How ‘Masking’ uncomfortable emotions can lead to ‘Autistic Burnout’…

Masking painful emotions can lead to significant damage to one’s mental and physical health. When people hide their true emotions, they may experience increased stress, anxiety, and depression.

For instance, a woman with autism described how relentlessly working to maintain her mask led to constant fear and exhaustion, highlighting the damaging effects of camouflaging one’s true self.

Emotionally, masking can result in a profound sense of disconnection from one’s authentic self, leading to feelings of loneliness and isolation. This disconnection can also prevent individuals from receiving the help they need, as their condition may go unnoticed by both themselves and others. Over time, the constant effort to suppress or fake emotions can lead to emotional exhaustion and potential mental health challenges, such as increased stress, anxiety, and depression.

Physically, masking can also have negative repercussions. Dr. Sean Ormond, dual board-certified in Anesthesiology and Interventional Pain Management, emphasizes that concealing pain symptoms can prevent individuals from addressing the root cause of their discomfort, potentially leading to greater agony in the long term.

Moreover, research has found that autistic adults who reported higher levels of masking also reported higher levels of anxiety and depression. This indicates that the act of masking can exacerbate existing mental health conditions and create new ones.

Masking can also affect relationships. By hiding their true emotions, individuals may confuse and frustrate their loved ones, leading to a loss of trust and confidence in the relationship. Additionally, the need to mask can become so ingrained that it happens unconsciously, making it difficult for individuals to recognize and address their own feelings.

In summary, masking painful emotions can lead to significant damage, including increased stress, anxiety, depression, physical discomfort, and strained relationships.

Masking painful emotions, or the act of hiding or suppressing one’s true feelings, can have significant and far-reaching consequences on both mental and physical health. This behaviour is often adopted as a coping mechanism to fit in socially, avoid negative judgments, or maintain relationships and professional standing. However, the long-term effects of masking can be detrimental, leading to a range of issues including emotional exhaustion, anxiety, depression, and even physical illnesses.

Emotional and Psychological Consequences

1. Emotional Exhaustion and Burnout

Masking emotions requires a constant effort to suppress or alter one’s true feelings, which can be emotionally draining. Over time, this can lead to emotional exhaustion and burnout. The stress of maintaining a facade can be overwhelming, especially for individuals who are neurodivergent or have mental health conditions like anxiety or depression.

2. Anxiety and Depression

Research has shown that individuals who engage in emotional masking are more likely to experience heightened levels of anxiety and depression. The constant suppression of emotions can create a cycle of negative thoughts and feelings, leading to a decline in mental health. For example, a study found that autistic adults who reported higher levels of masking also reported higher levels of anxiety and depression.

3. Identity Issues and Loss of Self

Masking can create a sense of disconnection from one’s authentic self. When individuals consistently hide their true feelings and behaviours, they may begin to lose touch with who they are. This can lead to identity issues and a feeling of being inauthentic, which can further exacerbate mental health problems.

4. Strained Relationships

While masking may initially help individuals maintain relationships, it can ultimately lead to strained or damaged connections. Hiding one’s true feelings can make it difficult for others to understand and support them, leading to frustration and mistrust. Over time, this can erode the quality of relationships and lead to isolation.

Physical Consequences

1. Stress-Related Illnesses

The stress of masking emotions can have physical manifestations. Chronic stress can weaken the immune system, increase the risk of cardiovascular disease, and contribute to other health issues such as headaches, muscle tension, and gastrointestinal problems.

2. Chronic Pain

Masking physical pain with painkillers or other methods can prevent individuals from addressing the root cause of their discomfort. This can lead to chronic pain conditions that are more difficult to treat. The nervous system sends pain signals to alert the body to damage, and masking these signals can delay necessary medical intervention.

Social and Professional Consequences

1. Professional Strain

In professional settings, masking emotions can be a double-edged sword. While it may help individuals maintain a professional demeanor, it can also lead to burnout and decreased job satisfaction. The pressure to conform to societal expectations can be particularly challenging for neurodivergent individuals, who may find it difficult to hide their true selves.

2. Social Isolation

Masking can lead to social isolation as individuals may avoid social situations where they feel they need to maintain their facade. This can result in a lack of social support, which is crucial for mental and emotional well-being.

Strategies for Addressing Masking

1. Self-Awareness and Self-Compassion

The first step in addressing masking is to become aware of the behavior and its impact. Practicing self-compassion and kindness can help individuals reduce the negative thoughts and feelings associated with masking. Journaling and therapy can be useful tools in this process.

2. Seeking Professional Help

Therapy can provide a safe space for individuals to explore their emotions and develop healthier coping mechanisms. Cognitive-behavioural therapy (CBT) and other forms of therapy can help individuals understand and address the underlying issues that contribute to masking.

3. Building Authentic Connections

Building authentic connections with others can help reduce the need to mask. This involves being open and vulnerable, which can foster deeper and more meaningful relationships.

Conclusion

Masking painful emotions can have severe and long-lasting consequences on mental, emotional, and physical health. While it may serve as a short-term coping mechanism, the long-term effects can be detrimental. By becoming aware of the behavior, seeking professional help, and building authentic connections, individuals can reduce the need to mask and improve their overall well-being.

Summary Table

Consequence	Description	Comments
Emotional Exhaustion and Burnout	Constant effort to suppress or alter true feelings leads to emotional drain and burnout.	Masking feelings at work and at home.
Anxiety and Depression	Higher levels of anxiety and depression due to constant suppression of emotions.	Emotional fatigue.
Identity Issues and Loss of Self	Disconnection from authentic self and identity issues.	The entropy of Identity.
Strained Relationships	Difficulty in maintaining authentic relationships due to hidden emotions.	Shielding someone from a painful reality.
Stress-Related Illnesses	Physical manifestations of chronic stress, including weakened immune system and cardiovascular issues.	Possible IBS and chest pains.
Chronic Pain	Delayed medical intervention due to masking physical pain.	Delayed medical treatments leads to additional complications.
Professional Strain	Burnout and decreased job satisfaction in professional settings.	Difficulty feeling positive emotions.
Social Isolation	Avoidance of social situations leading to lack of social support.	Social engagement does not feel authentic.

References

1. Cage, E., & Troxell-Whitman, Z. (2019). Understanding the Reasons, Contexts and Costs of Camouflaging for Autistic Adults. Autism in Adulthood, 1(1), 30-45. Link

• This study explores the reasons, contexts, and costs of camouflaging for autistic adults, highlighting the emotional and psychological consequences.

1. Ormond, S. (2021). The Hidden Dangers of Masking Pain. Pain Management Network. Link

• This article discusses the physical consequences of masking pain and the importance of addressing the root cause of discomfort.

1. Hull, L., Petrou, A., Mandy, W., & Lai, M.-C. (2020). Gender Differences in Camouflaging Autistic Traits: A Systematic Review. Journal of Autism and Developmental Disorders, 50(8), 2758-2776. Link

• This review examines gender differences in camouflaging autistic traits, including the psychological and social impacts.

1. Lai, M.-C., Kassee, C., Besney, R., Bonato, S., Hull, L., Mandy, W., & Baron-Cohen, S. (2019). Prevalence of Autism in the United Kingdom: A National Population-Based Cohort Study. Epidemiology and Psychiatric Sciences, 28(4), 397-405. Link

• This study provides insights into the prevalence of autism and the challenges faced by individuals who mask their symptoms.

1. Hill, E. L., Flaxman, S., & Pellicano, E. (2016). Social Camouflaging in Autism Spectrum Disorder: A Systematic Review. Molecular Autism, 7(1), 1-18. Link

• This review explores the concept of social camouflaging in autism spectrum disorder and its impact on mental health.

1. Segerstrom, S. C., & Miller, G. E. (2004). Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry. Psychological Bulletin, 130(4), 601-630. Link

• This meta-analysis examines the relationship between psychological stress and the human immune system, highlighting the physical consequences of chronic stress.

1. Hull, L., Mandy, W., & Petrou, A. (2018). The Female Autism Phenotype and Camouflaging: A Narrative Review. Review Journal of Autism and Developmental Disorders, 5(2), 135-144. Link

• This review focuses on the female autism phenotype and the role of camouflaging in mental health.

1. Livingston, L. A., & Happé, F. (2017). Conceptualising Camouflaging in Autism Spectrum Conditions: A Systematic Review. Lancet Psychiatry, 4(3), 235-241. Link