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Luke Row is a BACP registered psychodynamic therapist in Croydon, South London, with advanced training at Tavistock Relationships. He works with individuals who've tried managing their symptoms and couples tired of managing each other, people ready to understand what's underneath. Book a session →

Human Experience
It's January. You've made the list. By February, you'll have quietly abandoned most of it. This isn't a failure of willpower. It's something else entirely.

Human Experience
Someone you've been dating for three weeks doesn't text back for two hours and your brain goes: 'They hate me. I'll die alone.' That's BPD.

Human Experience
You're drowning, but everyone else is looking to you for a life raft. That's the particular hell of leadership when your mental health is falling apart.

You've become so good at reading the room that you forgot you were doing it. The scanning, the adjusting, the constant translation - it feels like breathing now. Automatic. Invisible. The effort only shows up as exhaustion you can't quite explain.
You learned the rules. Make eye contact, but not too much. Laugh when they laugh. Mirror their body language. Track the conversation for the right moment to contribute. Perform interest in small talk. Know when a question is genuine and when it's a ritual. Know when silence is comfortable and when it's awkward.
None of this is intuitive for you. Every piece of it was studied, reverse-engineered from observation, practised until it looked natural. And it does look natural - that's the problem. You pass so well that nobody knows what it costs.
You know. You know because by the time you get home you can barely speak. Because weekends disappear into recovery from the week. Because you cancel plans not out of preference but genuine incapacity. Because there is nothing left.
Imagine spending every waking moment speaking a foreign language. Not badly - fluently, even. But it's not your first language. Every sentence requires a fraction of a second of translation. Every joke needs processing. Every idiom is learned rather than felt. You can do it. You've been doing it your entire life. But it's never effortless, and it's never will be.
That's what social interaction feels like when you're autistic and passing. The neurotypical world operates on a set of unwritten rules that everyone else seems to absorb through osmosis. You had to learn them the hard way - through mistakes, through rejection, through the slow, painful accumulation of data about what's expected and what gets punished.
And the punishment for getting it wrong was real. Being called weird. Being excluded. Being the last one picked, the one people tolerated rather than wanted. So you got better at the performance. You studied people like a subject, and you passed the exam. But you never stopped studying.
The mask works. That's the cruel part. People like the masked version of you. They find you charming, or interesting, or easy to be around. The irony is heavy: the version of you that people accept isn't you. It's a sophisticated approximation built from years of careful observation.
And because the mask works, you start to lose track of what's underneath it. You've been performing for so long that the boundaries between the performance and the person have blurred. You're not sure which of your preferences are real and which are borrowed. You don't know if you actually enjoy the things you say you enjoy or if you chose them because they were safe, normal, unremarkable.
The mask doesn't just hide you from other people. It hides you from yourself.
This is what makes late diagnosis so destabilising. When someone says "you might be autistic" and it clicks - when the entire history of your life suddenly rearranges itself around this new information - the relief is enormous. But so is the loss. Because now you have to ask: who am I without the mask? And you might not know.
When the mask becomes too heavy, something breaks. Not dramatically - slowly, quietly, like a machine running past its limits. Skills you relied on start to fail. The social script that usually runs smoothly starts glitching. Sensory sensitivity, always there but manageable, becomes overwhelming. You lose capacity you thought was permanent.
This is autistic burnout, and it's often misdiagnosed as depression. The symptoms overlap - withdrawal, exhaustion, loss of motivation, inability to function at your usual level. But the cause is different. Depression is a mood disorder. Autistic burnout is what happens when you've been spending more energy than you have, for longer than you can sustain, pretending to be something you're not.
The treatment for depression is often activation - getting out, socialising, building routine. The treatment for autistic burnout is the opposite: reducing demands, stopping the performance, allowing recovery. Getting it wrong makes things worse.
And because autistic burnout is poorly understood - because most professionals still think of autism as something that affects children - many autistic adults cycle through burnout repeatedly, each time more depleted, each time recovering less fully, without ever understanding what's happening to them.
Underneath the exhaustion, there's usually grief. For the years spent performing. For the friendships that were never quite real because the person they liked wasn't quite real. For the energy spent learning rules that other people don't even know exist. For the version of your life that might have been possible if you'd known sooner, if anyone had noticed, if the world was built differently.
There's grief for the child who tried so hard to fit in and learned that the price of belonging was hiding. Who understood early that their natural way of being - the stimming, the intensity, the need for routine, the difficulty with transitions - was unacceptable. Who buried those parts so effectively that even they forgot they existed.
And there's anger, too. At the professionals who missed it. At the family members who explained it away. At a society that demands conformity and then pathologises the effort it takes to achieve it.
The therapy room can be another place to perform. Sitting in the right position, making the right amount of eye contact, saying insightful things at the right pace. Many autistic people arrive in therapy already masked, giving the therapist the version they think is wanted.
What's needed is the opposite. A space where you can stop performing. Where eye contact is optional, where silence doesn't need filling, where you can stim or move or look away without it being interpreted as resistance or avoidance.
The work isn't about learning to pass better. It's about what happens when you stop passing. Who you are underneath the decades of adaptation. What you actually want, feel, need, when you're not running the translation software.
This is uncomfortable, because the mask has been there so long it feels like skin. Taking it off can feel like dissolution. But underneath the performance, there is someone. Someone who has been waiting, probably longer than they realise, to be met.
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