Unmasking at Midlife: When Our Nervous Systems Say No

May 30

For years, I understood my anxiety and depression through the lens of childhood trauma. That made sense. It was a coherent story: what happened to me and around me shaped how I move through the world. I knew my job was to metabolize that history, grieve it, integrate it. I did that work. And continue to do it.

But somewhere in my late thirties, as my body began shifting into perimenopause, something else became undeniable. The unmasking wasn't just about processing old wounds. It was my nervous system finally saying, I cannot do this anymore. Not because I'm broken. But because what I've been asked to do, what all of us have been asked to do in our capitalist patriarchal society, is unsustainable.

I acquired a new understanding of myself at age 40 when I was assessed for ADHD. This was after years of therapy, medication trials, supplements, exercise routines, and more. When the labels for my ongoing symptoms, irritability, mood shifts, anxiety, sleep issues, and then autoimmune concerns, began to feel overwhelming and in need of better organization, the next step was assessment.

During this assessment, my provider asked me, do you want to explore Autistic identity? I remember thinking and saying out loud, how would that help me now, at this time? I was no longer in a workplace setting where accommodation paperwork was the goal. I was lucky enough to have started my own practice at the age of 31.

I set the rhythm and expectations, encompassed all the roles with administrative and clinical components. My ADHD interest and drive, my hyper focus on helping more people… it led me round and round the cycle of burnout.

I didn't accept Autism as a part of my identity until I was 44. And I still found myself questioning it until more patterns became evident, shifting off of some medications revealed the sensory stressors I had quietly filed away as, that's just my anxiety.

But my nervous system has always known. For decades, it has managed an enormous amount of simultaneous input, complexity, and relational labor while cramming itself into structures designed for different neurotypes entirely. Structures built on productivity, capitalism, neurotypical expectations, and the unspoken rule that if you don't fit, you are the problem. Push harder, keep going, you can do it… all phrases that encouraged me to ignore the cycles and warning signs that my body could not keep pace.

Burnout is a familiar term in society, especially in helper and healer professionals. Autistic burnout is one with increasing research, see those cited below. And we need to know more. Next month I will attend an international conference on Autistic Burnout. I am hopeful.

What if what we call a midlife crisis is actually the moment when masking becomes physically impossible? When perimenopause or andropause or other hormonal shifts strip away the neurochemical bandwidth that once made the cramming in, of all of the things, survivable. When our bodies, our nervous systems, finally refuse.

And that refusal isn't pathology. It's information. I love information. I thrive when I can get curious and deep dive and share those discoveries with those I am closest to. Bringing that information to share with others who are seeking a more inclusive frame to view themselves with — that is what keeps me going.

And in the last two years, I have realized I must build in more pauses for myself to breathe, reflect and stop masking, camouflaging and over compensating.

And so, two weekends ago I went to my first unmasking retreat. It was like no other trip I've been on. We were encouraged from weeks before we went to share our needs, accommodations, food, temperature and activity preferences. That alone set us up for being cared for. To help each of us challenge the hyper independence that can be harmful, that can help us mask our own needs from ourselves. I knew two people, one who is an incredible friend, and her husband who helped each of us to continue to lean in and ask for what we needed. The two of them led this group of 10, mostly strangers to one another, through 3 ½ days of seeing our own patterns. How we missed seeing ourselves. How others have seen us. And our efforts to belong or fit with family or friends, to people please, impacted our own identity formation and awareness. I am choosing to look at this as a gift now.

Because exploring this AuDHD identity now, during this phase of life, means I can reassess what is working and not, what my body needs me to do differently, and what my system needs to be whole and free to be me. And I can do it alongside these new friends as we compare our patterns, adaptations and interests.

I don't pretend to have all of the answers, but one I do know, understanding my own neurology better, means I can support my system better. Along the way, the support I find, I will share. I hope that some of these supports may help you or those you know too.