Perfectionism and Mental Health
Perfectionism has been described as a double-edged sword.
For some people, setting high expectations motivates them to keep learning and improving.
But often people find that perfectionism holds them back. It makes them feel overwhelmed, because they’re trying to do everything just right. Perfectionism can also get people feeling stuck, afraid to make mistakes or try new things.
The research on perfectionism and mental health definitely raises some red flags.
Perfectionism has been linked with increased rates of mental health concerns, particularly anxiety, depression, obsessive-compulsive disorder (OCD), and eating disorders.
These studies are correlational, which means that we can’t say for sure that perfectionism directly causes mental health issues. But perfectionism has been identified as a potential risk factor.
In this article, I’ll explore how perfectionism overlaps with several mental health concerns.
What is Perfectionism?
Perfectionism involves striving to meet high standards of success, whether that’s at work, school, or home. People living with perfectionism place a lot of pressure on themselves to reach their goals. Because they often link their self-worth to their accomplishments.
And they tend to be highly self-critical, focusing on their flaws instead of their strengths. Perfectionism is often associated with fears of failing, disappointing others, or being seen as “not good enough.”
Perfectionism can become an issue when it interferes with a person’s daily life, sucks up their time and energy, or gets in the way of their relationships. This is called maladaptive perfectionism.
And there are often negative emotions that come with perfectionism, like anxiety, exhaustion, shame, guilt, frustration, or irritability. Particularly when people who experience perfectionism feel like they’re not living up to expectations.
Perfectionism and Anxiety
Anxiety involves having intense fears or worries about one or more situations. For example, people may worry about something bad happening to their loved ones, developing a serious health issue, or doing something embarrassing.
People living with anxiety often have physical symptoms, like racing heart rate, shortness of breath, chest pains, muscle tension, dizziness, restlessness, stomach aches, or difficulty sleeping.
The high standards of perfectionism can contribute to feelings of anxiety, particularly when people have big deadlines or important events coming up.
Also, anxiety and perfectionism can both involve rumination, which happens when people get stuck thinking about the same things over and over again.
Some common areas of rumination for anxiety and perfectionism include:
“What if” questions about the future (e.g., “What if I fail this test?”)
Worst-case scenarios (e.g., “What if something bad happens to my family?”)
Wondering what other people are thinking (e.g., “Did they think that was stupid?”)
Dwelling on past mistakes
Questioning their decisions
Avoidance is another aspect of both anxiety and perfectionism. People living with these issues often stay away from situations that stress them out, like going new places or trying new things.
Perfectionism and Depression
Depression is defined by low mood and sadness, along with fatigue, a loss of interest in one’s usual activities, difficulties concentrating, and feelings of guilt or worthlessness.
One area of overlap between depression and perfectionism is negative thinking. With both issues, people regularly dwell on past mistakes and expect negative outcomes going forward.
People experiencing depression or perfectionism also tend to be very self-critical. They may label themselves in unkind ways, like calling themselves a "loser" or a "failure." They frequently have trouble seeing their strengths or acknowledging when positive moments happen.
With perfectionism, like depression, people often struggle with feelings of worthlessness. Especially when they’re not achieving what they think they should.
People facing depression or perfectionism can also have difficulty taking action. They may put off making decisions or getting things done because they feel overwhelmed by everything involved. Or hopeless about reaching their goals.
Perfectionism and OCD
There are several areas of overlap between maladaptive perfectionism and OCD.
People living with OCD experience unwanted, intrusive thoughts that are upsetting to them. They then feel compelled to perform repetitive behaviours to offset those thoughts. For example, a person who is worried about causing a fire may repeatedly check that their stove is turned off.
People experiencing OCD typically know that their rituals are unreasonable, but have trouble stopping them.
With both OCD and perfectionism, people tend to have issues coping with uncertainty. They often feel a need for control and have trouble adapting to change.
Perfectionism, OCD, and anxiety can all involve seeking reassurance to deal with unknown situations. People may repeatedly ask questions (“Are you sure this is safe?”), check things over (e.g., checking the stove), or do extensive research in an effort to feel more confident.
OCD and perfectionism can also involve a preoccupation with maintaining order, following rules, and checking details. People often work excessively on tasks or projects until things feel “just right.”
And they can get trapped in rigid routines (like cleaning the same area of their home several times a day) because they feel uncomfortable when things aren’t done to specific standards.
Perfectionism and Eating Disorders
Eating disorders involve issues in a one’s eating behaviours that negatively impact their physical health or day-to-day life.
Like perfectionism, eating disorders are often associated with unrealistic standards; in this case, related to one’s weight, body size, or eating habits. As people strive to meet these standards, they often get more and more restrictive over time.
Eating disorders and perfectionism can both involve a need to feel “in control” by following strict rules. They also tend to involve all-or-nothing thinking, such as black-and-white beliefs about what constitutes “healthy” versus “unhealthy” foods.
High levels of self-criticism are common with both eating disorders and perfectionism. People experiencing disordered eating may beat themselves up for how they look or what they eat. And get upset when they can’t reach the impossibly high standards they’ve set for themselves. Mistakes or setbacks are typically viewed as personal failures.
With both eating disorders and perfectionism, people tend to be concerned with how they appear to others. People living with eating disorders often describe feeling a sense of pressure to look or eat a certain way. They may initially receive compliments or praise on their appearance, then take unhelpful behaviours even further to receive ongoing validation.
People experiencing either perfectionism or eating disorders also tend to compare themselves negatively to others, including their friends or people they see on social media.
Addressing Red Flags
While not everyone who deals with perfectionism will develop a mental health issue, it’s been consistently identified as a risk factor. So if perfectionism is negatively impacting your life, it’s important to take a proactive approach to addressing it.
About Dr. Marnie Rogers-de Jong
My goal is to help people who feel overwhelmed by anxiety and perfectionism overcome their fears, embrace their unique strengths, and feel more content with who they are. I’m a Registered Doctoral Psychologist with a PhD in Counselling Psychology. I offer in-person counselling in Saskatoon and video counselling across Saskatchewan and Alberta.
Learn more about counselling for perfectionism.
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