Masking

What is masking and what does it look like?

Masks refer to learned social, emotional, and academic behaviors that compensate for and/or hide ADHD symptoms (Varnel 2019, ADHD/AS/Dyslexia Family Resources Brussels [AFRB] 2009). Similar to the technique described in and by people with autism, masks emerge over time in response to the inability to cope with or be accepted by the neurotypical world. More than simply managing one's symptoms, masking is a quietly debilitating process of repression that leads children to develop "burn-out, depression, anxiety, and sometimes addictive behaviors" (AFRB 2009) and potentially miss out on early diagnosis and treatment for their ADHD (ADHDSurprise 2019). Masking has long-term effects, including self-medication and chronic under-functioning in academic and work environments (AFRB 2009). In addition to the emotional consequences that masking has on the neurodivergent child (discussed below), masking may lead adults in the child's life to deny that there is a problem, since symptoms are not as detectable as they would be without the mask (AFRB 2009, ADHDSurprise 2019). 

Masking can look like:

• Increased anxiety and/or hyper-vigilance 
• Isolation and withdrawal from social and/or academic situations
• Emotional repression (especially if the child is normally vibrant and/or hyperactive)
• Imitating other children's social behaviors  
• Increased inattention or, alternatively, hyperfocus
• Obsessive organization of materials and work
• Sleep problems
• Low self-esteem
• Lower-than-expected academic achievement, even with accommodations
• Excessive time spent on homework (e.g., re-reading, editing)
• Body tightness and/or control over movements, fidgets, or tics 

Neurodivergent children might mask for a variety of reasons based on their individual personalities and symptoms. Masking is sometimes a conscious undertaking -- especially in adults who have had opportunities to examine their behavior for years following a diagnosis -- but for most children the process is unconscious, as it was for me and for many other childhood-onset ADHDers I've spoken to. One of the main reasons for masking is that of social acceptance and conformity.  

Masking and social behaviors

Children with ADHD often mask because they find it difficult to function and be accepted as they are with visible symptoms. Because neurodivergent students may exhibit socially unacceptable behaviors (Stewart 2017) such as inattentiveness or interrupting during conversations, their concentrated efforts to act in socially acceptable ways (and appear neurotypical) are ways of seeking connection, integration, and approval. Nicole Faulkner writes in The Irish Times of her experience as a girl with ADHD:

Neurodivergent women often slip through the cracks of diagnosis because they can appear smart or gifted....We work extra hard to prove ourselves. Combined with hyperfocus ... this results in flashes of brilliance. We’re also experts at masking symptoms. We form habits by mirroring the social behaviors of those around us....Burnout is what happens when the mask slips. Your entire world comes crashing down, and you don’t have the executive function to figure out which way is up. (Faulkner 2020)

Similarly, Pina Varnel notes that "masking ADHD is extremely exhausting and muddying sense of self [sic]." For years, I did not realize that I was masking, that many of the prosocial behaviors I'd been forced to cultivate to offset my ADHD symptoms were artificial and tiring for me to maintain. I recall trying to act "like the other girls" in middle school by whispering when the teacher called on me in class (instead of speaking loudly with an "unregulated" volume), repressing my emotional reactions, and hyper-focusing on schoolwork, socializing, and eating habits (all of which were challenging for me). Although I was "high-achieving" and medicated for my ADHD and my sensory processing issues, medication alone was not enough to fully mask my symptoms and make me feel "normal." 

It would seem that ADHD symptom management, then, requires comprehensive medical and social-emotional intervention that emphasizes not only comfortable and relevant behavioral shifts for the child but also principles of anti-ableism, self-worth, and community acceptance.