Masking ADHD traits may help adults fit in socially, but it can come at a cost to their mental health and well-being, according to new research from Simon Fraser University.
A new SFU study found more than 91 per cent of adult participants with attention-deficit/hyperactivity disorder (ADHD) reported hiding, suppressing or compensating for their ADHD traits to navigate social situations. For example, someone might pretend to pay attention, suppress their urge to fidget, rehearse conversations or over-prepare for meetings to fit social norms.
"Camouflaging or masking strategies may help you get your foot in the door socially, in relationships or at work, but they often leave people feeling exhausted, disconnected from their true selves and less close or connected to others," says Marisa Mylett, researcher and lead author of the study.
"Many participants reported experiencing an internal trade-off between safety and authentic expression that may reflect the stigma and negative social responses and feedback folks with ADHD often receive since childhood."
Key findings:
- 91.6% of the study's 202 survey participants said they masked their ADHD traits in a range of social situations like work, public spaces, and in personal relationships.
- Participants reported that camouflaging can help with social success, but can lead to exhaustion, anxiety, depression, and identity disturbance.
- Camouflaging demands high cognitive effort, impairing attention, memory, and focus, and can make core ADHD symptoms worse.
- Some participants reported feeling irritable, anxious, and needing days to recover after intense camouflaging efforts.
- They also said camouflaging can lead to others dismissing their struggles, reduce their access to support, and perpetuate ADHD stigma.
- Some participants said masking their ADHD symptoms led to less genuine connections and feelings of inauthenticity.
Published in Research in Neurodiversity, the study interviewed 202 people in British Columbia aged 16 or older who reported being diagnosed with ADHD by pediatrician, medical doctor, psychologist or psychiatrist.
More than 91 per cent of participants said they camouflaged their ADHD traits to some extent. Many participants described camouflaging at work, in public spaces and in personal relationships to fit in socially and be seen as capable and likeable. Many people also masked to avoid judgement, rejection or discrimination.
Common strategies included pretending, mimicking others, overpreparing, avoiding social situations, suppressing impulses like fidgeting or interrupting, and self-medicating.
While masking may help people get through day-to-day interactions, the study found it often leads to exhaustion, anxiety, depression and low self-esteem. Many participants also reported feelings of inauthenticity, impostor syndrome and uncertainty about their identity.
The additional cognitive effort needed to mask ADHD traits can also make core ADHD traits worse, impacting attention, memory and concentration. Some participants reported feeling irritable or anxious and needing days to recover after periods of intense camouflaging.
Findings from the study suggest that masking may delay diagnosis and limit access to support.
Recognizing camouflaging behaviours is critical for clinicians, says Grace Iarocci, psychology professor and co-author of the study.
"It's not that adults with ADHD have a distorted way of seeing the world. They're responding to real social expectations and pressures and using masking to cope," Iarocci says.
"We need to understand how difficult their day-to-day life is, and how much cognitive effort or mental energy they're putting into everyday living so we can help them find healthy ways to manage."
Camouflaging can be ingrained from early experiences, and learning to unmask may take significant time and effort, but researchers say the burden of change should not fall on the individual.
"The finding that many adults with ADHD feel they have to camouflage as a survival strategy suggests that there's a lot of work to be done in society to reduce stigma and shift norms towards accepting diverse neurotypes," says Mylett.
SFU experts available
GRACE IAROCCI, professor, psychology, director of the Autism and Developmental Disabilities Lab
MARISA MYLETT, researcher, doctoral clinician, psychology
TROY BOUCHER, researcher, doctoral clinician, psychology
