Masking in autism and ADHD: discuss

[Doctor Eliza]

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This thread is prompted by a close friend seeking psychotherapy with a master’s level clinician who decided to do a “deep dive assessment” into “neurodiversity” and has spent like 6 sessions giving questionnaires and interviewing her. Her verdict was ADHD and high functioning autism. (I strongly doubt this diagnostic picture as her friend of 30 yrs.) The therapist’s explanation was that the combination of the two creates an “offsetting effect which makes it easier to mask.” I don’t really understand how that would work.

So, what’s your take on masking? What is the difference between masking and adapting? And if you are not showing your symptoms how do you have enough functional impairment to qualify for the diagnosis?

Would love some of the great minds here to weigh in. I know I am skeptical about the concept due to the excessive use of the term masking on social media and in pop psych. And I’m feeling protective of my friend being treated by someone likely practicing out of scope. But I can be convinced to reconsider.

 

[lg1527]

I don’t dismiss the concept of masking, but it’s definitely making assessments more challenging. When every absence of observable difficulty during testing, at school, or in the community is attributed to masking, it becomes hard to tell what’s true adaptation versus concealment. I also believe social media has amplified this to the point where any lack of impairment is seen as proof of masking. Would love to know if there’s actual research that helps distinguish the two.