What is ‘High-Masking’ Autism in Adults and Why is it Constantly Missed? Psychiatrist Answers

Autism, also known as Autism Spectrum Disorder (ASD), is a neurodevelopmental condition that affects how a person perceives, communicates, and interacts with the world. This disorder often goes unidentified. There are some adults who ‘mask’ or hide their autism to blend in with others. But why do some adults hide it and does it affect their mental health in any way? Today, this article will explain it to you.

To get into the depth of this topic, we interacted with Dr Abhinit Kumar, Senior Consultant, Psychiatry, ShardaCare-Healthcity, Greater Noida. 

What is ‘High-Masking’ Autism in Adults?

Let us begin by understanding what high masking autism in adults means. Some autistic individuals learn, over time, to hide their autistic traits. To do so, they copy social behaviour and attempt to blend in. Their main motive to do so is because they want to be treated better, feel included, and questioned less. This behavior is often termed as autism masking. It is also described as camouflaging autism.

So what are the signs of autism masking? Dr Kumar lists them down for our better understanding:

• A person who masks may feel unusually tired after social gatherings.
• They find noisy or crowded places overwhelming.
• They struggle with unexpected changes.
• They feel that they are constantly ‘performing’ rather than simply being themselves. Some individuals may wonder why everyday interactions seem more difficult for them despite appearing to cope well. 

“These experiences alone do not mean a person is autistic, but they may be worth discussing with a qualified mental health professional or developmental specialist, especially if they affect daily life,” adds the expert. 

Why Do Some Adults Hide Their Autism?

A 2023 study, published in the Frontiers in Psychiatry journal, mentions many autistic adults learn to hide their true self and difficulties to fit into the world. This behavior consists of forcing eye contact or hiding natural reactions. In this finding, the researchers examined multiple existing studies to understand why autistic adults mask, who takes part in it the most, and how it affects their daily lives. 

The study discovered that high-masking behavior is most common in adult females. This is why their autism is completely missed by doctors. Autistic adults mask to avoid judgment, do well in professional settings, make friends, and protect themselves from being treated differently. 

While high masking may help adults blend in temporarily, constantly suppressing their true nature makes them exert enormous mental effort. Over time, this feels like a heavy burden, which can cause chronic exhaustion and a confusing loss of personal identity. The study confirmed that this constant camouflaging is strongly associated with serious mental health problems, including severe anxiety, depression, and autistic burnout.

Why Is Autism Sometimes Recognised Only in Adulthood?

Now that we know what high masking autism is, let us try and understand why it often goes unnoticed. Dr Kumar says that not everyone on the autism spectrum is recognised during childhood. 

The expert explains further, “Some people spend years learning to blend into social situations by carefully adapting their behaviour to match what others expect. Many people become experts at observing others, rehearsing conversations, making eye contact even when it feels uncomfortable, or hiding their need for routine and quiet spaces. From the outside, everything may appear perfectly normal. On the inside, however, keeping up this effort every day can be mentally and emotionally exhausting.”

Ways to Support Adults With Autism

There are different ways with which you can support an autistic adults and children. Dr Kumar lists some ways to do:

• Greater awareness is important because understanding often brings relief, self-acceptance, and access to appropriate support.
• Families, schools, workplaces, and society can make a meaningful difference by valuing different ways of thinking, communicating, and interacting instead of expecting everyone to fit the same mold.
• Autism is a difference in the way the brain develops and processes the world. It is not a flaw, a lack of intelligence, or something to hide. A more understanding society begins by listening without judgement and recognising that every individual deserves the opportunity to be accepted for who they are.

ALSO READ- OCD Vs. Autism: Understanding the Key Differences and Overlapping Traits

Conclusion

High-masking autism is a sad reality, where many adults spend their lives ‘camouflaging’ their true traits to fit into the world. These individuals hide their autism and constantly perform to navigate social and professional environments. This causes severe burnout, anxiety, and a loss of identity. Recognising these hidden struggles is the first important step toward an accurate diagnosis, practicing self-acceptance, and finding the right mental health support. We can try to foster a more inclusive and empathetic society, and create safer spaces where autistic individuals feel empowered and do not need to mask who they are.