Co-written with Jess, Psychologist and Director of Neutral Minds, https://www.neutralmindspsychology.com.au, @neutralmindspsychology (Instagram), admin@neutralmindspsychology.com.au

If you're autistic or ADHD, you know what it's like to show up differently in different spaces. You might find yourself mimicking facial expressions, matching someone's tone of voice, suppressing your natural movements, or carefully choosing which thoughts you share. These are survival strategies. They helped you navigate a world not always built for how your brain works.

But here's the thing: these strategies have a cost.

What is masking and people-pleasing, anyway?

Masking and people-pleasing can look similar on the surface, but they operate differently.

Masking is when you suppress or hide your natural traits, reactions, and ways of being to fit neurotypical expectations. It might look like unconsciously blending in, mimicking facial expressions or tone of voice, or suppressing the movements (stimming) that help regulate your nervous system. Often, it happens without you even noticing.

People-pleasing is a pattern where you prioritise others' needs, opinions, and approval over your own. This might show up as difficulty saying no, constantly seeking external validation, going to great lengths to avoid conflict, apologising, or struggling to set and maintain boundaries.

They're different patterns, but they often exist together. And when you're putting energy into either one, let alone both, in every single interaction? That's exhausting.

What happens to your brain when you're masking

Research shows that autistic females engage in higher levels of camouflaging than males, and the effort involved is substantial. When you mask, your brain essentially runs two cognitive systems simultaneously. You're managing both how you naturally think and feel, while also managing the presentation you're showing the world (Hull, Petrides, & Mandy, 2020).

The human toll is real. According to research published in the journal Autism, approximately 70% of autistic adults report feeling compelled to camouflage in public settings. Over time, all this effort to constantly self-monitor and mask your mannerisms, words, and behaviours can take a significant toll and drain your energy, potentially leading to burnout.

Research also suggests that sustained masking acts as a continuous stressor on your nervous system. Over time, this can contribute to dysregulated stress responses, physical exhaustion, and increased risk of anxiety and depression (Cage & Troxell-Whitman, 2019).

The impact of people-pleasing

When you're focused on managing others' feelings and meeting their expectations, several things happen:

Your nervous system stays in a state of high alert. You're constantly scanning for signs of disapproval or conflict, which keeps your threat-detection system activated. This is especially pronounced in ADHD, where rejection sensitivity dysphoria can make the fear of disapproval feel intensely painful.

You end up with little room for rest or recovery. There's no energy left for you because all of it's going toward keeping others comfortable.

Resentment builds quietly underneath. Hiding your frustration or anger takes emotional work, and that accumulates over time.

You can lose touch with who you actually are. When you're living to meet external expectations, it becomes harder to recognise what you actually need or want.

Where burnout comes in

Over time, constantly masking and people-pleasing can lead to burnout. Autistic burnout is a syndrome that results from chronic life stress and a mismatch between expectations and abilities without adequate support. Researchers have found it to be characterised by pervasive, long-term exhaustion, loss of function, and reduced tolerance to stimulus (Raymaker et al., 2020).

Burnout isn't just feeling tired. Research identifies three key dimensions:

Exhaustion: A deep sense of being drained, both physically and emotionally. Your energy reserves feel depleted.

Cynicism: A growing detachment from things you once cared about. Work or activities start to feel pointless or hollow.

Inefficacy: A sense that you can't do anything right or that your efforts don't matter. You might question whether you're actually competent.

And burnout shows up in different ways. You might notice physical changes like headaches, stomach issues, or sleep disruptions. Emotionally, there's often self-doubt, helplessness, or a feeling of being trapped. Behaviourally, you might withdraw from people, procrastinate, become irritable, or turn to substances to cope (HelpGuide, 2024; Mayo Clinic, 2023).

What might actually help

Managing burnout typically involves practical steps like prioritising rest, setting boundaries, building social support, and gently reviewing what you're actually committed to doing. Those things matter (Beyond Blue, 2024).

But there's something deeper worth exploring too: what's driving the masking or people-pleasing in the first place? Often, these patterns developed because they helped you feel safer. Sometimes there's a history of interpersonal difficulty, childhood experiences, or bullying involved. Sometimes it's connected to undiagnosed or diagnosed autism or ADHD.

Understanding the source can help you make different choices going forward.

A note: If you're experiencing burnout or feeling overwhelmed, speaking with a mental health professional such as a psychologist can help you understand what's happening and explore ways forward that feel right for you.

If you're in crisis or having thoughts of self-harm, please reach out:

• Lifeline: 13 11 14 (call or text, available 24/7)

• Crisis Text Line or 000 for emergency services

References

Beyond Blue. (2024). Burnout. https://www.beyondblue.org.au/mental-health/work/burnout

Cage, E., & Troxell-Whitman, Z. (2019). Understanding the reasons, contexts and costs of camouflaging for autistic adults. Journal of Autism and Developmental Disorders, 49(5), 1899–1911. https://doi.org/10.1007/s10803-018-03878-x

HelpGuide. (2024). Burnout prevention and recovery. https://www.helpguide.org/mental-health/stress/burnout-prevention-and-recovery

Hull, L., Petrides, K. V., & Mandy, W. (2020). The female autism phenotype and camouflaging: A narrative review. Review Journal of Autism and Developmental Disorders, 7, 306–317. https://doi.org/10.1007/s40489-020-00197-9

Mayo Clinic. (2023). Burnout prevention and recovery [Fact sheet]. https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642

Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Delos Santos, A., Kapp, S. K., Hunter, M., Joyce, A., & Nicolaidis, C. (2020). "Having all of your internal resources exhausted beyond measure and being left with no clean-up crew": Defining autistic burnout. Autism in Adulthood, 2(2), 132–143. https://doi.org/10.1089/aut.2019.0079