The Hidden Cost of Masking: Anxiety and Burnout in Neurodivergent Adults

Many adults exploring autism or ADHD later in life describe a quiet, long-term tiredness that doesn’t improve with rest.

They may have spent years appearing capable, sociable, organised, or emotionally steady on the outside, while privately working extremely hard to manage sensory overload, social expectations, communication differences, or anxiety about “getting things wrong.”

This effort is often called masking. Masking can involve rehearsing conversations in advance, copying other people’s social behaviours, suppressing stimming or natural responses, forcing eye contact, over-preparing to avoid mistakes, or hiding overwhelm, shutdown, or rising panic.

Beneath the surface, there is often hidden anxiety. At its strongest, this may feel like panic. At other times, it can present as a constant background hypervigilance, scanning the room, monitoring tone, replaying conversations afterwards, worrying about misreading social cues, or feeling “on guard” even in ordinary situations. Over time, this sustained anxiety can lead to emotional dysregulation. Feelings may escalate quickly, recovery from overwhelm may take longer, and there can be a swing between heightened anxiety and complete shutdown.

What Neurodivergent Burnout Can Feel Like

Burnout is not simply being busy or stressed. It can include:

• Emotional exhaustion
• Increased sensory sensitivity
• Brain fog or reduced concentration
• Irritability or tearfulness
• Sudden overwhelm that feels disproportionate
• Withdrawal from work or relationships
• A sense of not recognising yourself anymore

For some people, burnout becomes the point at which they begin exploring whether they may be neurodivergent. There can be relief in finding language for long-standing experiences, and grief for the years spent managing anxiety alone, or for the younger self who felt “too much” or “not enough.”

Counselling for Neurodivergent Adults

In therapy, awareness of masking strategies often emerges gradually. People may apologise for strong emotions, or worry they are “overreacting,” when in fact their nervous system has been under strain for years. They may say they are fine, while their body is signalling through burnout that things are not fine for them.

Counselling for neurodiversity offers a steady, confidential space where you do not need to perform, or regulate yourself for someone else. Together, we can explore where masking began, what anxiety has been protecting you from, how emotional dysregulation developed, and what support your nervous system may need now.

Unmasking is not about rejecting coping strategies overnight. Many adaptations developed for good reasons. Instead, it is about building self-understanding, reducing shame, and gradually creating a life that requires less constant vigilance. If you are looking for a therapist for autistic adults or ADHD in adults in Epsom or Surrey, you can read more about how I work on my Neurodiversity page.

You do not need a formal diagnosis to begin therapy. We start wherever you are.