Beyond the Facade: ADHD Women and the Cost of Masking

In honor of Women's History Month, this blog post is dedicated to all the incredible women navigating life with ADHD.

One of the most significant yet overlooked aspects of the female ADHD experience is masking—the exhausting effort of concealing ADHD traits to meet societal expectations.

The Hidden Struggle of ADHD Masking

At work, you're unstoppable. You run team meetings like a pro, juggle multiple projects effortlessly, and even remind others of their deadlines. But then you get home, and your reality is different. Last month’s electric bill? Still unpaid. Your houseplants? Well-loved but very thirsty.

Sound familiar? “I hold it together all day, only to fall apart at home.”

This disconnect between professional excellence and personal struggles is a hallmark of ADHD in women. Many of us have perfected the art of masking—so much so that we forget we’re even doing it. And its not just in our heads, the research confirms this! Work by Mowlem et al. (2019) highlights that women with ADHD often develop sophisticated coping mechanisms to conceal their symptoms, making it harder to recognize and diagnose ADHD in adulthood.

Why Are Women with ADHD So Good at Hiding Their Struggles?

Women with ADHD often go undiagnosed for years—not because they don’t struggle, but because they unconsciously become experts at concealing their struggles.

Social Conditioning: From the get go, girls receive different behavioral messages. We observe and adapt, becoming masters at mirroring "normal" behavior to avoid rejection (Holthe & Langvik, 2017). We become so convincing that we often fool ourselves—after all, how could we possibly have ADHD when we've gotten so good at hiding it?
Hormones (Yes, really!): Our ADHD symptoms rise and fall with our hormonal cycles (Roberts et al., 2018). Those carefully crafted coping strategies that work brilliantly one week can unravel the next. The reality? Those "good weeks" when everything clicks only add up to 10-14 days a month—and that's before we even talk about perimenopause and menopause.
The Masking Trap: The biggest trick of them all– The more skillfully we mask, the harder it becomes to get help. "But you're so put together!" is something you likely hear when explaining your struggles to others.

Those elaborate organizational systems you've built, the constellation of phone alarms, the sticky-note universe you've created - they're not evidence against your ADHD. They're proof of just how hard your ADHD brain works to maintain the facade.

The High Cost of ADHD Masking

Masking is like running multiple apps on your phone—it drains your battery faster than you realize.

According to Wicherkiewicz and Gambin (2024), chronic masking leads to:

Physical and emotional exhaustion from constantly suppressing ADHD traits
Increased anxiety due to continuous self-monitoring
Disconnection from your authentic self
Self-doubt and identity confusion, wondering: Who am I without the mask?

It is worth reflecting on whether your ADHD masking is causing any of these effects. There are strategies you can use to manage your masking energy, which I’ve included later in the article.

Strategic Masking to Find a Balance

The advice, "just be yourself" is oversimplified.

While it would be fantastic to be able to live life unmasked, in reality, masking can serve a useful and practical purpose. Masking can help us navigate professional settings, social interactions, or unfamiliar environments.

But when masking becomes constant, it drains mental and emotional energy, leading to burnout. The key to not overdoing it (and subsequently burning out) is strategic masking—choosing when and where to use it while ensuring it doesn’t cause irreparable damage.

The Energy Budget Strategy for ADHD Women Who Mask

Think of masking like a monthly energy budget—spend it wisely. If you’ve heard of the Spoon Theory, you’re likely familiar with strategies to conserve energy.

To conserve energy, you can:

Identify when masking is necessary vs. when it's optional. Sometimes we can unintentionally have the mask “on” at all times, so we need to be consciously aware of when it doesn’t have to be.
Schedule “mask-free” recovery time between social or high-energy situations. For professionals, this may look like consciously not scheduling a full day of meetings for yourself, even though you would like to just get them over with.
Create safe spaces where you can be fully yourself.
Build relationships with people who accept your authentic ADHD self. Start with other ADHD-ers!
Reduce exposure to environments that require heavy masking.

You will likely have more energy you want to “spend” than you have available. It’s important to keep tabs on your reserves, so you can use them when they matter most!

Assessment Strategies for ADHD Practitioners

While society often associates ADHD with disorganization or a lack of focus, women with ADHD often develop effective coping mechanisms that mask these symptoms. For practitioners, this means going beyond surface-level impressions and taking a deeper look at the nuances of their experiences.

If you want to more effectively assess and support women with ADHD, keep these points in mind:

A polished exterior does not rule out ADHD.
You will want to assess energy expenditure and recovery patterns, not just task completion.
Hormones influence ADHD symptoms and treatment effectiveness.
Learn more about and become familiar with compensatory strategies and burnout.
Be mindful that traditional diagnostic criteria may overlook ADHD women due to masking.

By taking into account the subtle signs of masking, energy patterns, and hormonal influences, you can provide more personalized and effective care. Understanding these complexities will not only improve the accuracy of your assessments but also enable you to offer genuinely impactful support.

Moving Forward with Masking

Whether you're a woman navigating ADHD or a practitioner supporting those who are, becoming aware of masking is the first step to better assessing and managing it. While masking may serve a functional purpose in certain situations, we must consciously take energy-saving measures to ensure masking does not take a toll on our mental, emotional, and physical well-being.

If you are a woman with ADHD, use the next 5 minutes (start a timer!) to think about the two most significant masking situations you encounter. Are there ways to conserve energy in these situations by accommodating your own masking needs?

If you’re unsure, you can always consult your ADHD peers and get recommendations based on their personal experience with similar issues (there are plenty of online spaces for us!); an ADHD coach can work with you one-on-one to choose research-backed strategies, or you can input your observations into Claude or ChatGPT to get a feel more general ways to conserve masking energy.

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This article first appeared in my Chaos Managed newsletter in March 2025. Click here to subscribe to Chaos Managed and receive the latest ADHD research updates and brain-based tips!

Research & Citations

Holthe, M. E. G., & Langvik, E. (2017). The Strives, Struggles, and Successes of Women Diagnosed With ADHD as Adults. SAGE Open, 7(1), 215824401770179. https://doi.org/10.1177/2158244017701799

Mowlem, F., Agnew-Blais, J., Taylor, E., & Asherson, P. (2019). Do different factors influence whether girls versus boys meet ADHD diagnostic criteria? Sex differences among children with high ADHD symptoms. Psychiatry Research, 272, 765–773. https://doi.org/10.1016/j.psychres.2018.12.128

Roberts, W., Milich, R., & Barkley, R. (2018). Primary Symptoms, Diagnostic Criteria, Subtyping, and Prevalence of ADHD. In Russell Barkley (Ed.), Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed., pp. 51–80). The Guilford Pres.

Wicherkiewicz, F., & Gambin, M. (2024). Relations Between Social Camouflaging, Life Satisfaction, and Depression Among Polish Women with ADHD. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-024-06410-6