Can masking contribute to anxiety or depression?

Long‑term masking can absolutely increase the risk of developing other mental health challenges, and clinicians see this pattern all the time in adults who were undiagnosed or unsupported for years. Masking requires constant self‑monitoring, emotional suppression, and effortful compensation, which places a chronic load on the nervous system. Over time, that sustained effort can contribute to anxiety, low mood, burnout, and a sense of disconnection from your authentic self. Many adults describe years of “holding it together,” only to find that the emotional cost eventually catches up with them. Clinicians understand this as a predictable outcome of living without accommodations, without language for your neurotype, and without environments that match how your brain actually works. When people finally unmask, often after diagnosis or self‑recognition, they frequently realize just how much energy they’ve been spending to appear “fine.” So yes, masking doesn’t cause anxiety or depression on its own, but it can significantly increase vulnerability to them, especially when combined with chronic stress, perfectionism, or environments that demand constant performance.