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Poor Mental Health and Perfectionism

Haley's clients at Millennial Pink Media, LLC include The Meadowglade, an outpatient mental health treatment center. This blog post first appeared for The Meadowglade in January 2020.

“It has to be perfect.”

“Anything less than perfection is a failure.”

“I should never make mistakes.”

Ever notice these thoughts running through your head? You may have a problem with perfectionism.

The APA describes perfectionism as ” believing that others will value you only if you are perfect.” Perfectionism can drive you to go to extremes to meet your own impossible standards or to keep up flawless appearances despite feeling anything but perfect.

Every trait has two sides. On the one hand, perfectionism can earn you praise at work, make you a great entertainer and drive you to achieve your goals. However, perfectionism can also be a causational factor of poor mental health, including anxiety and mood disorders.

Here’s how to recognize when perfectionism has become a problem in your life — and the steps you can take to get your mental health back on track.


Between meritocracy at work and school and images of perfection on social media, the modern world is full of pressures to keep up appearances — and those pressures are growing. According to research conducted at the University of British Columbia, measures of perfectionism on college campuses doubled between 1989 and 2016.

Sadly, this growing trend toward perfectionism is making us sick, both mentally and physically: Ariana Huffington, the founder of The Huffington Post, famously overworked herself to the point of collapse back in 2007 and has since become an advocate for better sleep and work-life balance. Psychologist Paul Hewitt, co-author of Perfectionism: A Relational Approach to Conceptualization, Assessment, and Treatment, told Vox that one college student became so obsessed with earning an A+ in a difficult course that he contemplated suicide.

Mental health professionals now recognize that perfectionism is a fast-track to depression, anxiety and eating disorders, among other health problems. Perfectionism affects our thoughts and behaviors to the point where it can cause clinical psychopathology if left untreated.


In short, perfectionists strive toward impossibly high standards to the point of exhaustion and/or mental distress.

A perfectionist might avoid tasks they know they cannot complete perfectly, or spend too much time on a task to ensure they complete it without error. They may believe that nothing they do is worthwhile unless it is perfect, constantly compare themselves to others or feel they should not need to work so hard to achieve their goals.

So, how can you tell if perfectionism is a significant problem in your life? If you’re a perfectionist, you may identify with the thoughts and behaviors of other perfectionists. Here are some examples of perfectionistic behaviors you may relate to if you, too, struggle with perfectionism:

  • Spending 30 minutes writing and rewriting a short email to “get it right”

  • Finding yourself excessively envious of a friend or colleague’s success

  • Skipping a class or avoiding a task at work because it’s difficult to complete to perfection

  • Avoiding playing a game or sport for fear of being shown up as less than perfect


It’s also possible to be a perfectionist in some areas of life, but not others (though this can still be just as harmful to your mental health as full-time perfectionism). Psychologists have identified a few distinct types of perfectionism to explain this phenomenon. Though they lead to similar thoughts and behaviors, their motives and outcomes may differ.

Types of perfectionism include:

  • Personal standards perfectionism. These perfectionists are driven by high personal standards, rather than external motivating factors. This type of perfectionism is thought to be less harmful than others, as long as the person’s goals make them feel energized rather than burned out.

  • Self-critical perfectionism. This type of perfectionism may be thought as personal standards perfectionism gone wrong: these perfectionists may be intimidated or worn-out by the goals they set for themselves, rather than excited or motivated. This type of perfectionism is more likely to lead to mental distress, including anxiety and depression.

  • Socially-prescribed perfectionism. People who are held to high societal or cultural standards — such as doctors, lawyers or actors — may struggle to meet the demands placed on them by society. This particular type of perfectionism is more likely to wear these people down to the point of self-harm or suicidality than other types of perfectionism.


In some cases, it’s difficult to distinguish personal standards perfectionism (or a healthy drive towards excellence) from harmful self-critical perfectionism.  Brene Brown, a psychologist who has spent years studying perfectionism, has found a way to distinguish perfectionism from high personal standards: she calls perfectionism a “20-ton shield.”

According to Brown, we may think our perfectionism will protect us, but instead, it is the very thing that prevents us from finding the happiness we so fervently seek. Unlike striving for excellence, Brown has found that perfectionism creates the debilitating belief that our self-worth is tied to our accomplishments — while ironically preventing us from achieving the success we desire.


By now, it should be clear that perfectionism is not all it is cracked up to be. Perfectionism can lead to feelings of anxiety, frustration, resentment, helplessness and envy, and even contribute to the development of mental illness.

Thankfully, change is possible! If you recognize you or someone you love as a perfectionist, you can overcome your perfectionism with a deliberate effort to alter your perfectionistic thoughts and behaviors. Here are some steps you can take, derived from the principles of Cognitive-Behavioral Therapy (CBT), to overcome your perfectionism for good.


One reason why perfectionistic thoughts are so destructive is that they are often rooted in false beliefs. Once we learn to recognize the errors in our perfectionistic thinking, however, we can reframe those thoughts in a way that is constructive to growth and success, rather than procrastination and burnout.

CBT defines a number of thinking errors that are relevant to perfectionistic thinking, including but not limited to:

  • All-or-nothing thinking. Also called “black-and-white thinking,” this thinking error leads people to believe that they are either a success or a failure, without recognizing the gray area that often exists between two variables.

  • Catastrophic thinking. People who think this way believe the worst will happen, and often exaggerate the probability of a negative outcome. For example, they may believe they won’t be able to survive the humiliation of bombing a work presentation or big exam, rather than accepting a more realistic outcome.

  • Should statements. Perfectionists may also think in should statements, such as “I should have gotten an A+ instead of an A-” or “I should never make mistakes.” These statements create feelings of helplessness, rather than encouraging our ability to cope.

By learning to recognize and interrupt these thoughts as they come, perfectionists can develop new, more realistic ways of thinking. Replacing negative thinking errors with realistic thoughts includes using positive self-statements to drown out our self-critical thoughts.

Examples of these:

  • “All I can do is my best!”

  • “Nobody is perfect!”

  • “I’m only human!”

  • “It’s okay not to be liked by everyone!”

  • “It’s okay to have a bad day!”

Of course, replacing negative thoughts with positive ones is often easier said than done! Keeping a log of negative thoughts you have throughout the day can help you become better at spotting thinking errors and replacing them with realistic thoughts. Check out this printable CBT Thought Log to help you keep track of any erroneous, perfectionistic thinking, your emotional response to it and the realistic thought you hope to replace it with.


Perfectionists often have trouble seeing things from others’ point-of-view. Taking on the perspective of another person who isn’t a perfectionist can help you further challenge your perfectionistic thinking.

To try perspective taking for yourself, try asking yourself the following questions when you notice a negative thought pop into your head:

  • How might a close friend or family member see this situation? (Try to choose someone who isn’t a perfectionist!)

  • Are there other ways to look at this situation that I may not be considering?

  • Will this still matter in five days, five months or five years?

  • What might I tell a close friend who was having similar thoughts?


Oftentimes, the underlying emotion behind perfectionism is fear. You might even call it a phobia of imperfection — which is why it makes sense to use exposure therapy exercises to combat perfectionism!

Exposure and Response Prevention (ERP) is a mode of therapy used to treat anxiety, phobias and Obsessive-Compulsive Disorder. In this type of therapy, the patient purposefully exposes themselves to their fears in a safe environment, little by little.

You can try it for yourself at home by coming up with a list of structured activities designed to challenge your fear of imperfection. For example, you might try:

  • Purposely wearing a shirt with a small stain on it

  • Leaving a grammatical error in an email or paper

  • Allowing an area of the house to become visibly messy

  • Talk at a meeting or party without rehearsing what you’re going to say

  • Try a new activity or restaurant without doing any research first

In order for ERP exercises to work, they must be repeated often — so, try choosing activities to overcome your fear of imperfection at least once or twice per day! Start with activities that don’t feel as scary to you, in order to work your way up to your “big fears.” And remember: you can always enlist the help of a qualified mental health therapist if ERP becomes too distressing or overwhelming on your own.


Do your perfectionistic tendencies cause you daily distress? If you’re overwhelmed or upset by trying to tackle perfectionism on your own, it may be time to seek the help of a qualified mental health professional. A therapist or counselor can help you reframe your perfectionistic thoughts and change perfectionistic behaviors so you can start feeling happier and healthier faster.

CBT and ERP are both effective outpatient treatment modalities for perfectionism, especially that caused by an underlying anxiety or mood disorder. Contact us here at The Meadowglade to learn more about our outpatient treatment offerings for anxiety, depression and perfectionism! And remember: admitting you need help is a strength, not a weakness.

If you’re looking for treatment for mental health issues caused by perfectionism – such as depression, look no further than The Meadowglade. We’re an outpatient facility with a solid reputation for treating mental health issues and helping people develop healthy coping mechanisms for themselves. We also take most insurances, so reach out to see if we take your insurance and how we can help!