ADHD Masking in Teens: (RSD) Signs and Causes of Exhaustion and Ways to Cope
As teenagers work out who they are and where they belong in the world, many learn to soften their opinions or hide parts of themselves in order to fit in socially. In most cases, this is a natural part of growing up, but sometimes, masking is hiding something more significant, such as ADHD.
Masking is common among neurodivergent teens, particularly those with ADHD, who may work hard to suppress traits they fear will draw attention or lead to judgment. While it’s understandable why teens with ADHD would want to mask, it can lead to damaging mental health conditions. This makes early identification and treatment of teen ADHD masking incredibly important. To help with both, this page covers:
- What ADHD masking in teens means
- Examples of ADHD masking in teens
- How ADHD masking can affect teen life
- Unmasking strategies for adolescents with ADHD
- How Mission Prep can provide the support your teen needs
What Is ADHD Masking in Teens?
Research into neurodevelopmental conditions describes it as a deliberate or automatic strategy to avoid standing out or being judged. Though first studied in autism, masking is now recognized in ADHD as well.¹
For teens, masking might mean fewer questions from teachers and less scrutiny from peers, but that relief is short-lived and mentally exhausting.1 This is why masking has been linked to issues like burnout and other mental health difficulties that can significantly affect a teen’s quality of life.
Example of ADHD Masking in Teens
When a teen with ADHD is masking their symptoms, it can affect far more than we might realize. What looks like an ordinary school day on the surface can involve constant effort beneath it.
To help bring this to life, the example below follows Jamie through a typical day at school. Jamie’s story will show just how demanding masking can be, even when everything appears “fine” from the outside.
During the first class of the day, Jamie finds himself squeezing his hands in his lap to avoid fidgeting while the teacher is giving instructions on the next task. He’s so focused on not fidgeting that he misses the instructions entirely. This is proof of how exhausting it is just to appear composed in class.
Cut to lunch, and Jamie is talking to his friend about last night’s sports game. What his friend doesn’t realize is that before speaking, Jamie is rehearsing each response to ensure his natural thoughts don’t creep out.
He tries to ignore that the noise and lights are making it hard to concentrate, and avoids mentioning it to friends, who don’t seem bothered.
During science class, Jamie secretly writes tasks down neatly, even though the sequence of steps feels overwhelming. When a partner points out a mistake Jamie made, he apologizes quickly and tries to act as though he simply “missed it”, attempting to hide how his attention had drifted for a moment earlier.
Jamie is back at home now, and the energy spent on “fitting in” has left him drained. He knows homework needs to be done, and that it doesn’t care about how tired he is. He can feel the burnout from masking ADHD, knowing that it all begins again tomorrow.
Jamie’s story is a clear presentation of ADHD symptoms and how he tries his best to mask them to fit in. Burnout is one consequence of this kind of constant effort, but it’s not the only one.
In the next section, we focus on the different areas that are affected by teen ADHD and masking.
How Can ADHD Masking Affect Teen Lives?
Burnout From ADHD masking
Many neurodivergent teens learn to suppress or “mask” ADHD traits to fit in at school or to meet social expectations. One study that followed 15-18-year-old girls with ADHD found that the constant masking was so exhausting that they reported needing to rest or even take a nap after school.2 The girls described holding back their natural energy to avoid seeming annoying, sticking to topics their friends were interested in, and suppressing hyperactive traits.2
The researchers concluded that these methods of masking required continual self-monitoring, leading to emotional and psychological exhaustion.
Anxiety and ADHD Masking
Direct research on anxiety and ADHD masking is limited, but we can draw on findings from other neurodivergent conditions where the link is clearer. Autism, for example, also features elements of masking that have been linked to new or worsening anxiety symptoms.
One study found that higher levels of social camouflaging were linked to generalized and social anxiety, while another found that masking is strongly associated with anxiety across both autistic and non-autistic individuals.3-4
Depression and Emotional Fatigue
Researchers have also linked masking, and the emotional fatigue it can bring, to depression.5
The study focused on lifetime depression and camouflaging scores found that autistic participants with a history of depression reported a higher camouflaging score. This led researchers to conclude that camouflaging strongly predicted lifetime depression, even after controlling for factors like age and autism traits.5
Notably, camouflaging did help facilitate social interaction, but these benefits came at a high emotional and psychological cost.5
Emotional Dysregulation in ADHD Teens
Strong research has shown that emotional dysregulation is common in those with ADHD, and masking behaviors can make it worse.6
One large study on the upsetting experiences of 57 adolescents aged 11–15 with ADHD found four recurring themes linked with emotional dysregulation: social conflict, masking, self-doubt, and sensory mismatch.6
For adolescents with ADHD specifically, it was found that masking often occurred to avoid punishment for their ADHD behaviors. But this came at a cost, as the children noted that masking made them feel misunderstood and increased their emotional burden.6 This suggests that when teens are forced to suppress their natural reactions, their emotions may be affected internally.
Researchers concluded that neurodivergent teens face roughly double the emotional intensity of upsetting experiences compared to neurotypical peers.
Low Self-Esteem and Masking
A 2024 study that examined camouflaging in the general population confirmed that while people do it for safety or belonging, these behaviors can trigger diminished self-esteem and feelings of inauthenticity.7 This matters because this type of emotional suppression is strongly linked to depression and anxiety.
Participants in the study reported feeling disconnected from their authentic selves when constantly adapting to others’ expectations.7
For neurodivergent teens in particular, one study found that masking was intertwined with self-doubt and shame,6 showing a clear link.
Unmasking Strategies for Adolescents With ADHD
ADHD treatment is not about changing who your teen is or trying to make their ADHD disappear. Instead, the focus is on reducing how overwhelming the symptoms feel in everyday life.
If your teen is masking to cope or fit in, the goal is to ease that pressure. That means helping them feel safe enough to be themselves, without constantly managing how they appear to others.
There are several practical ways parents can support this process and help reduce the pressure teens may feel to hide their ADHD traits. Below, we take a look at five potential ways you can help:
1) Build Diagnosis Acceptance and a Safe Identity Around ADHD
Studies show that a teen is more likely to mask when ADHD feels like something they have to hide from others. This makes the goal here simple: help them move from “ADHD is a flaw” to “ADHD is a difference I’m learning to manage“. Research on neurodivergent people links diagnosis acceptance with masking-related patterns, suggesting that when someone feels more settled in what their diagnosis means, they feel less pressure to camouflage.1
At home, this could look like:
Using non-shaming language.- Asking questions that give control, like “Where do you feel you have to ‘perform’ the most?“
- Praising effort and honesty, not just if something “looks fine.“
2) Teach Skills That Reduce the Need to Compensate
A lot of masking is compensating for predictable ADHD struggles, like time blindness or emotional overloads, and then panicking about how it looks. CBT for teens with ADHD focuses on practical skills that can reduce stress. These include planning, organization, problem solving, and developing new thinking patterns.8
This has been shown to reduce your teen’s need to constantly “hold it together” socially.
3) Treat Accommodations as Routine, Not ‘Special Treatment’
Masking spikes at school because expectations are public, like sitting still or keeping emotions contained. Clinical research shows that behavioral treatment for ADHD commonly includes parent training and a structured school-based intervention.9 This is often beneficial because changing the environment reduces the constant need for your teen to compensate alone.
You can work with your child’s school to establish:
Practical adjustments, like written instructions in the classroom rather than verbal ones.- A trusted staff member your teen can check in with when overwhelmed.
- A private ‘exit plan’ for overwhelming emotions, which can reduce the fear of being seen struggling.
4) Build Emotional Regulation Through Mindfulness
Studies on mindfulness-based interventions for teens with ADHD show significant improvements in ADHD symptoms and related functioning.10 Both teens and their parents can learn techniques like meditation and breathing exercises to strengthen emotional regulation skills. This can give teens healthier ways to manage intense emotions without suppressing them.
5) Tackle Stigma Directly
If a teen has learned that ADHD gets them labeled as “annoying” or “lazy”, hiding traits starts to feel logical. Research on ADHD stigma finds it can shape emotional well-being and negative self-view, and affect whether families seek support.11
Ways to push back against the stigma include:
Calling out stigma when it appears, like questioning bad comments from others, or even when your teen makes negative comments about themselves.- Separating the behavior from the identity: “That choice didn’t work, but it doesn’t mean you can’t do it.“
- Letting your teen decide when and whether to disclose their condition.
In some cases, these strategies aren’t enough, or other issues may be driving the masking. When that happens, the next step is to reach out for professional help.
Mission Prep: Therapy for The Consequences of ADHD Masking
If you’re noticing signs of ADHD masking in your teen, especially if attempts to reduce it at home or school have not brought relief, it may indicate something deeper that needs professional support. Research consistently links prolonged masking with anxiety, low mood, emotional strain, and difficulties with self-esteem. Identifying these patterns early can make a real difference in how supported your teen feels moving forward.
At Mission Prep, we support teens with ADHD who are struggling not only with symptoms but with the pressure to hide them. Our team understands how masking develops and how exhausting it can be for adolescents who are trying to fit in while managing their internal world.
We provide comprehensive assessment and evidence-based treatment tailored to neurodivergent teens, including support for ADHD alongside anxiety, depression, and emotional regulation difficulties. Our neurodiversity-affirming approach means care is designed around how teens actually experience and process the world, not how they are expected to.
Because masking rarely affects just one person, we also involve families in the treatment process. Through family-inclusive approaches, parents are supported in understanding their teen’s needs and helping their child feel safe being themselves.
Mission Prep offers both outpatient and residential options, allowing care to match your teen’s needs, whether that means staying connected to school or taking time in a structured, supportive environment to reset and rebuild confidence.
If you’re concerned about your teen and want guidance on next steps, reaching out can be a helpful place to start.
References
- Wurth, P., Fuermaier, A. N., 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. https://doi.org/10.3389/fpsyt.2025.1668780
- Grimell, J., Ericson, M., & Frick, M. A. (2025). Identity work among girls with ADHD: Struggling with Me and I, impression management, and social camouflaging in school. Frontiers in Psychology, 16. https://doi.org/10.3389/fpsyg.2025.1591135
- 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). https://doi.org/10.1186/s13229-021-00421-1
- Zubizarreta, S. C.-P., Isaksson, J., Faresjö, Å., Faresjö, T., Carracedo, A., Prieto, M. F., Bölte, S., & Lundin Remnélius, K. (2025). The impact of camouflaging autistic traits on psychological and physiological stress: A co-twin control study. Molecular Autism, 16(1). https://doi.org/10.1186/s13229-025-00695-9
- Gesi, C., Pisani, R., Tamburini, N., & Dell’Osso, B. (2025). The relationship between camouflaging and lifetime depression among adult autistic males and females. Brain Sciences, 15(9), 920. https://doi.org/10.3390/brainsci15090920
- Pavlopoulou, G., Chandler, S., Lukito, S., Kakoulidou, M., Matejko, M., Jackson, I., Balwani, B., Boyens, T., Poulton, D., Harvey-Nguyen, L., Glen, Z., Wilson, A., Ly, E., Macauley, E., Hurry, J., Baker, S., Sonuga-Barke, E. J. S., Danese, A., Downs, J., & Funnell, E. (2025). Situating emotion regulation in autism and ADHD through neurodivergent adolescents’ perspectives. Scientific Reports, 15(1). https://doi.org/10.1038/s41598-025-21208-x
- Ai, W., Cunningham, W. A., & Lai, M.-C. (2024). Camouflaging, internalized stigma, and mental health in the general population. International Journal of Social Psychiatry, 70(7), 1239–1253. https://doi.org/10.1177/00207640241260020
- Sprich, S. E., Burbridge, J., Lerner, J. A., & Safren, S. A. (2015). Cognitive-behavioral therapy for ADHD in adolescents: Clinical considerations and a case series. Cognitive and Behavioral Practice, 22(2), 116–126. https://doi.org/10.1016/j.cbpra.2015.01.001
- The MTA Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56(12), 1073. https://doi.org/10.1001/archpsyc.56.12.1073
- Wang, X., Chen, L., & Feng, T. (2025). The effects of mindfulness and cognitive strategy interventions on core symptoms in children with ADHD: A randomized controlled trial. Journal of Affective Disorders, 120513. https://doi.org/10.1016/j.jad.2025.120513
- Schoeman, R., & Voges, T. (2022). Attention-deficit hyperactivity disorder stigma: The silent barrier to care. South African Journal of Psychiatry, 28(0), 7. https://doi.org/10.4102/sajpsychiatry.v28i0.1865
