Behind the Perfect Mom Image: Double Masking in Autistic and ADHD Mothers
As a perinatal and early motherhood therapist in South Carolina working with neurodivergent women, I often see how invisible the strain of “holding it together” becomes during pregnancy and postpartum. Many of the mothers I support are not just navigating the transition into motherhood—they are also navigating layers of masking that make it harder to be seen, understood, and supported in clinical, social, and family spaces. This piece reflects that intersection.
The convergence of masking and the maintenance of the perfect mom image: double masking
Neurodivergent masking is when an autistic or ADHD person forces themselves to act “normal” in certain situations in order to camouflage their neurodivergent traits and appear neurotypical to match social expectations. This masking can come at a great cost to one’s mental, physical, and emotional health over time. Research has linked masking and camouflaging behaviors in autistic individuals to increased stress, burnout, social exhaustion, anxiety, and depression.
Mothers face well-documented societal pressures to bounce back, have it all together, and embody specific cultural, religious, and gender stereotypes depending on their community’s expectations. Openly admitting to struggling mentally, emotionally, or physically as a mother is often stigmatized and comes not only with the fear of judgment and ostracization, but also with the legitimate concern of being categorized as unfit and having their child removed.
When neurodivergent women become mothers, they may find themselves at the intersection of both masking neurodivergent traits and masking perinatal mood and anxiety symptoms by forcing themselves to appear as though they are thriving and easily adapting to their new role. This can become a type of “double masking,” or intense, complex camouflaging to be more palatable to society and maintain a sense of safety through blending in.
Emerging research on neurodivergent perinatal experiences highlights significant gaps in support, including lack of neurodiversity-affirming care, misunderstandings from healthcare providers, sensory overwhelm, communication barriers, and pressure to suppress or camouflage needs in order to navigate pregnancy, birth, and early motherhood safely (e.g., Kallitsoglou & Topalli, 2022; Young et al., 2024; Postpartum Support International, 2025). Studies also show that autistic mothers are more likely to report postpartum depression, isolation, and fear of judgment related to parenting, alongside challenges in communicating with professionals and accessing appropriate support (Pohl et al., 2020).
Recent literature also emphasizes the social and emotional pressures autistic mothers face in parenting spaces, where expectations of intensive motherhood, emotional performance, and social conformity can intensify camouflaging behaviors and contribute to exhaustion, identity strain, and reduced access to authentic support (Wilson et al., 2025).
At the same time, motherhood itself is a period of profound neurological, hormonal, emotional, sensory, and identity-related change. The transition to motherhood can increase vulnerability to stress, anxiety, sensory overload, and emotional dysregulation, making the added burden of chronic masking especially significant for neurodivergent women (Rogers et al., 2023).
This pressure to double mask often occurs when neurodivergent women are already under immense mental, emotional, sensory, and physical strain. Pretending everything is okay while internally struggling can increase mental health risks and prolong suffering without support. Even when seeking help, neurodivergent mothers may face discrimination and misunderstanding in mom groups, healthcare settings, and parenting spaces due to differences in communication style, sensory needs, and emotional expression (Tint et al., 2017).
ADHD and autistic mothers need neuroaffirming support systems and safe spaces to openly express themselves and their struggles with adapting to motherhood in ways that strengthen coping skills and increase capacity for the demands of motherhood, rather than punishing them for dropping their masks and showing up authentically.
Society is not built for neurodivergent people. It is not built for women, and it is not built for mothers. The pressure to conform within systems not built for them is amplified substantially during the perinatal period. By creating spaces where neurodivergent women feel comfortable, embraced, and welcomed as their authentic selves, we can connect with more mothers in meaningful and impactful ways that support both maternal mental health and child wellbeing.
References
Blackwell, C. (2025, November 18). Listening for intersections of neurodivergent experience and perinatal mental health. Postpartum Support International. https://postpartum.net/listening-for-intersections-of-neurodivergent-experience-and-perinatal-mental-health/
Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M.-C., & Mandy, W. (2017). “Putting on my best normal”: Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534. https://doi.org/10.1007/s10803-017-3166-5
Kallitsoglou, A., & Topalli, P. Z. (2022). Autism in the perinatal period: A scoping review. Journal of Autism and Developmental Disorders, 53(9), 3607–3623. https://doi.org/10.1007/s10803-022-05533-0
Pohl, A. L., Crockford, S. K., Blakemore, M., Allison, C., & Baron-Cohen, S. (2020). A comparative study of autistic and non-autistic women’s experience of motherhood. Molecular Autism, 11(3), 1–15. https://doi.org/10.1186/s13229-019-0304-2
Rogers, C., Obst, S., Teague, S. J., Rossen, L., Spry, E. A., Macdonald, J. A., Sunderland, M., Olsson, C. A., Youssef, G. J., & Hutchinson, D. M. (2023). Matrescence: Lifetime impact of motherhood on cognition and the brain. Nature Reviews Neuroscience, 24(10), 635–650. https://doi.org/10.1038/s41583-023-00732-x
Tint, A., Weiss, J. A., & Lunsky, Y. (2017). Identifying the clinical needs and patterns of health service use of adolescent girls and women with autism spectrum disorder. Autism Research, 10(9), 1558–1566. https://doi.org/10.1002/aur.1798
Wilson, N. J., Frawley, P., Foley, K.-R., & Trollor, J. (2025). Parenting while autistic: Social expectations, camouflaging, and the emotional labor of motherhood. International Journal of Disability, Development and Education. Advance online publication. https://doi.org/10.1080/08856257.2025.2511369
Young, E., Leavey, G., & Heaney, N. (2024). Neurodivergent experiences of pregnancy and early parenthood: A systematic review. Women and Birth, 37(2), e198–e210. https://doi.org/10.1016/j.wombi.2024.01.005
