Can shame mask ADHD symptoms?
Many people with ADHD spend years trying to appear “normal”, often without realising that the effort to hide their difficulties is a form of masking. Shame plays a key role in this behaviour. According to NHS guidance on ADHD, persistent criticism and misunderstanding of ADHD traits can lead individuals to internalise guilt and develop coping strategies that conceal symptoms. These may include overcompensating through perfectionism, people-pleasing, or overachievement.
NICE’s ADHD guideline (NG87) recognises that emotional dysregulation and rejection sensitivity often underlie these responses. When people are repeatedly told that they are “too much”, “lazy”, or “unfocused”, shame becomes a defence mechanism. Masking helps them avoid rejection but also distances them from their authentic identity. Private assessment pathways, such as ADHD Certify, can help individuals receive a timely diagnosis and begin to understand these emotional patterns in a supportive, structured way.
Understanding how shame can mask ADHD symptoms
Shame, emotional regulation, and masking
Research in Frontiers in Psychiatry (2023) shows that emotional dysregulation makes people with ADHD more vulnerable to shame. When they experience criticism, their emotional response can be intense and long-lasting, prompting efforts to hide perceived weaknesses. This can take the form of masking consciously controlling self-presentation to meet social expectations. While masking can help individuals fit in, it often leads to exhaustion, anxiety, and disconnection from self.
Rejection sensitivity and perfectionism
The Royal College of Psychiatrists notes that many people with ADHD develop perfectionistic or people-pleasing traits to cope with feelings of inadequacy. Rejection-sensitive dysphoria, a term describing the extreme emotional pain caused by perceived rejection, is common among adults with ADHD and contributes to overcompensation. Although these behaviours may appear successful externally, they can hide underlying difficulties and delay recognition or diagnosis.
Gender, stigma, and late diagnosis
Women and individuals diagnosed later in life often report higher rates of masking. Studies in BJPsych Open (2024) and a Healthwatch England report (2025) highlight how social expectations around competence and emotional control encourage people, especially women, to conceal ADHD traits. This long-term masking can lead to emotional burnout, anxiety, and identity confusion. NHS evidence suggests that unmasking, learning to live more authentically after diagnosis can help restore self-esteem and improve wellbeing.
Support and recovery
NICE and RCPsych recommend psychoeducation, adapted cognitive behavioural therapy (CBT), and compassion-focused approaches to reduce shame and rebuild self-acceptance. Coaching and peer groups are also shown to help people recognise masking patterns and develop healthier coping strategies. These interventions aim not to remove coping skills, but to replace shame-based behaviours with self-understanding and resilience.
Key takeaway
Shame can mask ADHD symptoms by driving people to hide or overcompensate for their challenges. While masking may temporarily protect against rejection, it often leads to emotional exhaustion and delayed recognition of ADHD. Understanding that these behaviours stem from shame, not weakness, allows individuals to seek appropriate support and live more authentically.
