Why Perfectionism and Anxiety Disorders Go Hand-in-Hand

“Other than those people who have suffered greatly because of their perfectionism or the perfectionism of a loved one, the average person has very little understanding of how destructive perfectionism can be,” says Dr. Gordon Flett, a psychologist at York University. While perfectionists may appear to have it together on the surface, underneath the thin veneer of perfection lies deep turmoil that may both drive and result from the pursuit of perfection. Psychologist Thomas S. Greenspon explains, “Perfectionistic people typically believe that they can never be good enough, that mistakes are signs of personal flaws, and that the only route to acceptability as a person is to be perfect.”

Often, this turmoil can be difficult for others to see or even for the perfectionist to acknowledge, as those who suffer often work diligently to maintain a cohesive image of accomplishment and well-being. As a result, perfectionists who are struggling with psychological distress may be less likely to receive the help they need, causing ever-deeper levels of emotional pain that can sometimes end in acts of self-destruction; research has linked perfectionism to nonsuicidal self-injury, and a 2007 study on suicides in Alaska found that 56% of those who took their own lives were described as perfectionists by family and friends.

The specific nature of a perfectionist’s distress can come in many forms, but the common thread that appears to run through perfectionist experiences is anxiety. As Melissa Dahl of New York Magazineelegantly writes, “Perfectionism is more than pushing yourself to do your best to achieve a goal; it’s a reflection of an inner self mired in anxiety.” This anxiety may take the form of any number of disorders, including Generalized Anxiety Disorder, Panic Disorder, and Obsessive Compulsive Disorder, and may arise from either specific triggering events or unknown sources.

The exact relationship between perfectionism and anxiety is complicated; the pursuit of perfection becomes a maladaptive way of coping with the distress of anxiety and perfectionism itself further fuels the anxiety by creating high standards that the anxiety may prevent you from achieving. “Many people with anxiety have difficulty gauging when tasks are completed to their satisfaction,” says clinical psychologist Kathariya Mokrue.

They often say, ‘It’s hard for me to know when I need to stop’ despite their having invested tremendous time and energy. Then what eventually happens next is fatigue and exhaustion, or a loved one pleads for them to stop. Their ‘internal thermometer’ for when to stop is essentially not calibrated properly. Risks associated with being wrong or imperfect are often blown out of proportion, leading to maladaptive anxiety. This anxiety, in turn, serves as a signal to work frantically, and it is only when this signal is drowned out by physical or mental exhaustion that people stop.

Often, procrastination, risk-aversion, frustration, exhaustion, and lack of focus interfere with the ability to complete tasks to your high standards. Ultimately, however, even the successful completion of tasks is not enough to quell the anxiety, which quickly finds a new target. For perfectionists, self-judgment is ever-present and anxiety is constantly looming as you anticipate the ways you can fall short.

Although the roots of some people’s psychological distress remain nebulous, Merely Me, a mental health writer, can trace the exact lineage of both her perfectionism and anxiety. Raised in a poor household by a mom who suffered from schizophrenia, she “grew up thinking that in order to change my life situation some day, that I would not only have to excel in school but that I had to be perfect.” Deeply insecure about her family’s poverty and her mother’s mental illness, she tried desperately to achieve scholastically to compensate for her perceived shortcomings. Simultaneously, a part of her believed that if she were perfect her mom would be cured.

Finish this sentence: If I am not perfect then …? As a child I would finish that sentence with: My mother will never be happy or sane. I will never get out of poverty. I will be unloved. As an adult my thinking is similar to when I was a child. I feel that if I am not perfect that my household will fall apart, my son with autism will regress, and everyone will be disappointed in me. Every perfectionist has their own variation of this theme.

Merely Me starkly describes how perfectionism evolves as a maladaptive coping mechanism to deal with overwhelming and consuming anxiety. Perhaps the most interesting thing about her description is her articulation of perfectionism causing a kind of magical thinking regarding the well-being of others, giving her an illusion of control that was simultaneously damaging for its falsehood and comforting for the sense of control it gave her in a situation where she had none. This, for many, is the locus of perfectionism.