ADHD and Autism Masking in Women: Burnout, Anxiety and Mental Healt

So many neurodivergent women spend years looking like they are coping while quietly drowning underneath the surface.

The smiling through overwhelm.
The replaying conversations at 2am.
The forcing yourself through noisy environments.
The trying so hard to appear “normal,” “organised,” “calm,” or “together” that you barely know what you actually need anymore.

For many Autistic and ADHD women, masking becomes second nature. We learn to hide our struggles, suppress our needs, and perform versions of ourselves that feel more socially acceptable.

But masking comes with a cost.

Research has linked long-term masking in autistic adults to higher rates of anxiety, depression, burnout, emotional exhaustion, and poorer mental health outcomes (Hull et al., 2017; Cage & Troxell-Whitman, 2019).

And many neurodivergent women do not even realise masking is part of the problem.

Masking, sometimes called autistic masking or ADHD masking, is when neurodivergent people hide, suppress, or compensate for traits to fit social expectations or avoid judgement.'

It can look like:

• Forcing eye contact or physical contact

• Copying social behaviours

• Rehearsing conversations

• People-pleasing

• Hiding sensory overwhelm

• Suppressing stimming

• Overworking to appear organised

• Pretending to be “fine” when overwhelmed

Many neurodivergent women become highly skilled at masking from a young age, especially because girls are often socialised to be agreeable, emotionally aware, and socially adaptable.

One of the hardest parts about masking is that it often works externally.

People see:

• The capable employee

• The organised friend

• The “high functioning” woman

• The person who keeps showing up

• The woman who looks like she is coping

What they do not see is the mental load underneath it.

The sensory overload.
The constant self-monitoring.
The overthinking.
The emotional exhaustion.
The shame spirals after social interactions.

Many ADHD and Autistic women spend years believing they are lazy, dramatic, broken, or “bad at life,” when actually they are surviving life with a nervous system running on overdrive.

Masking is not just “trying hard.”

It is constant self-surveillance.

It is walking into a social situation and internally analysing:

• Am I talking too much?

• Did I interrupt?

• Was that weird?

• Am I making enough eye contact?

• Do I sound rude?

• Why did they react like that?

It is sitting in sensory discomfort while pretending everything is fine.
It is forcing yourself through environments that drain you because you think you “should.”

It is trying to appear calm while your nervous system is internally sprinting a marathon.

For many neurodivergent women, masking becomes a full-time job on top of work, relationships, parenting, and life admin.

No wonder so many ND women experience autistic burnout, ADHD burnout, chronic anxiety, and emotional exhaustion.

Studies have found that social camouflaging and masking are associated with poorer mental health outcomes in autistic adults, including increased anxiety and depression (Hull et al., 2017).

Cage and Troxell-Whitman (2019) also found that many autistic adults described masking as emotionally exhausting and linked it to burnout, identity confusion, and reduced wellbeing.

Many neurodivergent women become so used to overriding their needs that they stop noticing them altogether.

They disconnect from:

• Rest

• Hunger

• Boundaries

• Sensory overload

• Joy

• Emotional needs

• Capacity

Everything becomes about surviving the day.

Many neurodivergent women feel intense pressure to be:

• Calm

• Organised

• Productive

• Social

• Emotionally regulated

• Easy to be around

• Helpful

• High achieving

And when we cannot maintain that effortlessly?
The shame creeps in.

So we mask harder.

We overprepare.
We overfunction.
We overgive.
We people-please.
We push through burnout while telling ourselves to “try harder.”

Meanwhile, the nervous system is quietly sending distress signals everywhere.

The irony is that many ADHD and Autistic women are deeply empathetic, creative, passionate, insightful, and caring.

But survival mode buries those strengths under exhaustion.

One of the most painful impacts of long-term masking is identity loss.

Many late-diagnosed neurodivergent women realise they have spent years becoming who everyone else needed them to be.

The capable one.
The easy-going one.
The achiever.
The helper.

And underneath all of that, many women are left wondering:
Who am I actually?

What do I enjoy?
What helps my nervous system?
What are my genuine needs versus survival strategies?

Unmasking is not about becoming someone new.

It is about slowly reconnecting with the person underneath years of performance and self-suppression.

So many neurodivergent women have spent years believing they were failing because life felt harder for them than it seemed for everyone else.

But struggling under chronic sensory, emotional, cognitive, and social overload is not failure.

It is a nervous system asking for support.

The problem was never that you were “too much.”
The problem was trying to carry too much while pretending you were fine.

And maybe the shift is this:

Not:
“How do I become less difficult?”

But:
“How do I stop abandoning myself?”

Because you deserve relationships, workplaces, friendships, and environments where your nervous system does not have to perform constantly just to belong.

When we understand the cost of unmasking - it can make us want to rip the mask off, all at once. It can feel overwhelming (where to start?), possibly scary (because we aren't sure underneath) and risky as well (what if people reject me?)

To unmask safely, we need to go slowly, we need to start small and safe and relearn what it is we truly like and need. It can be easier to do with others and much simpler when there is a process to follow.

This is why I made the unamsking women small group program for support, structure and safety - because we don't have to do things the hard way.

You can find out about the groups here:
https://www.mumshine.com.au/unmasking-women-group

Cage, E., & Troxell-Whitman, Z. (2019). Understanding the reasons, contexts and costs of camouflaging for autistic adults. Journal of Autism and Developmental Disorders, 49(5), 1899–1911. https://doi.org/10.1007/s10803-018-03878-x

Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M. C., & Mandy, W. (2017). “Putting on my best normal”: Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534. https://doi.org/10.1007/s10803-017-3166-5