October 21, 2025
Explore the phenomenon of imposter syndrome, its mental health links, and evidence-based ways to overcome self-doubt.
The term imposter syndrome (also known as the impostor phenomenon) refers to the pervasive experience of doubting one’s achievements, attributing success to external factors (such as luck) and living with a persistent fear of being exposed as a fraud, despite evidence of competence.
In this article, we explore the phenomenon of imposter syndrome in depth, examine how it intersects with mental-health conditions including depression, anxiety, ADHD, OCD, borderline personality disorder (BPD), psychosis, eating disorders and more, and highlight practical strategies for clinicians and clients in a mental-health setting.
The phenomenon of imposter syndrome was first described by Pauline R. Clance and Suzanne A. Imes in 1978. Though not classified as a formal psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the International Classification of Diseases (ICD), it is widely recognized in academic and clinical literature as a psychological pattern with significant associations to mental-health outcomes.
Characteristics include:
Though the term may feel colloquial, it has real implications for mental health and professional functioning. Research among medical students found strong associations between imposter phenomenon and both depression (PR = 1.53) and anxiety (PR = 1.317) in one sample.
In work-settings, individuals with imposter syndrome report lower job satisfaction, higher burnout, less organisational citizenship behaviour. Thus, for a clinic like ours in the mental-health space, recognising and addressing the phenomenon is essential — especially when patients present with underlying pathologies.
The relationship between imposter syndrome and mood or anxiety disorders is robust. Studies indicate that the self-critical, fraudulent-feeling mindset contributes to depressive and anxious symptomology.
From a clinical perspective, when a person presents with depression or anxiety, it is prudent to assess whether they are also struggling with imposter feelings — as this can serve as a perpetuating factor in self-esteem, rumination, avoidance, and inhibition of help-seeking.
While direct research on imposter syndrome in ADHD is more limited, the mechanisms overlap: ADHD may lead to inconsistent performance, missed deadlines, or executive-function struggles, which can trigger beliefs of being “less than” peers and heighten imposter feelings. A clinician should explore whether the patient attributes performance gaps to personal incompetence rather than neuro-cognitive variation or organisational factors.
The perfectionism and over-checking common in OCD can dovetail with imposter syndrome’s perfectionist subtype (those who feel they must never make mistakes). For example, the “perfectionist imposter” feels that unless something is flawless they are a fraud. This intersection may increase risk of rumination, avoidance of tasks unless “perfect” and exacerbate OCD cycles.
Individuals with BPD often struggle with identity-instability, feelings of emptiness and self-worth issues. When combined with imposter syndrome, they may feel not only like a fraud externally, but also internally disconnected from a consistent self-identity. Clinically, this may manifest as alternating between over-compensating and self-devaluation, and may require integrated treatment strategies.
The link here is less direct, but still relevant: for individuals in early-phase psychosis or established schizophrenia, self-doubt, stigma, and internalized shame can fuel a belief of being fraudulent or undeserving of support or recovery. Addressing imposter-type cognitions may improve engagement, help-seeking, and adherence.
Eating disorders often involve perfectionism, black-and-white thinking (“If I’m not perfect, I’m worthless”), shame, and high self-criticism. Those same beliefs can underpin imposter syndrome: “I only succeeded because I represented the perfect body/image; if that falters, I am a fraud.” Integrative treatment can benefit from recognizing this overlap.
According to research, there are five commonly described sub-types of imposter syndrome:
For conditions like ADHD, OCD, BPD, psychosis or eating disorders, the treatment of imposter syndrome does not stand alone — rather it is integrated:
Given the overlapping psychological, neurocognitive and social dimensions, an integrative approach is key. At clinics like ours, being located in Chelsea, NYC, we emphasise multidisciplinary perspectives: psychiatry, psychotherapy, nutritional work, executive-function coaching, trauma-informed care, group support. In doing so, we can address imposter syndrome in the context of broader mental-health conditions and life-circumstances rather than silo it as a “self-help” issue.
In addition, from a marketing & SEO standpoint, creating content about “imposter syndrome + ADHD,” “imposter syndrome in anxiety/depression,” or “therapy for imposter syndrome NYC” helps attract the target audience of high-achieving professionals in metropolitan contexts who may silently carry these beliefs while coping with comorbid conditions.
The phenomenon of imposter syndrome is widespread, particularly amongst high-achieving professionals and students, but it remains under-recognized in many clinical settings. Because it often co-occurs with depression, anxiety, ADHD, OCD, eating disorders, BPD and even psychosis-spectrum challenges, it merits attention from integrative mental-health providers. By understanding the cognitive-behavioral underpinnings, recognizing sub-types, integrating with comorbid conditions, and deploying evidence-based strategies, clinicians and clients can jointly dismantle fraudulent-self beliefs, reinforce internalized competence, and unlock fuller growth and well-being.
Integrative Psych is a leading practice in Chelsea, Manhattan, committed to providing integrative, evidence-informed treatment for complex mental-health conditions in adults and emerging adults. Our team of psychiatrists, clinical psychologists, neuropsychologists, executive-function coaches and mindfulness practitioners collaborates to create personalized care plans — because we know mental health is multi-dimensional. If you or someone you know has ever felt like they’re “not good enough,” “faking it,” or “exposed” despite outward success, we welcome you to explore our specialty in perfectionism, imposter syndrome, ADHD, anxiety, mood disorders and beyond. Visit us at Integrative Psych.org or reach out to schedule a consultation in our Chelsea office — together we turn self-doubt into self-mastery.
We're now accepting new patients
