Autism Camouflaging: Stress, Burnout & Surprising Research Findings

Many autistic individuals report feeling compelled to conceal or downplay their autistic traits to fit into social settings governed by neurotypical norms. This can involve maintaining eye contact despite discomfort, rehearsing conversational responses in advance, or suppressing natural reactions in socially and sensorially demanding environments. This is known as camouflaging or masking – a phenomenon receiving increasing attention in autism research and linked to diminished quality of life, increased stress, and a higher risk of autistic burnout.

The Hidden Costs of Fitting In

A previous study, based on surveys of autistic individuals, indicated that camouflaging occurs in various contexts: interactions with supervisors at work, neighbours, potential employers, and generally with non-autistic people. Motivations range from being taken seriously and performing well at work to reducing social “embarrassments” and making new friends. Regardless of whether this camouflaging is constant or intermittent, the study found This proves associated with poorer mental health.

The Biological Impact of Masking

Karl Lundin Remnélius, a researcher at the Karolinska Institute’s npf-kunskapscenter KIND, explains that numerous studies based on the lived experiences of autistic individuals demonstrate that camouflaging is both strenuous and energy-consuming. He notes that while quantifying the prevalence is difficult, these strategies can contribute to both psychological and physical health issues within the autism community. Many individuals also express a desire to reduce these strategies to lessen stress and live more authentically.

Remnélius and colleagues recently conducted a unique study to further understand the consequences of camouflaging. This marks the first time researchers have used an objective biological measure to investigate the stress that can arise from concealing autistic traits in social situations.

How the Study Was Conducted

The study involved 315 twins, 69 of whom had been diagnosed with autism. Researchers analyzed several-centimeter-long hair strands to measure cortisol levels over the preceding months. Cortisol, a stress hormone, is released during demanding situations to enhance the body’s mental and physical preparedness, but chronically elevated levels can have negative consequences.

Participants also self-reported their autistic traits and underwent a clinical assessment by a psychologist using the ADOS-2, which involves observing an individual’s behavior during standardized activities. A discrepancy between an individual’s self-assessment and the psychologist’s evaluation was interpreted as an indication of camouflaging – suggesting the individual experiences autistic traits that aren’t outwardly visible due to masking.

Unexpected Findings

Analysis revealed a correlation between higher levels of camouflaging behavior and prolonged increases in cortisol levels, particularly among those with an autism diagnosis – a finding consistent with previous studies using self-assessments and interviews.

However, further analysis of twin pairs where both individuals have autism yielded a surprising result. The autistic twin who camouflaged more exhibited lower levels of the stress hormone cortisol compared to their sibling who camouflaged less.

Remnélius acknowledges this “reversed relationship” is unexpected and requires further investigation. Two potential explanations are offered: camouflaging may serve as a protective mechanism in certain situations, reducing the risk of negative reactions from neurotypical individuals, or those with higher camouflaging behaviors and lower cortisol levels may be at risk of autistic burnout, where cortisol levels can decline with prolonged exhaustion.

Future Research and Nuance

The study’s limitations include the lack of a well-established measure of participants’ perceived stress levels and an absence of data on their self-reported quality of life and mental health. The findings underscore the complexity of the topic, and Remnélius emphasizes the need for more research.

He notes that the results are preliminary and require follow-up with a larger sample size and additional stress measures. The fundamental question remains: does camouflaging lead to higher cortisol levels and increased risk of burnout, or are other factors at play?

Remnélius stresses the importance of a nuanced discussion about camouflaging, recognizing that it encompasses a range of strategies, some of which can be constructive or even necessary. He cautions against viewing camouflaging as a monolithic concept, as certain strategies can be helpful in promoting inclusion and facilitating social interactions.

Researchers plan to investigate camouflaging in individuals with both autism and ADHD, as well as those with other neurodevelopmental conditions like language disorders and intellectual disabilities.

Frequently Asked Questions

What is camouflaging or masking?

Camouflaging or masking refers to the strategies autistic individuals use to conceal their natural behaviors to appear neurotypical, such as maintaining eye contact or rehearsing conversations.

Is camouflaging always negative?

While often linked to increased stress and burnout, camouflaging can sometimes serve as a protective mechanism, reducing the risk of negative social interactions.

What did the study measure to assess stress?

The study measured cortisol levels in hair samples, a biological marker of stress, to objectively assess the impact of camouflaging.

Considering the complexities of camouflaging and its impact on autistic individuals, what steps can society take to foster greater acceptance and understanding of neurodiversity?