What is masking - and what does it cost you?

By Emma Kearns, Founder of Seren Neurodiversity

I want to start with a question. Not a diagnostic one, not a clinical one. Just this:

Have you ever walked out of a social situation, a meeting, a family gathering, a perfectly ordinary Tuesday, and felt completely hollowed out? Not tired in the way that sleep fixes. Something deeper than that. A flatness. An emptiness you could not quite explain to anyone, because from the outside, nothing particularly difficult had happened.

If you have, I want you to keep reading.

Because there is a very good chance that what you were feeling is what happens after masking. And if nobody has ever explained that to you properly, it is long overdue.

What is masking?

Masking, in the context of neurodivergence, means learning to hide the way your brain actually works. It is the gap between how you feel on the inside and how you present on the outside. The performance of being fine, being normal, being like everyone else - maintained at significant personal cost, often without even knowing you are doing it.

It starts early. Usually in childhood, and usually so gradually that it never feels like a decision. You learn that certain reactions get you in trouble. That fidgeting, the doodling, the foottap, not being able to sit still in your chair - mean you have people assuming you aren’t paying attention, aren’t working hard enough, aren’t listening. That your enthusiasm for particular topics exhausts people. That being too loud, too much, too intense is not welcome. So you learn to dial yourself down. You learn to watch and copy. You learn which version of yourself goes down well, and you lead with that one.

By the time I speak with most women, this process has been running for twenty, thirty, sometimes forty years. It is not conscious anymore. It is just what they do.

And that is precisely what makes it so hard to see - and so costly to carry.

Why women mask more

I am going to say something that probably will not surprise you, but that I think needs saying clearly: women and girls are socialised, from an extraordinarily young age, to mask.

Before neurodivergence is even part of the picture, the social expectations placed on girls - to be organised, emotionally regulated, quiet, considerate, agreeable - are a near-perfect recipe for driving neurodivergent traits underground

A boy who cannot sit still, who interrupts constantly, who struggles when plans change - he gets noticed. He may not always get the right help, but he gets noticed. A girl doing the same internal work, using every bit of her energy to hold herself together, to look like she is keeping up, to smile and make eye contact and follow the script - she gets called mature. Quiet. A good girl. A pleasure to have in class.

She is not recognised. She is rewarded for hiding.

This is one of the main reasons neurodivergent wormen are identified so much later than men. Not because the conditions are rarer in women. Because the masking is more thorough, more socially expected, and more consistently reinforced.

What masking actually looks like

Because it is so automatic, and so varied, masking can be hard to spot in yourself - especially if you have been doing it your whole life and have never had a framework to understand it.

Here are some of the ways I see it show up most often in the women I work with.

Mirroring. Adopting the speech patterns, interests, mannerisms, and opinions of the people around you - not because you are dishonest, but because it is genuinely safer and easier than being yourself and hoping for the best. Some women do this so thoroughly that they describe not really knowing, outside of a relationship or a group, who they actually are.

Over-preparation. Scripting conversations in advance. Rehearsing what you will say at the meeting. Going over social interactions afterwards to analyse what landed and what did not. Spending enormous mental energy managing situations that other people seem to navigate without a second thought.

Performing calm. Holding yourself very still when internally every part of you wants to move. Keeping your voice level when you are overwhelmed. Smiling when you are on the edge. Getting very good at looking okay.

Social camouflage. Following social rules so precisely, so effortfully, that you pass. You are seen as friendly, engaged, appropriate. Nobody sees the internal running commentary. Nobody sees how many calculations went into that exchange.

Suppressing sensory responses. Not reacting to the noise, the light, the smell, the texture - because reacting is odd, and drawing attention to it is worse. Filing it away. Getting on with things.

None of this looks like struggle from the outside. That is, of course, the entire point. And it is exactly why it so often goes unrecognised for so long.

The cost of masking over decades

I am not going to pretend this is a light topic, because it is not. The cost of long-term masking is significant, and I think it deserves to be named properly.

Exhaustion that does not make sense. When your entire day requires active management of how you come across, sleep does not fully touch it. The tiredness I hear described most often by the women I work with is not physical. It is the specific tiredness of having been someone slightly different from yourself for eight, ten, twelve hours. Rest helps - but it does not reach the root.

Not knowing who you are. This one takes people by surprise. If you have spent your whole life presenting an edited version of yourself, there is often, underneath, a real uncertainty about what the unedited version even looks like. What do I actually enjoy? What do I actually need? What would I choose, if I were not calculating what the acceptable answer is? These are not small questions, and they deserve to be taken seriously.

Chronic anxiety. Masking and anxiety are deeply intertwined. When you are permanently monitoring yourself, permanently managing perception, permanently alert to getting it wrong - your nervous system does not get to rest. Over years, this creates a baseline level of tension and hypervigilance that can be very hard to distinguish from an anxiety disorder. For many women, what has been treated as anxiety is actually the nervous system response to sustained, decades-long effort.

Burnout. Neurodivergent burnout is not the same as ordinary burnout, though they share features. They tend to come on after a period of sustained masking - often triggered by a change that removes the usual structure and scaffolding. A new job, a relationship breakdown, a baby, a house move. The system that was holding things together, just about, runs out of capacity. The mask stops working. And the crash that follows can be severe and disorienting and very difficult to understand if you do not know what caused it.

A persistent sense of fraudulence. This is perhaps the thing I hear most. The feeling that you are only keeping things together through relentless effort, and that one day someone will notice. That you are performing competence, not actually competent. That the life you have built is somehow borrowed. Imposter syndrome, people call it - but for unrecognised neurodivergent women, it is often less a ‘syndrome’ and more an accurate description of the daily reality of masking.

Why the mask is so hard to take off

If masking costs this much, why not simply stop?

I want to answer this carefully, because the question deserves a careful answer.

The mask was not a choice, in any meaningful sense. It was a survival response. It developed because it was necessary - because the alternative, being visibly different in environments that were not built for you, came with real consequences. Social exclusion. Professional penalties. Relationships that fell apart. The mask kept you safe.

And it is very difficult to stop doing something that has kept you safe, especially when you are not entirely sure what is on the other side of it.

There is also the question of identity. For women who have been masking for thirty or forty years, the mask has become part of the self-concept. It is not a costume they put on consciously each morning. It has become, in some ways, who they think they are. Removing it requires a significant renegotiation of the self - a process that is genuinely disorienting, and that takes time.

What I want to be clear about is this: understanding your masking is not about forcing yourself to behave differently in situations that are not safe. It is not about making yourself vulnerable before you are ready. It is about beginning to notice what is actually you and what is performance. That distinction - just beginning to see it - is often where something important starts to shift.

What happens when the masking is finally understood

I have sat with women at the moment they first understood what masking was and recognised it in themselves. It is not one thing. It is usually a mixture of relief, sadness, and a rather dizzying sense of retrospection - looking back across years through an entirely different frame.

The relief is significant. Having a name for something you have been doing without knowing, and understanding why it costs what it does, tends to lift a particular kind of weight. Not all of it. But a particular kind.

The sadness is also real. For the energy spent. For the years of not quite fitting and not knowing why. For the girl who worked so incredibly hard to pass, and was told she was simply good at managing herself.

What comes after that, in my experience, is possibility. Because once you understand the mask, you can begin to make choices about where and when it is necessary, and where and when it is not. You can start to build, slowly and carefully, a life that has some genuine room in it for the actual you.

That is not a small thing. It is, honestly, one of the most significant shifts I witness in my work.

Frequently asked questions: masking in neurodivergent women

What is masking?

Masking is the process of concealing neurodivergent traits in order to appear neurotypical. It involves suppressing natural behaviours - fidgeting, emotional responses, communication styles - and replacing them with learned, socially acceptable alternatives. In women and girls, it is often so thorough and so automatic that it goes unrecognised for decades.

How do I know if I am masking?

Common signs include: feeling significantly more exhausted after social situations than seems warranted; a sense of not knowing who you really are outside of the roles you perform; a strong gap between how you appear to others and how you actually feel; a history of being described as mature, capable, or adaptable while privately feeling like you are holding yourself together with enormous effort. If any of that resonates, it is worth exploring.

Can masking cause burnout?

Yes. Sustained masking is one of the primary drivers of neurodivergent  burnout. When the effort required to maintain the mask exceeds available resources - often triggered by a significant life change - the system can fail suddenly and significantly. Understanding the role masking has played is often essential to recovering from burnout and reducing the likelihood of it happening again.

Do I need a diagnosis to get support around masking?

No. At Seren, a formal diagnosis is not a requirement. Many of the women I work with are self-identified, or are in the process of seeking assessment, or have simply spent long enough wondering whether something has been missed to know that they deserve some support regardless of what a piece of paper says. What matters is not the label. It is the understanding, and what you do with it.

If you recognise yourself in any of this - if that description of hollowed-out exhaustion landed somewhere familiar - I would love to talk. Not to tell you what you are or are not, but to help you begin to understand what has been happening, and what a life with less of that cost in it might actually look like.

You can find me at www.seren-neurodiversity.co.uk or book a free 30-minute call - I would be glad to hear from you.