“They’re going to figure out I don’t really belong here.”
For many high-achievers, that thought is a familiar one. Imposter syndrome is the persistent sense that your accomplishments are a fluke and that exposure is just one mistake away.
For many people, imposter syndrome shows up as a passing thought. For others, it becomes a steady inner voice that shapes how they work, rest, and feel about themselves. And while imposter syndrome is not a diagnosable mental health condition, research suggests it often shows up alongside conditions such as anxiety and depression.
What is imposter syndrome?
The term “imposter phenomenon” was first introduced in 1978 by psychologists Pauline Clance and Suzanne Imes, who noticed a pattern among high-achieving women who could not internalize their own success and instead felt like frauds.
Today, imposter syndrome is understood as a broader experience that can affect anyone, across genders, ethnicities, careers, and life stages. People with imposter syndrome typically:
- Doubt their abilities even when there is clear evidence of competence
- Attribute success to luck, timing, or other people’s help
- Fear being “exposed” as not as smart or capable as others believe
- Set impossibly high standards and feel like failures when they fall short
It is worth noting that imposter syndrome is not a formal psychiatric diagnosis, but it is a recognized psychological pattern.
A 2020 systematic review published in the Journal of General Internal Medicine analyzed 62 peer-reviewed studies covering more than 14,000 participants. The prevalence of imposter syndrome varied widely from 9% to 82%, depending on the population studied and the screening tool used.
A more recent 2025 meta-analysis in BMC Psychology found that among health service providers, the pooled prevalence was about 62%.
The takeaway from these studies is clear: imposter feelings are common, especially in professional, academic, and caregiving environments where the pressure to perform runs high.
What are the signs of imposter syndrome?
Imposter syndrome can look different from person to person, but several patterns tend to show up consistently. You may recognize yourself in some of these signs:
- Chronic self-doubt. Even after positive feedback, you find ways to dismiss it.
- Discounting accomplishments. You credit luck, timing, or other people rather than your own effort or ability.
- Fear of being “found out.” You worry that one mistake will reveal you are not as capable as people think.
- Perfectionism. You hold yourself to impossibly high standards and feel crushed when you fall short.
- Overworking. You compensate for your self-doubt by working harder, longer, or more anxiously than the task requires.
- Avoiding new challenges. You hesitate to apply for promotions, share ideas, or take on visible work because the stakes of “failure” feel too high.
These patterns are not signs of weakness. They are signs that your internal narrative may have drifted out of step with reality.
How is imposter syndrome linked to anxiety and depression?
This is where the mental health connection becomes especially important. While imposter syndrome itself is not a diagnosis, research consistently shows it overlaps with several mental health concerns.
Anxiety, depression, stress, burnout, and low self-esteem as the most significant factors associated with imposter syndrome.
In other words, the same thought patterns that fuel imposter feelings — harsh self-criticism, catastrophic thinking, fear of failure — are also central to conditions like generalized anxiety disorder and major depressive disorder. When those patterns run unchecked, they can:
- Increase chronic stress and disrupt sleep
- Contribute to symptoms of anxiety, including racing thoughts and physical tension
- Feed depressive symptoms like hopelessness, low motivation, and exhaustion
- Lead to burnout, especially in demanding careers
This is why imposter syndrome is worth taking seriously. Left unaddressed, it can wear down your mental health over time, even if the feelings started out as “just” self-doubt.
What causes imposter syndrome?
There is no single cause. Researchers point to a mix of personal, family, and environmental factors that can contribute. Common ones include:
- Family dynamics. Growing up in households that prized achievement, comparison, or constant high performance can set the stage for imposter feelings later.
- Personality traits. Perfectionism, anxiety sensitivity, and a strong inner critic are all associated with imposter syndrome.
- Workplace and academic environments. Highly competitive settings, lack of representation, and unclear feedback can amplify self-doubt.
- Identity and belonging. People who are underrepresented in their field, including women, people of color, and first-generation professionals, often report higher levels of imposter syndrome.
Understanding the roots of your imposter feelings can be a meaningful first step toward addressing them.
How therapy can help with imposter syndrome
Because imposter syndrome is fueled by thought patterns, talk therapy is often the most effective way to address it. Cognitive behavioral therapy (CBT) in particular has a strong evidence base.
CBT is a structured, short-term form of therapy that helps you identify the unhelpful thought patterns driving your self-doubt and replace them with more balanced, realistic ones. A 2024 study published in Education Research and Medical Sciences found that CBT significantly improved mental health, self-esteem, and emotional regulation in students experiencing imposter syndrome.
In therapy, you might work on:
- Recognizing cognitive distortions like all-or-nothing thinking and discounting the positive
- Building self-compassion to soften harsh inner self-talk
- Developing realistic responses to perfectionistic thoughts
- Addressing co-occurring anxiety or depression
- Reconnecting your sense of self-worth to evidence of your real abilities
For people whose imposter feelings are tangled with significant anxiety or depression, therapy can be combined with psychiatric care or medication management for a more complete approach.
At Pacific Mind Health, our therapists offer evidence-based modalities including CBT, dialectical behavior therapy (DBT), and eye-movement desensitization and reprocessing (EMDR) for people navigating self-doubt, perfectionism, and the mental health concerns that can come with them.
For patients whose symptoms extend into clinical anxiety or depression, our psychiatry team can offer medication management and interventional options as part of a broader treatment plan.
When to seek professional support
It can be hard to know when imposter feelings cross the line from “uncomfortable” to “worth talking to someone about.” A few signs that it may be time to reach out:
- You feel persistently anxious, low, or exhausted
- Self-doubt is affecting your work performance or career decisions
- You are avoiding opportunities because you fear failure or exposure
- You are noticing symptoms of depression or anxiety
- Self-criticism is starting to feel unrelenting
If you or someone you know is experiencing a mental health crisis, call or text 988 to reach the Suicide and Crisis Lifeline. US military veterans can press 1 to be connected directly with the Veterans Crisis Line.
Frequently asked questions
Is imposter syndrome a real mental health condition?
Imposter syndrome is not a formal psychiatric diagnosis. However, it is widely recognized in peer-reviewed research as a real psychological pattern that can affect mental health, especially when it overlaps with anxiety, depression, or burnout.
Can imposter syndrome cause anxiety or depression?
Imposter syndrome does not directly cause anxiety or depression, but research shows the two often go hand in hand. The thought patterns that drive imposter feelings — self-criticism, fear of failure, perfectionism — also play a role in anxiety and depression. Over time, unaddressed imposter feelings can contribute to chronic stress and worsen mental health symptoms.
Who is most likely to experience imposter syndrome?
Imposter syndrome can affect anyone, but it is especially common among high-achievers, students, healthcare workers, and people in competitive professional fields. People who are underrepresented in their field, including women, people of color, and first-generation professionals, often report higher levels of imposter feelings.
Does therapy help with imposter syndrome?
Yes. Research suggests that cognitive behavioral therapy (CBT) is particularly effective at addressing the thought patterns behind imposter syndrome. Therapy can help you recognize self-defeating beliefs, build self-compassion, and address any co-occurring anxiety or depression.
How do I know if I should see a therapist for imposter syndrome?
If self-doubt is affecting your sleep, work, mood, or relationships, or if it is paired with symptoms of anxiety or depression, it may be time to talk with a mental health professional. A therapist can help you understand what is driving your imposter feelings and give you tools to respond to them more effectively.
Looking for mental health care services near you?
Pacific Mind Health offers medication management, therapy, and interventional treatments like transcranial magnetic stimulation (TMS) and ketamine and Spravato (esketamine).
Located in Southern California and serving patients across the state, Pacific Mind Health was founded by Joshua Flatow, MD, a board-certified psychiatrist and published research author.
Ready to take the next step? Schedule a free consultation and start your mental health journey today.
