be worthwhile to differentiate between "being polite according to the current society's rules" and "desperately pretending to be normal to not suffer from being perceived as bad/wrong/etc due to one's neurodevelopmental differences". Someone neurotypical who is putting on their work persona is not camouflaging/masking. The extralinguistic referents of these lexical items are different.

We already go through a lot of stress to just exist. A sociocultural approach would recognise that it is *exhausting* to mask all the time for the benefit of others and to one's own detriment. We have no problem with ramps for handicapped people - we accommodate their disability. Why is the idea of not forcing us to mask different?

Society has made rules to reward certain behaviours and punish others. These are very recent inventions if we look at humanity on a timescale from, say, 30, 000 BCE to now. We could just change the rules. Which can make the entire "neurodivergent people should mask, it's just the polite thing to do" stance look a bit farcical.

Hypothetical situation of the day:
What if you found yourself in a society that rewards hyperactivity and frowns upon people sitting around in silence, without moving? A society that rewards ADHD behaviour and frowns on neurotypical behaviour?

Edit: I am autistic and have ADHD. It's often difficult for me to tell what is supposed to be autistic masking and ADHD masking.

[zensukai]

I do love your work Dr Barkley, however, I do disagree with your assessment here. I feel when it is all put into perspective, it is just the nomenclature being used. Whether one chooses to use "masking" or "coping", I feel is irrelevant. The question one should be asking is, why? Why are we doing/acting in that way. Are we managing our symptoms to "cope" or if we are doing it to blend it because we are afraid of being shamed or rejected?

I feel the message you have shared is telling folks with ADHD that it is not ok to be your authentic self. Really? Noone is perfect and there are times when we do make mistakes -- sadly, folks with ADHD experience those moments much more. I was diagnosed as a child and then again at 55 and I know that in my younger years I was a pain in the ass. But I also know that in my 30-50's I carried and still carry a lot of shame for who I am and how I acted/performed/succeed in life. So through those 30-50's I forsure masked who I was, because I was afraid of who I was -- being told that something is wrong with you; that normal people don't behave in that way ... this is not ok.

Should we then tell people who have physical disabilities to not be their authentic selves? I feel there is a big difference in being responsible for your authentic self and just doing whatever you want and then using one's struggles as an excuse.

[Hyperion]

I love how you're here to call people on their BS re ADHD. There's so many grifters right now trying to make money off of us with tools that don't work, books with claims that somehow our ADHD is entirely the result of trauma, etc

[wilaustu]

It seems like Dr. Barkley is missing something nuanced about the distinction between trying to improve/manage your symptoms while being open and honest about your struggles, vs. trying to surpress and conceal every internal struggle you experience out of shame and fear of rejection.

[ktbreathingin]

It seems to me that the articles brought up in this video are part of a wider conversation within the adhd and autistic community, which is directed at and by people within those communities, using language that people with those communities understand. I have never seen any part ot instance of this conversation advocate for leaning into our struggles by 'giving into our worst impulses' - no one is suggesting we scream and hit out when we are upset because we have adhd, or refuse to do our work, or not care what our friends want or need because 'we need to be ourselves'. It's not even sarcasm to suggest that is what is being encouraged - it feels more like wilful ignorance. Masking is being unable to tell people you are struggling at all, because it marks you out as different. It means not being able to be open with loved one because you are trying just to be 'normal'. It means not listening to, or even not knowing, where your limits are, or the amount of capacity you have because you have been told that you *should* be able to do more. I know from personal experience it can lead to burnout and anxiety. Masking meant I wasn't diagnosed till I was 44. That I spent my life up till I was about 40 thinking I was bad at being a person because I struggled with things other people told me were easy. I think you conflate 'coping skills' that help us manage our adhd, with 'masking' where we pretend we don't have a problem at all. The adhd and autistic folk having this conversation do not make that mistake. It wouldn't occur to us to conflate them. You would do well to listen.