High Masking Should Be Its Own Mental Health Diagnosis
Why the act of hiding your true self to survive socially is more than exhaustion—it is chronic psychological harm that meets every criterion for a diagnosis.
Clinically, we diagnose what breaks down, not what overperforms. Yet high masking—the art of appearing fine while eroding inside—meets every clinical standard for psychiatric classification. Maybe it’s time to name it for what it is.
By: Lindsey Mackereth, MA, LPCC, LADC
As a clinician, I use the DSM every day. It gives us a shared language for diagnosing, treating, and validating human distress. But I also see its limits, especially when it comes to the kinds of suffering that do not fit neatly into existing categories.
One of those unclassified syndromes, in my view, is high masking.
High masking is often described as a coping strategy, a way neurodivergent individuals (autistic, ADHD, AuDHD, or otherwise sensitive and divergent) learn to suppress their natural ways of being in order to appear “normal.”
But if we strip away the euphemisms, what we are really describing is a chronic, distress-based behavioral syndrome that affects mood, cognition, behavior, physiology, and identity.
In other words: high masking meets every criterion for a mental health disorder.