Masking in mental health conditions | Smart TMS

Introduction to Masking

Masking is a term used to describe the act of concealing one’s true identity, behaviours, emotions, or thoughts in order to blend in with societal norms or to avoid negative reactions from others. It’s a coping mechanism that is prevalent in conditions such as autism, ADHD, anxiety disorders, and depression, where their natural behaviour or mental health symptoms may not align with societal expectations. Although masking is associated with helping individuals to cope with their symptoms, it can be a significant stressor and can harmfully impact the mental health and well-being of those who practice it leading to further problems in the future.

Masking in Specific Mental Health Conditions

Different mental health conditions present unique challenges and patterns of masking:

• Autism Spectrum Disorder (ASD): Individuals with autism often mask by mimicking social behaviours and suppressing self-stimulatory behaviour. This can help them fit in socially but can also lead to significant mental health challenges, including anxiety and depression.
• Attention-Deficit/Hyperactivity Disorder (ADHD): People with ADHD may mask their symptoms by working extra hard to stay organised, suppressing impulsive behaviours, and hiding their struggles with attention. This often leads to chronic stress and a sense of inadequacy.
• Anxiety Disorders: Those with anxiety may mask their symptoms by putting on a calm front, avoiding situations that trigger their anxiety, or using substances to cope. This can result in a cycle of avoidance and increased anxiety.
• Depression: Individuals with depression might mask their low mood and lack of energy by forcing themselves to appear cheerful and engaged. This often leads to further exhaustion and a sense of disconnection from others.

The Psychological Toll of Masking

While masking can help individuals navigate social situations, it comes with significant psychological costs. The effort required to maintain can lead to:

• Emotional Exhaustion: Constantly suppressing one’s true self and emotions can be draining. This emotional labour can lead to chronic stress and burnout.
• Identity Confusion: Over time, the distinction between one’s true self and the masked persona can merge, leading to a loss of identity and self-worth.
• Increased Anxiety and Depression: The fear of being “found out” or the stress of maintaining the mask can exacerbate anxiety and depression. The gap between the inner experience and outer presentation can also lead to feelings of isolation and alienation.
• Delayed Diagnosis and Treatment: Masking can make it difficult for healthcare providers to accurately diagnose and treat mental health conditions. The appearance of ‘normal’ behaviours may lead to underestimating the severity of symptoms, resulting in inadequate support and intervention. This can in turn prevent the individual getting the treatment that can best work for them.

Childhood Origins

Masking behaviours often originate in childhood. Children who experience bullying, trauma, or abuse may find that hiding their true selves is a way to avoid further harm. This survival mechanism can become deeply ingrained and carry over into adulthood, where it becomes a habitual response to stress or social anxiety.

The Impact of Long-Term Masking

Long-term masking can have significant impacts on an individual’s well-being. It can lead to increased stress, anxiety, and a loss of personal identity. The constant effort to appear ‘normal’ or to hide one’s true self can prevent individuals from forming genuine connections and accessing the support they need. Furthermore, masking does exactly what it says: it hides the problem. Untreated mental illness can significantly impact an individual and suffering in silence only makes it worse.

Finding a Path Forward

Recognising the need to unmask and be authentic is the first step towards a healthier psychological state. Seeking professional help, finding supportive communities, and developing self-acceptance are crucial in reducing the need to mask. It’s important for society to create environments where neurodiversity is understood and accepted, allowing individuals to live authentically without fear of judgment. Moreover, a better insight into our own masking habits can help ourselves and others recognise these patterns of behaviour.

Conclusion

Masking is a protective strategy that can help individuals in the short term but may lead to negative consequences if sustained over time. Understanding and addressing the reasons behind masking, especially in neurodivergent individuals, is essential for promoting mental health and well-being. By fostering acceptance and support, we can help reduce the need for masking and encourage everyone to embrace their true selves.

Transcranial magnetic stimulation (TMS) treatment

TMS treatment is a non-invasive, medication-free treatment, proven effective in treating depression, anxiety, ADHD and many other conditions. TMS treats the actual brain circuits involved in your condition, rather than flooding the brain with chemicals. TMS can help individuals by reducing symptoms of mental health conditions and prevent the need for masking. At Smart TMS, every element of the treatment process is patient-first and the team will do their best to make individuals feel comfortable from their first enquiry to final treatment session. It is important to speak openly in your initial consultation so our clinicians can accurately prescribe the best treatment for patient symptoms.

References:

1. Masking: What It Means to ‘Mask’ Your Symptoms – Frida. https://www.talkwithfrida.com/learn/masking-what-it-means-to-mask-your-symptoms/.
2. Frida’s Adult ADHD Library: Resources, Education, Articles – Frida. https://www.talkwithfrida.com/learn/.