We all mask our true feelings at times to hide our vulnerability. Even though we may be worried about money, angry at a friend, blue from a break-up, or exhausted with work, we still answer “Fine” or “Good” when people ask how we are.
People with mental health issues, however, may routinely hide their true emotions beneath a “mask.” Over time, the consequences of concealing their real feelings can be detrimental to their well-being. This is known as mental health masking.
What You’ll Learn
- What is mental health masking?
- Why do people mask their mental health symptoms?
- What are the different types of masking?
- What is neurodivergent masking?
Quick Read
Mental health masking is the act of concealing one’s true emotions and behaviors to fit in or avoid judgment. Many people, especially those with mental health issues or neurodevelopmental conditions like autism or ADHD, adopt this coping mechanism to avoid stigma and maintain relationships.
While masking can provide a sense of social acceptance, it often leads to emotional exhaustion, burnout, and a disconnect from one’s authentic self. Over time, masking can worsen mental health, hinder authentic relationships, and lead to physical symptoms like fatigue and headaches.
Supporting someone who masks requires sensitivity and compassion. Creating a safe environment for open communication, actively listening, and validating their feelings can help. Professional treatment options, like those offered at PrairieCare, focus on assisting individuals to express their genuine emotions and heal from the effects of masking.
What Is Mental Health Masking?
Masking in mental health refers to the act of concealing or suppressing one’s true thoughts, feelings, and behaviors to fit in or avoid negative judgment from others. It’s a coping mechanism often adopted by individuals with neurodevelopmental conditions, like autism or ADHD, or those experiencing other mental health challenges. While masking can offer a sense of social acceptance and safety, it can also lead to emotional exhaustion, burnout, and a disconnect from one’s authentic self.
Masking involves consciously or unconsciously altering one’s behavior to appear more socially acceptable or “normal.” This may include:
- Presenting a false persona: Creating a fabricated image of oneself to appear more socially desirable
- Mimicking: Copying the facial expressions, gestures, or speech patterns of others
- Suppressing emotions: Hiding feelings of sadness, anxiety, or anger to avoid appearing vulnerable or different
- Controlling natural responses: Forcing eye contact, suppressing stimming behaviors (like hand-flapping), or avoiding natural reactions to sensory input
- Overthinking social interactions: Analyzing past interactions, rehearsing responses, and constantly monitoring one’s behavior.
The Cost of Masking
Over time, people who repeatedly mask their emotions, behaviors, and authentic selves may experience a variety of negative consequences. Masking can make mental health worse, prevent people from forming genuine relationships, and lead to physical problems. Here are some of the potential effects of masking:
- Emotional exhaustion and burnout: Constantly monitoring and suppressing one’s true self can be incredibly draining.
- Difficulty forming authentic connections: Masking can hinder the development of genuine relationships and create feelings of isolation.
- Increased anxiety and depression: The pressure to maintain a facade can exacerbate existing mental health conditions or contribute to new ones.
- Lack of support: Masking can obscure the severity of a person’s mental health symptoms, making it harder for those around them to provide support.
- Physical symptoms: Some people may experience physical manifestations of stress related to masking, such as headaches, fatigue, or stomach problems.
Masking and Hidden Depression
One example of masking is hidden depression, also known as smiling depression. An absence of visible symptoms marks this type of depression. Hence, people with hidden depression may appear cheerful and jovial on the outside. And they may do well at work or in school. Moreover, they may succeed socially, maintaining a large circle of friends.
But they deliberately hide their melancholy and despondency because they fear how others will perceive them. Other times, people with hidden depression are so detached from their pain that they aren’t even aware they’re wearing a mask.
Hidden depression is not formally recognized as a disorder by the Diagnostic and Statistical Manual of Mental Disorders. But it can have life-threatening consequences. People who are unconsciously denying their distress and don’t seek treatment may eventually experience a mental health crisis.
Types of Mental Health Masking
Masking is a learned behavior that looks different from person to person. For some, it may include adopting particular facial expressions and body language. For others, it’s more behavior-focused. Here are some common ways people mask their true identities:
Social masking
Engaging in social behaviors that don’t come naturally is a form of social masking. Some people change their tone of voice or communication patterns. Others laugh at jokes they don’t understand or pretend to like activities they don’t enjoy just to fit in. Putting on a happy face to cover painful feelings is a form of social masking behavior as well.
Behavior masking
People with attention deficit/hyperactivity disorder (ADHD) may mask at work. For example, they may hide fidgeting or stimming behavior. These behaviors are repeated movements or words that people with ADHD may use to cope with stress and anxiety. Behavior masking involves consciously avoiding repetitive motions, such as bouncing a leg up and down or clicking a pen, to avoid irritating colleagues.
Compensation
Another type of masking behavior involves hiding the effort needed to get something done. People compensate for a mental health issue by spending more time and energy than others. And they may hide how much extra effort they’re expending to stay on track. This is a common strategy among people with ADHD and autism spectrum disorder (ASD).
Why Do People Mask Mental Health Issues?
Why do people hide their emotions, particularly if they are difficult or painful ones? In their families or communities, they may have received negative feedback for appearing sad, fearful, or confused. Wanting acceptance, they create compensation strategies to ensure others cannot see their true selves. That might mean donning a happy face when they’re anything but.
Masking is often driven by the desire to avoid stigma, discrimination, or negative consequences associated with mental health conditions. It can be a survival strategy developed in childhood to cope with bullying, trauma, or rejection. Individuals may also mask to navigate social situations, maintain employment, or build relationships. In a nutshell, people mask to protect themselves from the backlash—real or imagined—that may occur if family, friends, and colleagues see their true selves.
Masking in society
Social acceptance is a huge reason for masking mental health symptoms. The motivation isn’t hard to understand. Look at social media. We live in a culture that celebrates success and “living your best life.” Hence, people often mask mental health issues due to social pressure. They may feel ashamed that they’re not doing as well or feeling as upbeat as their peers.
Masking in relationships
Some people mask mental health symptoms to maintain relationships. They’re afraid of how loved ones or close friends will respond if they don’t display positive emotions. So they engage in masking behaviors to protect themselves. People who have experienced verbal, emotional, or physical abuse may be especially inclined to wear masks. Their goal is to avoid negative reactions they might receive if their symptoms are revealed.
Masking at work
It’s very common for people to hide their feelings and camouflage their true selves in front of colleagues or supervisors. In fact, a recent survey found that two-thirds of people feel the need to mask their emotions at work to appear professional. This type of behavior is prevalent among neurodivergent people.
Neurodivergence and Mental Health Masking
The umbrella term neurodivergence refers to individuals whose brains function and learn differently from the norm. Learning disabilities, ADHD, Down syndrome, epilepsy, obsessive-compulsive disorder, and autism are examples of neurodivergence. People with one or more of these conditions may mask to protect themselves from harassment, discrimination, or having their disability “outed.” Autistic masking is especially common.
What Is Autistic Masking?
When autistic people consciously or unconsciously suppress their natural behavior and responses, this is autistic masking. They know their reactions and behaviors may be viewed as inappropriate. Thus, they hide or control them to be accepted and fit in.
Some examples of autistic masking include:
- Memorizing and acting out social scripts and nonverbal body language they’ve seen in person or on TV
- Faking smiles or laughter when faced with uncomfortable situations or environments
- Quelling natural physical responses (such as flapping or rocking) to emotions and states of energy arousal
- Suppressing stimming behavior (the repetition of physical movements, words, or sounds to self-soothe)
- Resisting their own needs and preferences
- Relying on others to talk and make decisions when in a group
- Attempting to control all aspects of social situations to ensure greater predictability.
In some cases, autistic masking may prevent autistic adults (and children) from experiencing the stigma of autism. But the energy it takes to conceal their true identities takes a toll on their self-esteem and self-worth. Autistic women are especially at risk, as they mask to a greater extent than autistic men. Long-term masking can lead to serious physical and mental health problems.
How to Recognize Mental Health Masking
According to the National Institute of Mental Health (NIMH), nearly one in five adults in the United States suffers from a mental health disorder. Despite how common mental health conditions are, not everyone knows how to identify them. Identifying masking behavior is even more difficult because people who mask behave as if they don’t have a mental health problem.
People who mask act in opposition to how they feel inside. Someone with an anxiety disorder may be very talkative even though talking to people makes them uncomfortable. A person who’s depressed may smile a lot to hide their sadness. An individual with ADHD may attempt not to fidget or talk too much. Or people with autism spectrum disorder may try not to stim or may keep their unique interests to themselves.
While it can be challenging to identify people who mask, “maskers” may not even realize they’re wearing a mask because their behavior is unconscious. Unaware they’re concealing mental health symptoms, they may also be unaware of the impact masking has on their mental health.
Here are some signs you or someone you know may be masking:
- Looking to others for clues around how to behave; mirroring others’ facial expressions and behaviors
- Rehearsing or preparing scripted responses to questions and comments that may come up in social settings
- Suppressing specific body movements for fear that they will look odd, and other people might react negatively
- Needing to spend time alone after social engagements to decompress and feel like oneself again.
How to Support People Who Mask Mental Health Symptoms
Offering support to friends or loved ones who may be wearing masks is a delicate endeavor. It’s important to remember that not everyone wants support. Not everyone may be ready or able to remove their mask. Some people have been concealing their feelings and identities for so long that they don’t know the difference between their masks and their true selves.
With that in mind, share your concerns in private at a time when you won’t be rushed. The way you approach the conversation affects the outcome. Try to be as sensitive as possible. Here are a few suggestions to increase the chances of having a productive conversation:
- Create a safe and supportive environment. Encourage open communication and let them know it’s okay to be themselves.
- Express your concerns in a nonjudgmental way, offering examples of your friend or loved one’s behavior that worries you. Once you’ve voiced them, be quiet. Allow your friend or loved one to respond.
- Listen actively. Don’t interrupt. Focus on what your friend or loved one is saying. Strive to understand what they’re experiencing rather than offer up a solution.
- Validate their feelings. Don’t belittle or minimize them. You might simply say, “That sounds really hard.”
- Ask open-ended questions such as, “Can you describe what you mean?” or “Can you tell me more about how that feels?”
- Assure your friend or loved one that you care and that you’re there for them.
- Ask if there’s anything you can do, such as helping them to locate professional support.
- Be patient. Don’t pressure them to share more than they feel comfortable with. Unmasking can be a gradual process.
Support for Mental Health at PrairieCare
At PrairieCare, our team of experts addresses and heals a wide variety of mental health conditions. Part of the healing process involves helping people of all ages to speak openly about their feelings, overcome whatever shame they may be carrying, and realize they are not alone.
Our care team collaborates to conduct in-depth assessments and formulate tailored treatment plans for each client. Each patient’s treatment plan incorporates a variety of evidence-based and experiential modalities to support healing and growth.
With services and programs for all ages in the Twin Cities, Mankato, and Rochester, there’s no reason to wait to get the support you or a loved one needs to thrive. Call us at 952-826-8475 or use the button below to submit a request form.
Frequently Asked Questions
What is masking behavior?
- Masking behavior is the conscious or unconscious covering up of mental health symptoms to fit in and feel accepted by friends, family, and colleagues.
How can you tell if someone is masking?
- It’s not always easy to tell if someone is masking because they behave in ways that contradict how they feel. However, if someone is constantly smiling or agrees with everyone else all the time, they might be masking a mental health problem. The same is true if they frequently copy your facial expressions or body language.
What is neurodivergent masking?
- Neurodivergent masking refers to the practice of masking by people whose brains function differently from the norm. This includes people with learning disabilities, ADHD, and autism spectrum disorder. They may conceal or control their natural responses and behaviors to avoid attracting attention.
Is masking an ADHD trait?
- Not all people who have ADHD mask their symptoms, but some do. Examples of ADHD masking might be controlling fidgeting behavior. Or they may hide their struggles with tasks by spending long hours studying or working behind the scenes to ensure success.
Sources
- Autism Adulthood. 2021 Dec; 13 (4): 330–338.
- J Autism Dev Disord. 2020; 50 (10): 3638–3648.