Burnout happens when people with hidden disabilities (e.g., ADHD, PTSD, chronic illness) constantly mask symptoms or mimic workplace norms to appear “typical.” This ongoing effort creates chronic stress that can lead to burnout.
Why it happens:
- Continuous self-monitoring and behavior adjustment
- Pressure to meet unspoken workplace expectations
- Lack of accommodations, increasing mental and physical strain
Common symptoms:
- Persistent fatigue and reduced daily functioning
- Cognitive overload or loss of skills
- Anxiety, emotional shutdown, or withdrawal
Prevention and recovery:
- Request accommodations (flexible schedules, remote work, reduced sensory input)
- Set boundaries to limit constant masking
- Seek early support (therapy, peer groups, medical care)
Long-term sustainability depends on reducing masking—not just managing burnout.
Work in and of itself can be exhausting, but things can get even more challenging when you have a disability or chronic health condition, especially if it isn’t immediately visible or known to your coworkers. Not only do you have to manage the specifics of your condition, but you also have to worry about every little thing you say or do to make sure you seem “normal” at work.
This constant performance or masking may be essential to feeling safe and accepted in your workplace. However, for those with hidden disabilities, it often comes with a high cost and can even put you on the path to burnout, which brings its own host of physical and mental health challenges.
To survive at work while protecting your health, you need to understand the intricate relationship between hidden disabilities, masking, and burnout in the workplace. Here’s what you need to know.
What Are Hidden Disabilities?
An invisible or hidden disability is a neurological, psychological, or physical condition that impacts functioning but can’t be immediately detected through external observation. You may look at a person with a hidden disability and not realize they have a disability of any kind. This could be because they don’t have any physical markers, have received a misdiagnosis, or purposefully try to keep the truth of their disability to themselves.
Many different kinds of health conditions can constitute a hidden disability. Serious mental health conditions that require intensive or ongoing treatment, such as Attention-Deficit/Hyperactivity Disorder (ADHD), Post-Traumatic Stress Disorder (PTSD), bipolar disorder, and depression, can all be considered a hidden disability. Similarly, a huge number of physical conditions, encompassing everything from chronic pain, neurological issues like epilepsy, autoimmune disorders, gastrointestinal challenges, and more, can also be hidden disabilities.
Despite their extensive differences, these kinds of conditions (and many, many more) share two characteristics: they can be serious enough to be debilitating for those who experience them, and others may not realize someone even has them.
Although not immediately visible to other people, hidden or invisible disabilities can still impact daily functioning and present similar challenges or impacts on your life as a more visible disability. Additional problems unique to those with hidden disabilities can arise due to the invisible nature of their specific condition. You may experience emotional tensions or difficulties in relationships or at work since you don’t “seem disabled” or you don’t appear to be struggling even when you are.
What Is Masking or Camouflaging?
Masking or camouflaging is the practice of concealing signs of a disability to better fit into various settings, including the workplace. It’s common among neurodivergent individuals who are autistic or have ADHD. Still, people with other hidden disabilities may also use these adaptive survival strategies to make it through the workday.
Though masking looks different for everyone depending on their unique circumstances, some common associated behaviors include:
- Rehearsing or scripting conversations in advance.
- Suppressing or hiding symptoms of a health condition.
- Mirroring coworkers’ behaviors, from their speech to their manner of dress.
Masking and camouflaging are all about protecting yourself and surviving the challenges of your environment. Any behavior that you use to hide your disability or health condition and “better” assimilate into the conventions of your workplace may be a form of masking.
Workplace Expectations That Reinforce Masking
Unfortunately, many workplace expectations related to productivity and communication styles can reinforce the need or drive to mask. These very cultural norms that dictate what it means to be professional are entirely unspoken, but deeply felt.
That includes foundational workplace traditions on which relationships are built, such as shaking hands when meeting someone new or making eye contact while speaking. It also includes the “right” kind of social participation with coworkers (such as not sharing “too much” about intense interests), as well as being constantly available to colleagues, management, and customers or clients, even when it’s difficult for you to do so.
These narrow definitions of professionalism and success in the workplace can easily, although often unintentionally, exclude individuals who are neurodivergent or chronically ill, or who have some kind of hidden disability. You may feel compelled to act or behave in a certain way, with the underlying threat that if you don’t, you’ll experience negative consequences as a result. A 2019 study of autistic adults found that people most commonly mask at work to facilitate better communication, perform better in their roles, support collaboration with colleagues, and ensure that colleagues take them seriously. These individuals worry they won’t be viewed as strong performers or collaborators in the workplace if they don’t mask.
You may worry about the consequences of not masking, which can range from the intangible (such as your coworkers or employers viewing you as “weird” or in a negative light) to the material (such as being overlooked for a raise or promotion). While these are important factors to take into account while navigating the workplace with a hidden disability, it’s also important to consider how chronic masking can affect you in other ways, especially when it comes to your health.
The Link Between Masking and Burnout
Burnout is “chronic workplace stress that has not been successfully managed,” and it’s a primary impact of long-term masking, with implications for both your professional life and your overall health. Among autistic adults, prolonged masking is associated with burnout due to the significant and constant effort required to maintain the mask effectively. Burnout, in turn, has been linked to myriad outcomes for these individuals.
At work, the consequences of burnout go far beyond reduced productivity or having trouble focusing. There’s a cumulative emotional and physical toll that can leave you deeply unsatisfied with your work life, degrade the quality of your work, and harm your professional reputation. In serious cases, it may require you to take a break from working to focus on your mental health. Not only does this present its own set of challenges you have to navigate when returning to the workforce, but it can also have implications for your long-term career trajectory and earning potential.
How Chronic Stress Impacts Mental and Physical Health
The effects of burnout aren’t limited to the professional sphere; they can also have serious impacts on both mental and physical health. Remember, burnout is unchecked, chronic stress. When your stress response (your body’s fight-or-flight response) remains activated for extended periods of time, you experience long-term exposure to hormones like cortisol that disrupt and deregulate your body’s natural processes.
This prolonged cortisol exposure can have negative effects on virtually every body system, including the endocrine, gastrointestinal, and nervous systems. Stress can disrupt your immune system’s response, leading to increased inflammation throughout the body. This interruption is thought to contribute to the development of many chronic conditions, including anxiety, depression, metabolic disorders, and autoimmune disorders. Chronic stress can even change how your brain functions, strengthening the parts that respond to stress and weakening those responsible for high-level tasks.
Beyond this, chronic stress can result in sleep troubles, as your body struggles to relax enough to achieve high-quality rest. Since your body’s ability to cope with stress decreases with poor sleep, this can create a feedback loop called the stress-sleep cycle.
These effects can be difficult for anyone to cope with, but they may be a particular concern if you’re already experiencing or managing a serious health condition or disability. Depending on the nature of your condition, chronic stress could even cause a flare-up of your health condition, exacerbate existing symptoms, or contribute to the development of new symptoms.
What Burnout Looks Like for People with Hidden Disabilities
Each person has a unique experience with chronic stress, but burnout tends to look different if you have a hidden disability than if you don’t. This distinction matters because hidden disability burnout rarely arrives as a single breaking point. Instead, it tends to accumulate quietly, each day of masking adding to a cognitive and emotional debt that compounds over time. By the time symptoms become obvious, you’ve already been running on empty for months.
Some of the most common signs of burnout include fatigue, changes in appetite or eating habits, and headaches. While you may experience these symptoms, you may also experience symptoms specific to burnout in neurodivergent individuals and people with hidden disabilities, such as:
- Intense exhaustion that interferes with daily acts of living
- Loss of skills, including communication skills
- Emotional shutdown, detachment, or flatness
- Overstimulation
- Cognitive overload, such as difficulty making decisions
- Becoming overwhelmed more easily
- Feelings of impending danger
- Reduced overall quality of life
Depending on the nature of your disability, you may experience some, none, or all of these symptoms (and possibly others) when you start to burn out. Even if the root cause of your burnout is workplace masking, these symptoms may feel more intense and serious if you mask in other settings as well. If you don’t have an opportunity to take your mask off, it’s difficult to give your brain and body the relaxation they need to thrive.
When “High Functioning” Becomes Unsustainable
Signs and symptoms of burnout can get further complicated if you’ve previously received or adopted the “high functioning” label. The now-outdated terms high and low functioning have been primarily used to describe the level of support that autistic individuals need, with high-functioning people not needing as much care. One of the primary reasons these labels have fallen out of use is that they diminish the true experiences of autistic people.
If you have autism and can work and live independently, but constantly experience burnout, being called high functioning can erase the reality of what your life is like. For some people, being deemed high functioning creates a high standard they feel compelled to meet, while being deemed low functioning can compel others to overcompensate or work harder than necessary to prove the label wrong. Both situations are unsustainable and harmful, and may even have serious consequences, such as a mental breakdown, that require intensive support.
Functioning labels can also be used when describing other health conditions, including high-functioning depression. Though this label isn’t problematic in this context, high-functioning depression or other mental health conditions can be similarly unsustainable. You may seem fine on the outside while deeply struggling inside. You could become unable to function due to the symptoms of your condition, as well as burnout. This makes it vital to get treatment before your symptoms, whatever their cause, develop and intensify.
The Importance of Early Intervention and Mental Health Support
If you’re experiencing burnout, it’s crucial to get support as soon as possible. For people with hidden disabilities, this is especially pressing. Years of masking can make burnout feel like background noise — something to push through rather than a signal that something is wrong. Many people don’t seek support until they’ve reached a crisis point, precisely because they’ve spent so long convincing themselves and others that they’re fine. Catching burnout earlier, before the masking-stress cycle fully compounds, makes recovery faster and less disruptive to every area of life.
Here are ways you can take a proactive approach to safeguarding your mental health that puts you in the best possible position to overcome burnout.
Types of Support That Can Help
Many different types of support can help you on your recovery journey. Some options to consider include:
- Therapy: Mental health support through individual therapy or counseling can be invaluable in healing from burnout. You may also want to explore something like cognitive behavioral therapy or trauma-informed therapy, as a more specialized modality might be a better fit for your needs.
- Peer support groups: Consider joining a group therapy program or a peer support group in your area. These groups provide an opportunity to connect with others who are experiencing similar challenges or difficulties, which can be comforting and also set the stage for developing lasting relationships.
- Medication management: In some situations, medication may be beneficial or even necessary to get your health back on track. You’ll need to discuss medication management options with your healthcare provider to determine if you’re a good candidate for this kind of support, as well as determine what kind and dosage of medication is best for you.
When seeking treatment, it’s important to work with qualified healthcare providers, particularly those who are well-versed in mental health support. A knowledgeable healthcare provider can help you find the treatments that will be most effective for your needs and circumstances. They can also help you plan in other areas of your life to further support your recovery. This may involve developing health habits to practice at home and seeking formal workplace accommodations. The right care team will also support adjusting your treatments as time goes on and your circumstances change.
Workplace Accommodations That Make a Difference
In addition to prioritizing your mental health outside of work, it’s important to take care of yourself at work, too. One of the best ways to do so is to seek accommodations for your disability.
Accommodations aren’t a sign of weakness, nor are they special treatment from your employer. They’re tools you have a right to use to ensure that doing your job is sustainable for you. Further, under the Americans with Disabilities Act (ADA), you’re entitled to request reasonable accommodations from your employer so you’re equipped to do your job to the same extent as someone who doesn’t have a disability.
The exact kind of accommodation you request will depend on what would be most beneficial for your health. Some common accommodations helpful for individuals with hidden disabilities include:
- Flexible work hours or schedules to account for fluctuations in energy (especially beneficial if hours can be shifted on a “when-needed” basis, rather than pre-planned)
- Permission to take short breaks, in addition to longer breaks or lunches, without scrutiny to rest and reset
- Remote or hybrid work options, if possible, to reduce sensory overload or strain and exhaustion from socializing
- Modified or reduced expectations for meetings (i.e., not being required to have your camera on if attending remotely, sharing the meeting agenda in advance)
- A workplace designed to reduce your particular sensory triggers (i.e., having low lights, a fragrance-free space, or a quiet workspace)
- Access to assistive tools, like noise-canceling headphones, text-to-speech software, or fidget tools
- Flexibility with socializing at work, such as being able to opt out of certain team-building events
Use these as a starting point; the right accommodation is whatever actually makes your job sustainable for you. If none of the above accommodations resonate with you, don’t hesitate to request something else that does. Accommodations should support you in your role, so what works well for one person might not be the right fit for you and vice versa.
How To Request Accommodations
That said, actually requesting accommodations isn’t always as easy as it sounds. The process is inherently vulnerable, and if you feel any amount of hesitation or anxiety about it, that’s completely normal and okay. If you haven’t disclosed your disability to anyone at work or if you’re worried people won’t believe you actually have a disability that requires accommodation, these feelings may be further amplified.
Here are a few tips that can help make the process of requesting accommodations a little easier:
- Start the conversation around accommodations with someone you trust, such as a reliable HR representative or a supportive manager.
- Frame your request around protecting your productivity, work quality, and overall well-being at work.
- Document your needs, as well as the conversations you have at work about how accommodations can support those needs (though keep in mind you don’t have to disclose a specific diagnosis if you don’t care to).
- Come prepared with several suggestions or possibilities of accommodations.
- Request a trial period for your accommodations, with a formal check-in several weeks or months later to evaluate how things are going.
- Be honest and forthcoming about what you need; don’t negotiate against yourself before speaking with your employer.
Requesting accommodations can be challenging, but it’s important to take care of yourself and your health. As long as you believe your employer will be receptive and that requesting accommodations won’t cause additional problems at work, it’s likely worth initiating the conversation and seeing what comes of it.
How Employers Can Prevent Burnout in Employees With Hidden Disabilities
While employees can take steps to both treat and prevent burnout in themselves, it’s arguably even more important for employers to be proactive in burnout prevention in the workplace. Doing so creates a more sustainable, inclusive environment for all employees.
Some effective burnout prevention strategies include:
- Communicating clearly and directly about everything, especially expectations, job requirements, performance, and any policy or process changes
- Offering alternatives to meetings, such as asynchronous updates, written meeting recaps or summaries, and recordings for employees to watch later
- Ensuring workflows are well-defined, consistent, and thoroughly documented
- Creating policies and offering benefits and perks that benefit employee wellness, such as flexible leave and wellness days
- Ensuring workloads and performance success metrics are well-defined and achievable for employees
- Encouraging and modeling healthy boundaries around availability while discouraging a culture of constant urgency
- Never requiring employees to participate in “mandatory fun,” especially outside of standard working hours
- Regularly checking in with employees about how they’re doing at work and assessing their workload and capacity, not just their performance
- Creating an environment of psychological safety so employees can ask for help and disclose their needs
- Proactively sharing information with employees about how to request accommodations or seek out support
Some of these strategies will take time to implement, and not all will fit every workplace culture. But actively working to reduce staff burnout benefits everyone at work, including and especially employees with hidden disabilities. That makes it a worthwhile undertaking, despite the effort and patience required.
Resources for People With Hidden Disabilities
Having a hidden disability can make it more difficult for you to navigate the working world. However, masking isn’t your only option to survive your job, and it may end up doing more harm than good. Your health and well-being matter, and you know best what your needs are. Do what you need to take care of yourself so that you’re in a position not just to survive, but to thrive both in and out of the workplace.
With that in mind, there are even more resources available to assist individuals with hidden disabilities. Please see the following resources for additional information and support:
Workplace and Employee Support Programs
- Equal Employment Opportunity Commission (EEOC): The EEOC enforces federal laws that prohibit workplace discrimination, including protections for individuals with disabilities. Their resources help employees understand their rights and outline steps for filing complaints if discrimination occurs.
- Mental Health America (MHA): A leading nonprofit offering screening tools, workplace mental health resources, and educational materials. MHA also advocates for policies that support mental health in professional environments.
- National Alliance on Mental Illness (NAMI): Provides education, support groups, and workplace mental health resources. NAMI’s programs are widely accessible and often available at the local level.
- The Sylvia Brafman Mental Health Center: The Sylvia Brafman Mental Health Center offers individualized, evidence-based treatment for individuals experiencing mental health challenges, including anxiety, depression, trauma, and burnout. Their programs emphasize early intervention, therapeutic support, and long-term care strategies, helping individuals manage symptoms in a way that aligns with both personal well-being and professional responsibilities.
Government and National Organizations
- National Council on Disability (NCD): An independent federal agency that provides policy recommendations and resources aimed at improving the lives of people with disabilities. NCD publishes research on workplace inclusion, mental health, and accessibility standards.
- ADA National Network: Offers guidance on rights and responsibilities under the Americans with Disabilities Act (ADA), including workplace accommodations and disclosure. Their regional centers provide free, confidential support.
- Substance Abuse and Mental Health Services Administration (SAMHSA): A key resource for mental health services, treatment locators, and educational materials. SAMHSA also offers a national helpline for individuals facing mental health or substance use challenges.
- Job Accommodation Network (JAN): Funded by the U.S. Department of Labor, JAN provides practical guidance on workplace accommodations, including examples tailored to specific conditions and job roles.
University and Educational Resources
- Stanford Office of Accessible Education (OAE): Provides a curated list of national disability organizations and resources, along with guidance on academic and workplace accommodations.
- Association on Higher Education and Disability (AHEAD): A professional organization that supports disability services in higher education and offers resources that often extend into early career and workplace transitions.
- Disability Rights Education & Defense Fund (DREDF): Focuses on legal advocacy, education, and training related to disability rights, including employment protections and accessibility standards.