When you’re young masking is a lot easier. Pair that with the ability to drink pots of coffee nonstop throughout the day to self medicate and the time to exercise for at least an hour every day and you can get by pretty effectively. At some point though you get old and busy enough that A: it’s not possible to physically drink enough coffee to self medicate anymore and B: you don’t always have 1-2h a day to devote to exercise. At that point it becomes apparent that you should probably be on medication if you want to remain high functioning.