Not currently in practice. Jerrin Mathew is a licensed Registered Nurse (RN, BSN) enrolled in a graduate psychiatric-mental health nurse practitioner program. He is not a licensed Advanced Practice Registered Nurse, is not accepting patients, and does not provide psychiatric evaluation, treatment, diagnosis, or prescribing services. This site is educational only.
JMJerrin Mathew
Writing/Adult Autism

Masking: the cost of performing normal at work

Every meeting is two jobs: the meeting, and the performance of being someone who finds meetings easy.

For high-performing professionals in Chicago and Chicagoland: This article reflects clinical evidence and direct experience. If you're in the Chicago area or Illinois, contact me to discuss your concerns.

Masking describes the deliberate, often automatic, suppression of autistic traits in order to appear neurotypical: rehearsing conversations, forcing eye contact, mirroring other people's expressions, suppressing the need to move or to step away, and carefully monitoring tone.

It works, in the sense that people often succeed in not being noticed. That success is the problem.

What it costs

Masking is continuous cognitive labour running underneath every interaction. People describe ending a workday with nothing left, not because the work was hard but because the performance was. Weekends become recovery rather than living.

Over years the cost compounds. Masking is consistently associated in research with exhaustion, anxiety, and depression, and with a sense of not knowing who one actually is beneath the performance.

Masking is not a social skill. It is a load, and loads accumulate.

Why professionals mask more

Professional environments reward exactly the behaviours masking produces: composure, social fluency, reading the room. The more senior the role, the more it depends on interaction, and the higher the masking demand. Promotion can be the event that tips someone from coping into burnout.

What helps

Not abandoning masking entirely — that is rarely realistic in a professional role. Rather, reducing the total load: building recovery time into the week deliberately, adjusting the environment where possible, choosing where to spend the effort, and being unmasked somewhere.

Knowing that this is what is happening is often the first relief. Exhaustion with a cause is easier to manage than exhaustion that seems to prove something is wrong with you.

Medical disclaimerThis article is educational and is not a diagnosis. Autism assessment in adults requires a qualified clinician experienced in adult presentations. If you are in crisis or having thoughts of suicide, call or text 988 in the United States.
References
  1. National Institute of Mental Health. Autism spectrum disorder. https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd
  2. National Institute of Mental Health. Anxiety disorders. https://www.nimh.nih.gov/health/topics/anxiety-disorders
  3. National Institute of Mental Health. Caring for your mental health. https://www.nimh.nih.gov/health/topics/caring-for-your-mental-health

Published August 2026 · Reviewed for accuracy against the sources listed above.

About the author

Jerrin Mathew, RN, BSN

Registered nurse with a clinical background spanning emergency medical services, long-term acute care, cardiac telemetry, and neurocritical care at a Level I trauma center. Currently completing graduate education in psychiatric-mental health nursing, with an expected graduation in 2027.

Writing here focuses on the intersection of psychiatric illness and demanding professional life — what gets missed, what gets mislabeled, and what is worth taking to a clinician.

More about my background →
Jerrin Mathew RN, BSN, PMHNP Student

Available in Chicago and Illinois. If you're in the Chicago area, Illinois, or surrounding Midwest and want to discuss your concerns, contact me for a free consultation.