ADHD Masking vs. Autistic Masking in Women: Understanding the Differences, Similarities, and Impacts

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ADHD Masking vs. Autistic Masking in Women

For women navigating ADHD or autism, adjusting behavior to meet neurotypical expectations is often a familiar struggle. Known as “masking” or “camouflaging,” this strategy helps women blend into social norms but can lead to mental and emotional strain. While masking occurs in both autistic and ADHD women, the reasons, techniques, and impacts often differ—though many experiences overlap, blurring the lines between the two conditions. Researchers are still uncovering how ADHD and autism intertwine in ways that can make their distinctions less clear-cut.

Reflection: Think about when you’ve felt the need to mask parts of yourself to “fit in.” Which parts of this experience resonate most with you?

Shared Motivations for Masking: Why ADHD and Autistic Women Hide Their Traits

Desire for Connection and Avoiding Stigma

For women with ADHD or autism, masking often begins as a means to connect and belong. These women, who may feel “different” in neurotypical settings, use masking as a protective shield against stigma.

• Societal Pressures: Many women feel pressured to “keep it together” in professional, social, and family roles, which may require hiding natural behaviors that could seem “out of place.”
• Fear of Judgment: Masking helps many women sidestep stereotypes or negative labels. ADHD masking might involve hiding inattentiveness or impulsivity, while autism masking may focus on managing social cues or sensory sensitivities.

Emotional Impact of Masking: Fatigue and Burnout

Masking can feel like an emotional weight, requiring constant effort that may lead to significant burnout. Hiding traits daily can be mentally exhausting, leading to burnout over time.

• Emotional Exhaustion: Consistent masking can drain emotional energy in both ADHD and autistic women, often leading to burnout, where managing symptoms becomes increasingly challenging.
• Mental Health Strain: This suppression of core aspects of one’s identity can contribute to higher rates of anxiety and depression in both groups, causing many women to feel disconnected or “lost” in their own lives.

Masking’s Role in Diagnosis and Treatment Challenges

Masking also affects diagnosis and treatment. The better someone masks, the easier it is for healthcare providers to miss or misinterpret their symptoms.

• Delayed Diagnosis: Many women with ADHD or autism receive a diagnosis later in life, as masking often conceals symptoms, leading to years without adequate support or understanding.
• Treatment Barriers: When masking is strong, providers may struggle to see the full scope of a patient’s experience, complicating treatment decisions.

Reflection: Ask yourself, How much of my life has been shaped by masking? What might I gain by letting some of it go?

Unique Aspects of ADHD Masking vs. Autistic Masking

While there are similarities, key differences exist in how and why ADHD and autistic women mask their traits, shedding light on each group’s unique experiences.

Distinct Motivations for ADHD Masking vs Autistic Masking

• ADHD: Masking for ADHD often stems from a desire to appear organized, focused, or calm. ADHD women may mask traits that others label as “lazy” or “unreliable” to meet productivity-focused expectations.
• Autism: Autistic women may mask to avoid social rejection or manage sensory discomfort. Their efforts often center on mimicking social behaviors or blending in to avoid being seen as “different.”

Different Masking Strategies for ADHD and Autism

The techniques each group uses to mask are shaped by their unique struggles and what they have been taught is "defective" about them:

• ADHD Masking Techniques:
  • Pretending to  Focus: Many women with ADHD appear highly attentive, even when their minds are drifting.
  • Controlling Impulsivity: Holding back spontaneous thoughts or actions helps navigate social situations but can be draining.
  • Overcompensation: Some put extensive effort into appearing organized, quiet, and perfectionistic, focusing heavily on routines despite hating them.
  • Socially: Keeping thoughts and opinions to themselves, agreeing and people-pleasing

• Autistic Masking Techniques:
  • Forcing Eye Contact: Autistic women may make themselves maintain eye contact, even when it feels uncomfortable.

• • Social Mimicry: Many copy observed behaviors, speech patterns, or body language to appear “typical.”
• • Suppressing Stimming: Although stimming helps self-regulate,  autistic people have been taught to mask these behaviors to avoid standing out.

Reflection: Which of these masking strategies feels most familiar to you? Have you adopted any without realizing it?

Blurring Boundaries: Overlapping Traits in ADHD Masking vs. Autistic Masking

The boundary between ADHD masking vs autistic masking can feel unclear, as both conditions overlap in ways that make it difficult to separate one from the other. For example:

• Sensory Sensitivities: Sensory issues are often linked with autism, but many with ADHD also report sensitivities to bright lights, loud sounds, or certain textures.

 

• Social Difficulties: Trouble with neurotypical social interactions, reading social cues, and maintaining relationships is not exclusive to autism; many women with ADHD experience similar struggles.

 

• Structure and Routine: Autistic people often depend on routines for stability, while ADHD women may also lean on structured habits to manage impulsivity and stay organized but it doesn't necessarily feel suitable for adhd people.

Reflection: Consider how these overlapping traits resonate with your experience. Do you see yourself in aspects of both ADHD and autism? What insights does that give you about your unique experience?

Consequences of Masking: Burnout, Identity Struggles, and Misdiagnosis

Masking doesn’t just influence mental health—it can affect nearly every area of a woman’s life, often in ways she may not fully realize.

• Burnout: Long-term masking of ADHD or autism can lead to severe burnout. For ADHD, burnout may look like distractibility and lack of interest, while for autism, it might involve sensory overload, withdrawal, and severe loss of skills.

• Identity Struggles: Consistent masking, especially from a young age, can create a disconnection from one’s true self, making self-acceptance more challenging.

 

• Misdiagnosis: Masking may obscure symptoms so well that women end up misdiagnosed or undiagnosed, especially if they show traits of both ADHD and autism.

Self-Compassion Practice: If you’ve been masking, try letting go of just one masking behavior today in your safest space. Reflect on how it feels. Is there someone you could trust to see the real you?

The Role of the Medical Community in Recognizing Masking

Healthcare providers play a crucial role in recognizing and addressing masking in ADHD and autistic women . With greater awareness, clinicians can better support those who mask.

• Training and Awareness: Clinicians who understand masking can identify ADHD and autism in women, even when symptoms are less visible.

 

• Personalized Support: Recognizing the toll of masking can help providers develop strategies that meet women’s authentic needs.

 

• Improved Diagnosis: By acknowledging overlaps and distinctions, healthcare providers can look for subtler signs, making more accurate diagnoses possible.

Conclusion: Addressing the Unique and Shared Challenges of Masking

ADHD and Autistic women may both mask to navigate social expectations, but their experiences and motivations differ in essential ways. These distinctions and the blurred boundaries highlight the need for empathy, improved support, and a better understanding of neurodiversity. We are still learning about the overlap between Autism and ADHD. And then there are a group of women that are AUDHD! Both autistic and ADHD and this is a more complicated presentation when it comes to masking.

Remember, masking isn’t something you must do forever. Each step toward unmasking opens up possibilities for self-acceptance and genuine connection. Give yourself the grace to be seen by others and yourself for who you are.

Reflection: What is one small way you can be more authentic today? What would you gain by letting your true self show?

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Kristen McClure: Neurodivergent-Affirming ADHD Therapist and Coach with 30 years experience in North Carolina and South Carolina Offering virtual therapy and coaching services across North Carolina, including Ashville, Raleigh, Durham, Wilmington, Greenville, and more. Also serving major South Carolina cities such as Charleston, Columbia, Greenville, Spartanburg, Rock Hill, and more.