Do stimulants just mask ADHD symptoms rather than actually treating the underlying condition?

No, and this framing gets the mechanism backwards. Stimulants work by improving the availability of dopamine and norepinephrine in brain circuits responsible for attention regulation and impulse control, addressing an underlying difference in how those circuits function, rather than covering up a symptom the way a painkiller masks pain without treating its cause. Symptoms return when medication wears off precisely because it's treating the regulation difficulty directly, not papering over something unrelated. If the change is persistent, distressing, or affecting daily functioning, contact your provider through the FasTreat portal rather than changing medication on your own. References: https://www.caddra.ca/wp-content/uploads/Canadian-ADHD-Practice-Guidelines-4.1-January-6-2021.pdf

I used to describe it as 'covering up' my ADHD until a doctor corrected me on this exact point. Changed how I think about taking it every morning, less like hiding something. Honestly changed how I talk about it with my kids too, framing it as something that helps him function rather than something we're hiding. Small shift in language, bigger shift in how it actually feels day to day.