What Is Mental Health Masking?

Collaborative Post

Many of us live with mental health conditions, but not all of us display the symptoms of these mental health conditions openly. In fact, many of us actively try to conceal mental illnesses and disabilities. This is known as mental health ‘masking’.

There are different reasons as to why people mask mental health conditions. Some people want to appear as ‘normal’ in order to not be negatively judged by others. Others are worried about being a burden to others or simply want to prove to themselves that they can manage without the support of others.

There are cases where masking can be beneficial. However, there are also many cases where masking can do greater harm than good. This post delves more into the different types of masking, when and when not to mask, and how to help others who you suspect may be masking.

What mental health conditions do people try to mask?

It’s possible to hide and conceal a number of different mental health conditions such as:

Anxiety

Many of us have had to hide our fear before. Those with anxiety may put on a brave face, while bottling up intense fears and hiding physical symptoms. This could include someone with PTSD not opening up about recurring nightmares, someone with OCD doing obsessive rituals in private or someone with social anxiety failing to reveal the fact they had a panic attack on the way to a social event.

Depression

Masked depression is often known as ‘smiling depression’ or ‘high-functioning depression’. People with this form of depression will put on a smile to the world and claim everything is fine while experiencing intense feelings of sadness and emptiness inside. Some people even reach the point of taking their own life without letting anyone know that they are suffering.

AD/HD

It’s also possible to mask symptoms of AD/HD. This can include heavily relying on timers and reminders to stay organised or contrastingly blaming mistakes caused by AD/HD on forgetfulness or carelessness. Those with AD/HD who tend to say impulsive things may even resort to being quiet in social situations in order to avoid saying the wrong thing. Making a conscious effort to restrain stimming behaviours like leg shaking could also be a form of masking.

Autism

A lot of people with autism also make an active daily effort to mask their condition. This can include relying on social scripts, restraining stimming behaviours, mimicking expressions, hiding one’s emotions or even going completely non-verbal in order to not display symptoms. Studies show that women are more likely to mask autism than men, however many men still learn to mask their autism.

What is the positive impact of masking?

Masking can be a way to build/maintain friendships and relationships. It may also be necessary during some job interviews in order to secure a job.

This is because, despite progress in recent years, there is still a stigma surrounding many mental health conditions. Many single people are wary of dating someone with a mental health condition. Similarly, many employers are wary of hiring someone with a mental health condition. Masking symptoms until we have won over people’s trust can prevent instant rejection by showing that there is more to us than our mental health condition. However, this does come at a toll…

What is the negative impact of masking?

Masking does not treat the condition, but simply covers it up. The concentration and willpower required to cover up symptoms can often leave many of us physically and mentally exhausted. This can result in an increased risk of getting ill either from burnout or a low immune system. Chronic stress may also result in ongoing symptoms like fatigue, headaches, achy muscles and digestive issues.

Quite often, a person can only mask their feelings and thoughts for so long before it all comes out. This can lead to outbursts or meltdowns that could make your condition look more manic. In the case of depression, masking may increase the risk of self-harm and suicidal thoughts by making the condition more draining and lonely than were you to share your feelings with someone.

It’s possible that masking may even lead to substance abuse. Because masking provides no relief, alcohol or drugs may become the only way to cope with one’s feelings. This is particularly the case with anxiety and depression, but it can also be a way of coping with masked autism or AD/HD.

Masking can also prevent people getting a diagnosis when they need it and getting the support they are entitled to. There is medication and therapy that can only be prescribed if you have a diagnosis - and to get a diagnosis, you have to be willing to display your symptoms.

Should you mask your mental health condition?

There are times when masking a mental health condition is necessary, but for most daily interactions you shouldn’t be masking symptoms. It is better to be yourself than to feel you are constantly trying to be someone else in order to fit in.

For people to understand your condition, the best thing you can do is to be open about it. That isn’t to say that you have to tell everyone you meet that you have depression or autism. However, you should open up to those who are closest to you. By helping them understand your condition and expressing your everyday feelings, you can teach your friends and family to be more tolerant and gain acceptance for who you are.

Therapy services like Prosper Health can provide you with someone who you can fully open up to about your feelings and your struggles with masking. While you may want to be more open and natural with friends and family, offloading too much of your feelings straight away might seem daunting and could be overwhelming. When talking to a therapist, you may feel more comfortable offloading everything.

How to spot masking in other people (and how to support these people)?

Masking is sometimes very hard to detect, because the whole purpose of masking is to disguise symptoms and act normal. That said, there are only so many symptoms that someone can mask, plus long-term masking can bring on its own complications. Therefore, you can still spot friends and family who may be masking.

One sign that someone is possibly masking is constant cheeriness and optimism, contrasted with constant exhaustion and frequent physical illness. People who are exhausted and ill are generally not happy all the time, and it could be because they are putting in so much effort to hide their emotions and control their impulses.

You may be able to encourage these people to open up by talking about your own problems and mental health concerns. Approaching this subject in a non-judgemental way can help others to feel comfortable opening up. A relaxed social setting can also help - a colleague may find it easier to open up over drinks after work than in the office where they feel masking is more necessary.

Conclusion

It’s important that those with mental health conditions do not feel they need to rely on masking. There are healthier ways to manage one’s symptoms that don’t involve constantly hiding them. Talking to a therapist is a good first step when it comes to learning how to be more open and honest with one’s symptoms, while still being able to function well in society. Like most things in life, being open with mental health symptoms is all about balance - there may be work situations where you have to mask, but you should be able to be yourself around friends and family.

—End of collaborative post—