Although imposter syndrome doesn't appear in the Diagnostic and Statistical Manual, the persistent feeling of not being good enough can be just as problematic as a diagnosable condition. Despite proven competence and expertise, imposter syndrome causes people to feel like a complete fraud. Rather than feel pride in their achievements, successful people may attribute their success to luck or temporary effort, rather than inherent ability. People with imposter syndrome often present to a therapist's office with a separate issue -- perhaps anxiety or depression. They usually don't want to acknowledge their underlying feelings of inadequacy, even to a therapist. The issue tends to emerge after a few therapy sessions, and successful treatment brings the person's thinking in line with the facts about her achievement so she can feel more authentic.