Masking and unmasking are central experiences for many autistic and ADHD adults, yet they are often poorly understood outside neurodivergent communities. Masking refers to the conscious or unconscious strategies people use to hide or suppress their neurodivergent traits. Unmasking, by contrast, is the gradual or intentional reduction of these strategies. It is not simply “stopping masking,” but a deeper psychological process involving identity, safety, and self‑acceptance. In this blog we review recent research into how these processes unfold and how they affect mental health, identity, and wellbeing.
What is Masking?
Masking has been described as a complex set of behaviours that help individuals “pass as non‑autistic” (Libsack et al., 2021). These behaviours may include suppressing stimming, forcing eye contact, copying social behaviours, rehearsing scripts, or monitoring tone and facial expressions. Researchers emphasise that masking can be both deliberate and automatic. Evans et al. (2023) note that autistic masking involves both conscious and unconscious tendencies to hide or suppress autistic traits, often shaped by years of social pressure. Bradshaw et al. (2021) similarly describe masking as a response that can become automatic over time, especially when individuals have repeatedly experienced disapproval or rejection.
What is Unmasking?
Unmasking, on the other hand, is far less clearly defined in literature. Poulsen et al. (2025) offer one of the few explicit definitions, describing sensory unmasking as a process of reclaiming autonomy through safe sensory expression and flow states such as monotropism. Other studies describe unmasking as a gradual shift that occurs in safe environments or trusted relationships. Bradley et al. (2021) found that some autistic adults described not needing to camouflage as much after diagnosis, or when they were with people who understood and accepted them. Miller et al. (2021) highlight that unmasking is not simply the opposite of masking but an ongoing negotiation of authenticity, social risk, and context. For some, unmasking is intertwined with broader identity shifts, such as during menopause, where autistic women reassess their masking behaviours and prioritise self‑care (Karavidas et al., 2021).
Why Unmask?
The triggers for unmasking vary widely. Diagnosis is one of the most powerful catalysts. Bradley et al. (2021) found that receiving an autism diagnosis often helps individuals understand their experiences and feel less pressure to conform. Wurth et al. (2025) similarly found that diagnosis acceptance is associated with reduced masking and improved quality of life in autistic and ADHD adults. Safe environments and relationships are also essential. Miller et al. (2021) report that people unmask primarily in contexts where they feel protected from judgment, such as with close friends or within neurodivergent communities. Burnout is another major trigger. Hull et al. (2021) and Bradley et al. (2021) both describe how exhaustion from sustained masking can lead to involuntary “mask slippage” or intentional unmasking when maintaining the façade becomes impossible.
What is it like to Unmask?
The lived experience of unmasking is often described as both liberating and frightening. Many autistic adults speak of the relief of “letting go” of exhausting performances (Bradley et al., 2021) and reconnecting with their authentic selves (Miller et al., 2021). Others describe the creativity and freedom that emerge when they no longer feel pressured to “think in the box” (Finch et al., 2022). Yet unmasking also exposes individuals to potential stigma, misunderstanding, or professional consequences. Giles‑Smith et al. (2023) found that autistic employees often weigh the risks of unmasking in the workplace, balancing authenticity with safety in environments that may not be supportive.
Barriers to Unmasking
Barriers to unmasking are significant. Stigma and discrimination remain the most powerful deterrents. Perry et al. (2021) found that autism‑related stigma drives camouflaging, and by extension, makes unmasking risky. Internalised stigma also plays a major role. Pearson and Rose (2021) argue that years of masking can create an “illusion of choice,” where individuals feel they must hide their traits even in safe contexts. Attaullah (2023) found that perceived stigma mediates the relationship between autistic identity and wellbeing, suggesting that internalised shame must be addressed before unmasking feels possible. Practical barriers also exist: workplaces that lack autism awareness, delayed diagnoses, economic vulnerability, and uncertainty about how others will respond (Giles‑Smith et al., 2023; van der Putten et al., 2024).
The Mental Health Impacts of Masking
The mental health impacts of masking are well‑documented. Hull et al. (2021) found strong associations between camouflaging and anxiety and depression. Evans et al. (2023) report that higher masking predicts increased depression, anxiety, interpersonal trauma, and reduced authenticity and self‑esteem. Cook et al. (2021) identify consistent links between masking and poorer mental health outcomes, including suicidality risk. Masking can also obscure support needs, leading to misdiagnosis or inadequate treatment (Dell’Osso et al., 2021). Burnout is a major consequence, with Bradshaw et al. (2021) describing masking as forcing the brain to “work overtime,” leading to exhaustion and crisis points where masking becomes unsustainable.
While the overall pattern of evidence indicates negative mental health consequences of camouflaging, recent research has highlighted important individual variability in these outcomes. Van Putten et al. (2023) examined whether the relationship between camouflaging and mental health difficulties differs among subgroups of autistic adults, finding that "camouflaging was moderately related to mental health difficulties" overall, but that "this relationship was strong for only a small subgroup of autistic adults, while for most others, the relationship was small or non-existent."
This finding has important clinical implications, suggesting that "clinicians should be aware of camouflaging and its possible link to mental health difficulties, but avoid generalizing negative consequences to all autistic individuals" (van Putten et al., 2023). The heterogeneity in outcomes may reflect differences in camouflaging strategies, social contexts, personal resources, or the degree to which individuals experience their camouflaging as volitional versus imposed.
Psychological Effects of Unmasking
The psychological effects of unmasking are also complex and appear to depend heavily on context, safety, and acceptance. Bradley et al. (2021) found that some autistic adults reported camouflaging less after receiving an autism diagnosis, or when they were with people who understood and accepted autism. Poulsen et al. (2025) conceptualise sensory unmasking as the expression of sensory needs and responses in safe environments, arguing that sensory safety, sensory anchoring, and opportunities for sensory reset may support regulation and wellbeing. However, unmasking may feel unsafe or distressing in contexts where stigma, misunderstanding, or discrimination remain. The benefits of unmasking therefore depend heavily on context, agency, and support.
The Authentic Self
Identity and authenticity are central themes in the research on masking. Evans et al. (2023) found that higher masking predicts lower authenticity, suggesting that masking creates disconnection from one’s true self. Many autistic adults who have used masking for years describe difficulty knowing their preferences or identity. The researchers suggest that practitioners be wary of strategies and therapies that encourage autistic masking and being ashamed of autistic traits. They strongly advocate for promoting forms of parenting, education, and therapy that respect autistic people's traits, communication styles, sensory needs, and autistic identity.
Gender and intersectional differences are also significant. Women and gender‑diverse individuals tend to mask more intensely and more often (Alaghband‑Rad et al., 2023). Masking can contribute to delayed or missed diagnoses, particularly for women and AFAB individuals (van der Putten et al., 2024). Life transitions such as menopause can prompt unmasking and identity renegotiation (Karavidas et al., 2021). Intersectional factors such as race, class, and sexuality shape masking and unmasking experiences, though research in these areas remains limited.
Masking ADHD vs Autism
Autistic and ADHD adults both engage in masking, but patterns differ. Autistic adults report higher levels of masking than ADHD adults, and autistic traits, but not ADHD traits, predict masking intensity (van der Putten et al., 2024). Co‑occurring autism and ADHD may intensify masking demands, and current tools may not fully capture ADHD‑specific masking.
Take-aways for Counsellors and Therapists
For counsellors and therapists, the implications are clear. Recognising masking is essential, especially because many autistic adults appear articulate or socially skilled while masking intensely (Bradshaw et al., 2021). Therapies that encourage “acting neurotypical” may worsen mental health (Evans et al., 2023). Neurodiversity‑affirming approaches, those that validate autistic communication, support sensory needs, and encourage authenticity, are highly recommended (for e.g. Wurth et al., 2025). Creating safe environments where clients can unmask without fear is central to effective practice. This includes predictable routines, sensory‑friendly spaces, explicit communication, and trauma‑informed care. Counsellors can also help clients make informed decisions about when and where to unmask, recognising that unmasking is not always safe or possible.
Take-aways for Autistic and ADHD Adults
For autistic and ADHD adults, the message from the research is clear: masking is not a personal failing. It is a response to environments that were not designed with neurodivergent people in mind. Unmasking is not a requirement; it is an option that should be guided by safety, support, and personal readiness. You deserve spaces where you can be your full, authentic self. You deserve to belong to yourself.
Where to from here?
We recommend the upcoming webcast on masking and unmasking in neurodivergent people, presented by Prof. Tony Attwood and Dr. Michelle Garnett.
Unmasking Neurodivergence (21st August 2026) is designed for autistic people aged 14 and over, parents and carers, health and education professionals, and employers. Masking is one of the most misunderstood aspects of the autistic experience, and one of the most significant contributors to burnout, anxiety, depression, identity confusion, and delayed diagnosis. Many autistic adults describe masking as both a survival strategy and a source of profound exhaustion, and professionals often see the consequences long before they recognise the cause. This presentation creates a safe, validating space to explore the why, how, and what next of unmasking, drawing on the science of masking, lived-experience realities, and the mental-health implications across the lifespan. Participants will learn how to recognise masking in themselves or the people they support, how to differentiate masking from coping, how chronic masking contributes to autistic burnout and identity fragmentation, and how to approach unmasking in ways that are safe, paced, and aligned with personal values, so that authenticity, wellbeing, autonomy, and relationships are protected.
The webcast runs 9:30am to 12:45pm AEST (Brisbane) and includes 3 hours of live training, live Q&A with Tony and Michelle, downloadable handouts, 60 days of recording access, CPD hours, and a Certificate of Attendance.
References
Alaghband-rad, J., Hajikarim-Hamedani, A., & Motamed, M. (2023). Camouflage and masking behavior in adult autism. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1108110
Attaullah, S., Khalil, S., & Qamar, R. F. (2023). Mediating role of perceived stigma and camouflaging in relationship between autistic identity and wellbeing among autistic adults. Journal of Development and Social Sciences, 4(3), 821–831. https://doi.org/10.47205/jdss.2023(4-iii)75
Belcher, H. L., Morein-Zamir, S., Mandy, W., & Ford, R. M. (2021). Camouflaging intent, first impressions, and age of ASC diagnosis in autistic men and women. Journal of Autism and Developmental Disorders, 52(4), 3413–3426. https://doi.org/10.1007/S10803-021-05221-3
Bradley, L., Shaw, R., Baron-Cohen, S., & Cassidy, S. (2021). Autistic adults' experiences of camouflaging and its perceived impact on mental health. Autism in Adulthood, 3(4), 320–329. https://doi.org/10.1089/AUT.2020.0071
Bradshaw, P., Pickett, C., van Driel, M. L., Brooker, K., & Urbanowicz, A (2021). Recognising, supporting and understanding autistic adults in general practice settings. Australian Journal of General Practice, 50(3), 126–130. https://doi.org/10.31128/AJGP-11-20-5722
Cola, M, Yankowitz, L. D., Tena, K., Russell, A., Bateman, L., Knox, A., Plate, S., Cubit, L. S., Zampella, C. J., Pandey, J., Schultz, R. T., & Parish-Morris, J. (2022). Sex differences in the first impressions made by girls and boys with autism. Molecular Autism, 13(1), 5. https://doi.org/10.1186/s13229-021-00483-1
Cook, J., Hull, L., Crane, L., & Mandy, W. (2021). Camouflaging in autism: A systematic review. Clinical Psychology Review, 89. https://doi.org/10.1016/J.CPR.2021.102080
Corbett, B. A., Schwartzman, J. M., Libsack, E. J., Muscatello, R. A., Lerner, M. D., Simmons, G. L., & White, S. W. (2021). Camouflaging in autism: Examining sex‐based and compensatory models in social cognition and communication. Autism Research, 14(1), 127–142. https://doi.org/10.1002/AUR.2440
Dell'Osso, L., Lorenzi, P., & Carpita, B. (2021). Camouflaging: Psychopathological meanings and clinical relevance in autism spectrum conditions. CNS Spectrums, 26(5), 437–439. https://doi.org/10.1017/S1092852920001467
Evans, Evans, J. A., Krumrei-Mancuso, E. J., & Rouse, S. V. (2024). What you are hiding could be hurting you: Autistic masking in relation to mental health, interpersonal trauma, authenticity, and self-esteem. Autism in Adulthood, 6(2), 229–240. https://doi.org/10.1089/aut.2022.0115
Finch, T. L., Mackintosh, J., Petrou, A., McConachie, H., Le Couteur, A., Garland, D., & Parr, J. R. (2022). "We couldn't think in the box if we tried. We can't even find the damn box": A qualitative study of the lived experiences of autistic adults and relatives of autistic adults. PLOS ONE, 17(3), e0264932. https://doi.org/10.1371/journal.pone.0264932
Giles-Smith, L., Popowich, E. (2023). Autistic employees in Canadian academic libraries: Barriers, opportunities, and ways forward. Canadian Journal of Academic Librarianship, 9, 1–22. https://doi.org/10.33137/cjal-rcbu.v9.39994
Hull, L., Levy, L., Lai, M. C., Petrides, K. V., Baron-Cohen, S., Allison, C., Smith, P., & Mandy, W. (2021). Is social camouflaging associated with anxiety and depression in autistic adults? Molecular Autism, 12(1), 13. https://doi.org/10.1186/S13229-021-00421-1
Karavidas, M., & de Visser, R. O. (2021). "It's not just in my head, and it's not just irrelevant": Autistic negotiations of menopausal transitions. Journal of Autism and Developmental Disorders, 52(3), 1143–1155. https://doi.org/10.1007/S10803-021-05010-Y
Klein, J., & Macoun, S. J.. (2025). Person-environment fit and social camouflaging in autism. New Ideas in Psychology, 76, 101112. https://doi.org/10.1016/j.newideapsych.2024.101112
Libsack, E. J., Keenan, E. G., Freden, C. E., Mirmina, J., Iskhakov, N., Krishnathasan, D., Lerner, M. D., & White, S. W. (2021). A systematic review of passing as non-autistic in autism spectrum disorder. Clinical Child and Family Psychology Review, 24(4), 783–812. https://doi.org/10.1007/S10567-021-00365-1
Miller, D., Rees, J., & Pearson, A. (2021). "Masking is life": Experiences of masking in autistic and nonautistic adults. Autism in Adulthood, 3(4), 330–338. https://doi.org/10.1089/AUT.2020.0083
Nica, D., & Hojbotă, A. M. (2024). Educating for authenticity? A discussion of impression management in the context of cross-neurotype and cross-cultural communication with possible implications for education. Revista Romaneasca pentru Educatie Multidimensionala, 16(4), 400–424. https://doi.org/10.18662/rrem/16.4/921
Pearson, A., & Rose, K. (2021). A conceptual analysis of autistic masking: Understanding the narrative of stigma and the illusion of choice. Autism in Adulthood, 3(1), 52–60. https://doi.org/10.1089/AUT.2020.0043
Perry, E., Mandy, W., Hull, L., & Cage, E. (2022). Understanding camouflaging as a response to autism-related stigma: A social identity theory approach. Journal of Autism and Developmental Disorders, 52(2), 800–810. https://doi.org/10.1007/S10803-021-04987-W
Poulsen, R., Heyworth, M., Chan, T., & Tan, D. W. (2025, September 18). A heoretical perspective of autistic sensory masking. *PsyArXiv*. https://doi.org/10.31234/osf.io/dgh86_v1
Pyszkowska, A. (2025). It is more anxiousness than role-playing: Social camouflaging conceptualization among adults on the autism spectrum compared to persons with social anxiety disorder. Journal of Autism and Developmental Disorders, 54(11), 3154–3166. https://doi.org/10.1007/s10803-024-06416-0
Radulski, E. M. (2022). Conceptualising autistic masking, camouflaging, and neurotypical privilege: Towards a minority group model of neurodiversity. Human Development, 66(2), 113–127. https://doi.org/10.1159/000524122
Schuck, R. K., Tagavi, D. M., Baiden, K. M. P., Dwyer, P., Williams, Z. J., Osuna, A., Ferguson, E. F., Jimenez Muñoz, M., Poyser, S. K., Johnson, J. F., & Vernon, T. W. (2022). Neurodiversity and autism intervention: Reconciling perspectives through a naturalistic developmental behavioral intervention framework. Journal of Autism and Developmental Disorders, 52 (10), 4625–4645. https://doi.org/10.1007/S10803-021-05316-X
van der Putten, W. J., Mol, A. J., Groenman, A. P., Radhoe, T. A., Torenvliet, C., van Rentergem, J. A., & Geurts, H. M. (2024). Is camouflaging unique for autism? A comparison of camouflaging between adults with autism and ADHD. Autism Research, 17 (3), 545–555. https://doi.org/10.1002/aur.3099
van der Putten, W. J., Mol, A. J., Radhoe, T. A., Torenvliet, C., Agelink van Rentergem, J. A., Groenman, A. P., & Geurts, H. M. (2024). The relationship between camouflaging and mental health: Are there differences among subgroups in autistic adults? Autism, 28 (4), 908-919. https://doi.org/10.1177/13623613231185402
Wurth, P., Fuermaier, A. B., Strand, A. H., & Thorell, L. B. (2025). Diagnosis acceptance, masking, and perceived benefits and challenges in adults with ADHD and ASD: Associations with quality of life. Frontiers in Psychiatry 16, 1668780. https://doi.org/10.3389/fpsyt.2025.1668780
