I spent a lot of years at the front of rooms. Pitching clients, running a company, standing up in front of people who seemed to think I knew what I was doing. And some part of my head was always off to the side, waiting for somebody to stand up and say, okay, who let this guy in?
So, is imposter syndrome worse for autistic and ADHD people? Probably. Nobody has proved it cleanly yet. What little research exists points that way, and I think the reason has a name we already know: masking.
First thing to get straight. Nobody gets diagnosed with imposter syndrome. You won't find it in the diagnostic manuals. The term covers that feeling that your success is a fluke and somebody's about to notice. Most people get a taste of it. Some of us live there.
What the research actually says
The biggest review I found is a 2020 systematic review in the Journal of General Internal Medicine. It pulled together 62 studies and about 14,000 people. Depending on which questionnaire and which cutoff the researchers used, somewhere between 9% and 82% of people screened positive. That spread tells you how fuzzy the thing is.
Two points from that review stuck with me. It turned up in men and women alike, from teenagers to people at the end of their careers. And it often travels with depression and anxiety. Also, as of their search, nobody had published a single study testing a treatment for it. Not one.
On ADHD, there's a 2026 study in Behavioral Sciences that surveyed 500 US college students. Students whose symptom scores suggested they might meet the criteria for ADHD had more imposter feelings, lower self-esteem and more distress about who they are. The researchers traced a path from ADHD symptoms to imposter feelings that ran partly through self-esteem and partly through masking. Caveats, because I hate it when people skip them: college students, self-report, a survey, and nobody in it was clinically assessed for the study.
On autism, I couldn't find a solid study that actually measures imposter syndrome in autistic adults. What I did find was a piece by Dr. Mary Doherty, an autistic doctor and founder of Autistic Doctors International, in Autism Research this year. The title is "People Think I'm a Fraud." A lot of late-diagnosed people will read that title and just nod.
Why masking makes you feel like a fake
Masking is copying how other people act so you pass. The eye contact you force. The face you hold in a meeting while your brain is screaming about the light buzzing overhead. I did it for 50 years without knowing it had a name, or that I was doing it at all. (More on that in what masking is.)
Here's the trap. If the thing people liked was a performance, then the praise goes to the performance. Not to you. So you can't take it in. Somebody says "great talk" and your brain files it under "the act worked again," which is a very different feeling from "I'm good at this."
And the better the act works, the worse it gets. Nobody sees the cost. They see a guy who ran a room. They don't see the hours of recovery after. Or the private certainty that if they saw the real wiring, they'd back away. So you end up feeling like a fraud twice: fake in the room, and fake for hiding how much it took.
There's another piece. A lot of us have very uneven skills. I could pitch a room full of strangers and then put off a simple phone call for days. When you can do the "hard" thing and not the "easy" one, you start to believe the hard thing must have been luck.
I have ADHD, along with BPD and Autism Spectrum Disorder (ASD). It shows most in the way I start things at full speed and then crash (I wrote about that in boom, then crash). If you do have ADHD, add years of report cards and bosses telling you that you're careless or not trying, and you can see how the fraud feeling gets built.
The other fraud feeling: am I even autistic?
Nobody warns you about this one. After a late diagnosis, the doubt flips direction. You stop wondering if you're a fake at work and start wondering if you're a fake autistic.
I got my diagnosis in the middle of a breakdown, in the COVID years, at an age when most people figure you'd have noticed by now. Some days I still catch myself thinking maybe I just wanted an explanation and found one. Maybe I talked my way into it. That's the same voice in different clothes. It does not care what the assessment said.
If you're there, the grief and relief after a late diagnosis post might help. The doubt seems to be common. It doesn't mean the diagnosis was wrong.
What has helped me, a bit
I don't have a cure. Neither does science, apparently. A few things take the edge off.
Writing down what actually happened. Not what the voice says happened. The project shipped. The client came back. The room didn't throw anything. When I look at it on paper, the "fluke" theory needs a lot of flukes.
Dropping the mask on purpose, in small places. Saying "I need a minute" instead of pretending I'm fine. Not forcing the eye contact. Then noticing that people mostly stayed. That's evidence too, and the voice hates it.
Knowing the pattern has a name. Sounds small. For me it was a big deal to learn that the fraud feeling and the masking were connected, and that neither one was proof I was broken.
Saying it out loud to someone. A therapist, or anyone who won't immediately try to talk you out of it. The voice is louder in your own head than in a room.
If the fraud feeling has started to sit on top of real depression or anxiety, that's a different conversation. Talk to your doctor or a psychologist. In Québec, Info-Social 811 is a place to start.
I still feel it, by the way. I felt it writing this. Somebody is going to read it and think, who does this guy think he is. Fair enough. I'm posting it anyway.
If the fraud feeling has turned into something heavier, the Get help now page has the numbers for your country.