The Hidden Cost of Unmasking: When Survival Strategies Weigh on the Body

When I sat down with Kara on my podcast Notes to My Nervous System, we explored a word that carries both freedom and exhaustion: unmasking.

For many autistic individuals, masking is the learned habit of camouflaging—suppressing stims, mimicking social cues, or hiding sensory sensitivities—in order to survive in a world built for neurotypicals. On the surface, masking can look like resilience. But beneath it, the nervous system is running a marathon every single day.

Unmasking, then, is the process of taking that mask off—choosing authenticity over performance. It’s a radical act of self-preservation, but it doesn’t come without cost.

What Happens in the Body When We Mask

Think about your body when you’re bracing through a thunderstorm. Shoulders tight. Heart racing. Breathing shallow. That’s the physiological state many autistic people live in when masking: constant hypervigilance.

Kara, who has both lived experience and a background in mental health nursing, explained it perfectly: “The body is in fight-or-flight so long, it forgets how to power down.” Chronic masking drives the stress response system into overdrive. Cortisol and adrenaline flood the body. Over time, this contributes to:

• Muscle pain, fatigue, and autoimmune flare-ups

• Digestive issues from a gut locked in fight-or-flight

• Anxiety, panic, and insomnia

• Burnout so deep it can take weeks—or months—to recover

This is not just emotional stress. It is embodied stress—etched into muscles, hormones, and organs.

The Courage (and Cost) of Unmasking

Kara compared unmasking to coming out. Both involve peeling back a carefully constructed survival layer. Both are liberating and terrifying.

When someone unmasks, they risk misunderstanding, rejection, even job loss (Kara shared stories of losing employment after disclosing autism). And yet, unmasking is also the path to nervous system relief. It allows the body to relax, even if just a little.

But here’s the paradox: stepping into authenticity can initially increase stress. Imagine walking into work without the armor you’ve worn for years. Your body is exposed, your nervous system raw. The adjustment period is real.

Why This Matters for All of Us

Even if you’re not autistic, this conversation matters. Many of us wear masks—at work, in relationships, even at home. Pretending we’re fine when we’re not. Shrugging off exhaustion. Smiling through grief.

Every mask has a cost. And every nervous system has a limit.

Unmasking invites us to ask: Where am I over-performing at the expense of my body? Where do I need to soften into authenticity?

Supporting Neurodiverse Friends, Clients, and Family

Kara and I talked about practical ways to make unmasking safer:

• Ask about sensory needs rather than assuming.

• Notice nonverbal cues (like a hoodie pulled up) that signal overwhelm.

• Offer flexibility instead of rigid expectations.

• Use grounding tools—like weighted blankets, fidget objects, or the 5-4-3-2-1 technique—to help regulate the nervous system in real time.

Most importantly: believe people when they say what they need.

A Takeaway for Your Nervous System

If masking has been your survival strategy—whether for autism, trauma, or simply to “get by”—your body deserves moments of rest. Try this today: unclench your jaw, roll your shoulders, breathe deeply, and remind yourself: It’s safe to be me here.

Because healing starts when the mask comes off.

Learn more about the podcast at https://youtu.be/eNdN7mWHRZU?si=RDyCII2m-7uReClS

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