ADHD: why hiding it doesn't just exhaust you, it pushes people away

You are in a meeting. For twenty minutes you have been nodding at exactly the right moment, holding eye contact for exactly the right length of time, watching that your leg does not start bouncing under the table. When someone asks what you think, you answer well. And yet, if you were asked what was said in the last five minutes, you could not say: all of your attention was going into looking attentive, not into listening.

You leave the meeting exhausted. Not because of the content, it was not difficult, but because of the work of sustaining the version of you that sat there. You get home with no energy left for anyone. Research has a name for this: masking, also called social camouflaging.

What masking is (and where the term comes from)

The word comes from autism research, where for more than a decade researchers have studied the behaviours autistic people use to conceal their traits in social situations. For years it was assumed to be specific to autism.

The obvious question took a long time to be asked: if people with ADHD also face social difficulties and stigma, do they hide their traits too? Some studies had already measured camouflaging in ADHD using questionnaires adapted from autism research, but until 2026 none had set out to explore in depth what that experience is like from the inside: what drives it, how it is done, and what it leaves behind.

That study now exists, and it is worth looking at carefully, including what it does not allow us to conclude.

Nine out of ten, in one study

A team at Simon Fraser University asked 202 people aged 16 to 73 with an ADHD diagnosis (mean age 29) about their motivations, their strategies and the consequences of hiding their traits. 79.2% reported at least one other mental health condition alongside ADHD, a proportion consistent with what is usually seen in this population.

The main finding: 91.6% (185 of the 202 people) said they mask their ADHD in social situations. They did so at work, in job interviews, at the supermarket, on public transport, around new people, and also with friends and family. One group described masking in every social situation; a few, even when alone.

It is worth saying where that figure comes from, because it changes how to read it. The analysis of these experiences is qualitative: written responses were studied, not scores. Participants did complete a standard ADHD symptom scale, and 97% scored above the clinical cut-off, but the sample was recruited online, through ADHD forums and ADHD communities on social media. We will come back to this later, because it matters.

Why people mask: it is almost always defence

When the reasons participants gave were grouped, the most frequently mentioned was to be liked (named by 53%), followed closely by avoiding adverse experiences (51.5%): ridicule, judgement, remarks, discrimination. After that came the wish to look “normal” and, in a substantial group, the idea that masking is not a choice but a survival tactic.

That is where the easy reading falls apart. This is not about wanting to impress. It is about keeping your job, about not being left out, about not being told again that you are disorganised or unprofessional. Several participants described masking specifically so that they would be taken seriously as professionals.

One important caveat about these percentages: the authors explicitly warn that these frequencies do not measure prevalence. They only count how many people happened to mention each theme in writing. Someone not mentioning a motivation does not mean they did not have it.

How people mask: hiding, holding back, compensating

The strategies fell into three broad groups. The most mentioned, named by 70.3%, was hiding and pretending: concealing movement of the hands or legs, pretending to pay attention, watching others and mirroring their behaviour, avoiding social situations, offering alternative explanations to cover up a lapse.

The second, mentioned by 58.4%, was suppression: holding back the urge to speak, to interrupt, to move, to show enthusiasm.

The third, by 45.1%, was compensation: arriving over-prepared, overworking, becoming hyper-organised, relying on alarms and notepads, building social encounters around a game or a physical activity.

A small group of participants also described using substances for this purpose, and a few considered their own prescribed treatment to be a form of masking. These two things are worth separating, because they are not the same. Prescribed, monitored treatment does not hide ADHD: it reduces the symptoms (and it is, in fact, one of the routes by which the need to mask goes down). You can read what works in ADHD treatment in another article on this blog. Holding your day together with something nobody prescribed is a different situation, and it is exactly the conversation worth having in a consultation. Never start, change or stop a treatment on your own.

The paradox: masking worsens what it hides

22.8% of participants described the mechanism with striking precision: masking interferes with important cognitive functions (attention, concentration, memory). Someone concentrates so hard on holding eye contact to show they are listening that they stop processing what is being said. Someone orders themselves not to interrupt, and that internal monitoring takes the place of the content of the meeting. Someone stops moving their leg, the very thing that was helping them focus, so that nobody thinks they are nervous.

The authors conclude that masking can conceal difficulties while at the same time intensifying ADHD symptoms and their consequences for day-to-day functioning. You pay twice: the effort of hiding, and the performance that effort takes with it. This is an interpretation drawn from what people described in writing: nobody measured cognitive performance with and without the mask.

What it costs: distance first, exhaustion after

The most mentioned, at 64.4%, was reduced closeness and connection with others. The same description keeps coming back: if people never see you as you are, nobody really gets to know you; relationships stay on the surface; some people end up with many friendly acquaintances and no close ones. And there is a cruel twist: several participants said that when they started masking less, some relationships broke down, because the people around them felt they had been lied to about who they were.

Then came effects on mental health (47.5%) (stress, anxiety before, during and after interactions, depressive symptoms, low self-esteem, shame) and exhaustion (45.1%), described as mental, physical and emotional, sometimes requiring several days to recover.

40.6% described something harder to name: the sense of hiding the person they really are, and in some cases of having masked for so long that they no longer know who that person is.

None of these three (the distance, the mood, the exhaustion) usually comes up in a consultation unless someone asks about them.

But not all masking is the same

It would be easy to end here with “stop masking”. That would be bad advice, and the study itself explains why.

First, because masking also did things for these people: 37.1% said it facilitates social interactions and their outcomes (getting the job, keeping the relationship, passing the interview). One participant summed it up without metaphor: it helps and it costs, at the same time.

Second, and more practically important: different strategies do not cost the same. According to the accounts, active suppression left considerable physical and mental discomfort, and pretending left identity and self-esteem problems. By contrast, certain forms of compensation (planning ahead, relying on helpful tools, using strategies to sustain attention) were experienced as useful, with minimal downside.

In plain terms: setting an alarm is not the same as holding your breath for eight hours. The useful question is not “do I mask or not?”, but which of these things am I doing, with whom, and what is each one costing me.

Why masking delays diagnosis

One consequence reaches beyond the individual. 15.4% of participants described masking as perpetuating unrealistic expectations and stigma: the people around them get used to the masked version, and when that version cannot be sustained, the reaction is harsher, not more understanding. Several people said their family, their teachers or even mental health professionals did not take their ADHD seriously precisely because they hid it well.

From this, the authors propose that masking may contribute to late or mistaken diagnosis of ADHD. That is a reasonable hypothesis, not a measured finding.

There is also a warning aimed at clinicians that patients may find worth knowing: the authors note that certain social skills interventions may inadvertently teach people to mask and in doing so affect the self-esteem, identity, close relationships and attention of the very person they were meant to help. Strategies recommended in a consultation need to be explained with their purpose, their limits and their risks, not handed out as a formula.

What about work? A side note about the traits

It is worth being clear up front about what follows and what it is not. No study has measured whether masking at work is a good idea or not. What does exist is research on something different: how many workplace ties people have depending on their level of symptoms.

Across two samples of US workers, full-time employees and entrepreneurs, those who scored higher on hyperactive-impulsive type symptoms reported more friendship ties and more colleagues coming to them for advice. But also more conflict, clearly among the entrepreneurs and only marginally among the employees. The author calls this a “mixed blessing”: the same traits that open some doors also increase friction. And the pattern did not hold for the inattentive subtype, which showed no such benefit in either sample.

The limits of that study are serious and worth keeping in view: it is cross-sectional (a single snapshot, not a sequence); ADHD was not measured with a clinical diagnosis but with a brief screening tool whose hyperactive symptom subscale consists of two questions; and everything rests on each person reporting their own ties, when the author himself warns that people with ADHD tend to overestimate how many friends they have. It cannot establish cause and effect.

With those caveats, it is good for one thing: a reminder that the real balance of these traits is more complicated than “hiding it always pays off”. The decision about who to be open with depends on each person’s environment, which only that person knows.

What this article cannot tell you

It is worth being honest about the ground we are standing on, because it is softer here than in other articles on this blog.

• Most people who recognise themselves here do not have ADHD. An estimated 3% or so of adults worldwide have it. The fact that 91.6% of people withADHD say they mask tells you nothing about the probability the other way round: leaving a meeting exhausted, or feeling that you are playing a part at work, are very common experiences, and most people who have them do not have ADHD. That does not invalidate anyone’s exhaustion; it only means the explanation may be a different one, and it is worth looking for it.
• The confounders are inside the sample itself. 17.6% of participants identified as autistic and 62.9% reported some form of anxiety, and the authors themselves warn that this level of anxiety may have raised how much they masked. In other words: much of what is called masking here may be social anxiety, autistic traits, or simply a reasonable response from someone who was treated badly.
• There is no Peruvian or Latin American data. 72.3% of the sample identified as White, and the authors themselves warn that this limits how far the findings apply to people from ethnically diverse backgrounds, because cultural norms about what is acceptable to show vary a great deal from place to place.
• The sample does not represent adult ADHD. 70.8% were women (a proportion that, as the authors note, does not reflect population estimates) and 71.8% were under 35. There are reasons to think women mask more because of gendered socialisation, so the 91.6% figure may be inflated by the composition of the sample.
• Diagnoses were self-reported and recruitment was online, through ADHD forums and communities. The study did not verify diagnoses with official documentation or carry out independent assessments, and the authors warn that this self-selection may have shaped which experiences were captured.
• Masking is neither a diagnosis nor a DSM-5 criterion, and there is still no instrument developed and validated specifically to measure it in ADHD.

With all that said: it is the first study to bring method to something many adults with ADHD had been describing for years without a way to name it. That the evidence is early does not mean the experience is not real.

If you are having a very hard time

Sustaining a version of yourself for years is wearing, and it often comes with shame, low self-esteem and low mood. If thoughts of harming yourself appear, do not face it alone: in Peru you can call Línea 113, option 5 (mental health), run by MINSA, free and available 24 hours. In an emergency, call 106 (SAMU) or go to the emergency department. These lines are answered in Spanish. If you cannot manage a call in Spanish, ask someone to call with you, or go directly to an emergency department.

When to seek help

This is not a diagnostic checklist. It is a guide to when it is worth having someone listen to you without rushing:

• you leave meetings or social gatherings exhausted, and the tiredness is not explained by what you actually did there;
• you put so much effort into looking attentive that afterwards you cannot remember what was discussed;
• you have many friendly acquaintances and few or none where you can be without performing;
• you were diagnosed with ADHD and the people around you do not believe it, or tell you it “does not show”;
• you are holding your functioning together with something a professional did not prescribe;
• the sense of playing a part has become permanent, or you are no longer sure who you are when nobody is watching.

That second-to-last point deserves saying separately: holding your day together with alcohol, with too much caffeine, or with anything nobody prescribed is not a reason for shame and not a reason to put off the consultation. It is one of the most important reasons to ask for one, and it helps to bring it up yourself early in the conversation, not at the end.

And something not on this list that matters just as much: if what you are carrying is persistent low mood, anxiety, or the sense that nothing interests you any more, that can be assessed and treated, whether or not ADHD turns out to be part of it.

A note for anyone arriving here hoping to confirm a diagnosis: if this has been going on for years and it is costing you your work, your relationships or your mood, what follows is not a label, it is a proper assessment (with a developmental history, information from someone who has known you for a long time, and ruling out other causes). Masking well is one of the reasons ADHD gets diagnosed late, something that also weighs on late diagnosis in women and that overlaps with sleep in ADHD.

Frequently asked questions

Is masking the same as having manners or behaving at work?
Everyone adjusts how they present themselves depending on the setting. What adults with ADHD describe is different, and the difference is the cost: a sustained effort to appear to be someone they are not (sometimes deliberate, and in many people so automatic by now that it only shows up as exhaustion) which interferes with attention while it is happening and feels like something you have to do, not something you choose. Behaving in a meeting does not usually leave someone without energy for the rest of the day.

If I mask this well, do I really have ADHD?
Functioning well on the outside does not rule out the diagnosis, but it does not confirm it either. In the only study that has explored the topic in depth, most participants with an ADHD diagnosis said they masked, and many described that this was exactly why the people around them did not take their difficulties seriously. That said, recognising yourself in that description is not enough: telling it apart from social anxiety, autistic traits, or the effects of real discrimination is the work of an assessment, not of an article.

So should I stop masking?
Not necessarily, and no one should make that decision based on an article. For many people masking serves a real safety function in environments where being visible has consequences. Not all forms of masking carry the same cost either. What helps is not switching it off abruptly, but knowing when you are using it, what it costs you, and where you can lower your guard safely.

I was diagnosed as an adult and my family says it does not show. What can I do?
This experience appears in the study: roughly one in six participants mentioned it. When someone has sustained a version of themselves for years, the people around them get used to that version and start doubting the diagnosis. It helps to explain what is not visible (the effort, the exhaustion afterwards, what falls apart when the effort is not enough) and, when possible, to have a professional take part in that conversation.

This article is for information only and does not replace an individual medical assessment. Do not start, change or stop any treatment without consulting your doctor.

References

1. Mylett ML, Boucher TQ, Iarocci G. “I wish I could just be myself”: Experiences of social camouflaging in adults with ADHD. Research in Neurodiversity. 2026;2:100018.
2. Marineau JE. Neurodiversity and workplace relationships: The impact of ADHD on social network ties. Acta Psychologica. 2026;264:106591.