How Perfectionism Leads to Depression and Anxiety

How Perfectionism Leads to Depression and Anxiety

My client (let’s call her Amanda) had it all by her 40th birthday: a high flying career, a PhD, a successful businessman for a husband, two healthy children, a show-home, the latest model of a car, the best holidays and… anxiety, spiralling out of control.

‘I am working so hard to make everything perfect, but it isn’t’,  Amanda says tearfully. There always appears to be something to sabotage her drive for perfection – children not getting straight A’s; husband refusing to go to the gym to get rid of that ‘beer belly’; her own legs too short and chunky for her liking; the list goes on and on.

Amanda is not alone in her despair: Many other women and men of all ages, backgrounds and walks of life are chasing the unattainable goal of perfection. This problem seems to be even worse for the millennials – those born after 1980.

According to a study of over 40,000 British, American, and Canadian university students (ages 18 to 25) published in the Psychological Bulletin, the majority of these young people showed signs of perfectionism driven by unrealistically high expectations, or ‘multidimensional perfectionism‘.

The authors of this research Thomas Curran and Andrew Hill pointed out that young people they have studied are noticeably harder on themselves and on others than members of previous generations. They are not only more dissatisfied with what they have, but also seemingly more dissatisfied with who they are. 

Females are more likely to suffer with anxiety disorders than males.

From an early age they were conditioned by society to believe that the perfect life and lifestyle (as evidenced by achievement, wealth, beauty, and social status and celebrity) are  there for them to grab if they try hard enough (or if they are lucky enough). Social media such as Instagram, Facebook, and Snapchat allow users to create a perfect public image – airbrushed and photoshopped beyond recognition – reinforcing the message that perfection is all around them. It is out there. Everyone else has it, but them.

As a consequence, their self-perception and self-esteem are eroded by the fear of negative social evaluation, unfavourable comparison with others and failure. They ask themselves: Why? Why is my life not perfect? Why am I not as successful, affluent, lucky or popular as others? Why is my body not even close to the faultless images I see in magazines and social media? Why?

When people focus on deficiencies long and hard enough, they often start blaming themselves for any difficulties they experience and any perceived imperfections, whether real or imagined. They soon learn to ignore the good things that are happening in their lives.  These tendencies could provide some explanation towards the high levels of mental health issues such as anxiety, depression, and eating disorders in the society preoccupied with the idea of perfection.

According to a recent report of the World Health Organization, females are more likely to suffer with anxiety disorders than males. However, there is a growing body of evidence  that many men and even young boys increasingly experience psychological distress under the impact of perfectionism, gender role socialisation, and the media.

A few years ago, a total of 32,827 people from 172 countries took part in the online stress test, devised by the BBC’s Lab UK and psychologists at the University of Liverpool, which is the biggest study of its kind ever undertaken in the UK. The findings of this study, published in the journal PLOS One singled out rumination (having thoughts stuck on replay in one’s head) as the biggest predictor of the most common mental health problems in the country.

According to Professor Peter Kinderman, who led this study, dwelling on negative thoughts and self-blame are crucial psychological pathways to depression and anxiety, with rumination being even more damaging than self-blame.

Dr Ellie Pontin, a clinical psychologist and research associate at the University of Liverpool, pointed out that this is a really positive message to all of us because, while we can’t change our past experiences or genetics, the way we think and deal with things can be changed.

Furthermore, helping someone tackle negative thought processes is not something that has to be done exclusively by clinical psychologists. When properly trained, other professionals also can deliver a variety of effective evidence-based interventions, including mindfulness-based therapiescognitive behavioural therapy, cognitive therapy, and coaching.  And this is exactly how I met Amanda who came to me looking for an answer to the dreaded ‘Why?’ question: Why her life is not picture-perfect despite all her efforts? 

Like many of my clients, both male and female, Amanda found herself in the middle of a perfect storm created by a combination of high aspirations and event higher expectations; challenges of keeping up appearances in all areas of her life; a deeply seated belief that others will value her only if she is perfect; and an ever-increasing fear that she is not good enough to meet all those challenges and expectations.

But this was some time ago. Since then, Amanda has re-discovered herself and her true values, and learned how to appreciate her life, with all its imperfections. She had learned how to think of, and deal with things she can control and those that she can’t. Her self-esteem is growing and her anxiety is greatly reduced. She has changed. And so can you. 


Zoryna O’Donnell, MBA, MSc, FInstLM is an international speaker, an author, an ICF coach and a mentor of the Warwick Business School (WBS) Mentoring Programme, providing career mentoring and advice to individual students and graduates of the MBA Programme at WBS. She is also a registered hypnotherapist, a master practitioner of NLP (neuro linguistic programming) and a trainer delivering many evidence-based programmes and interventions that help people to achieve positive changes in their personal and professional life, improve their mental health, build resilience and increase their well-being. You can connect with Zoryna on Twitter @ZorynaO’Donnell.


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  1. I am 34 years old with a beautiful, nuclear family, and have already attained enough educational and career success to \”hang my hat on.\”…still, I am not happy and I suffer greatly. I often remind myself to aim for \”being ok.\” That is, \”just try to be OK,\” instead of \”number one.\” At first it sounds awful to think of striving for \’mediocrity,\’ but really what we are doing is finding acceptance. The beauty of this thought is (when I latch on) It is freeing. Unfortunately, I spend more time ruminating and grasping for mental straws than living in peace.

    My struggles most often concern others; looking for validation, popularity, and acceptance from peers and subordinates who have no emotional investment in my success. Why does it come so easy to (insert name)? This has led to attempts to \”force\” relationships which is counterproductive. The high expectations are certainly smothering.

    Reply
    1. Hello. Mike. I am sorry to hear about your suffering. You are not alone here – many people, and many high achievers in particular, have similar experience of self-doubt and rumination. You can break free though. You can ask a properly trained professional for help or, at least explore mindfulness practice on your own – there is plenty of good (and free) resources online. To my clients in similar situations I offer a combination of coaching, NLP and cognitive hypnotherapy which can be delivered via Skype. Please feel free to connect with me on Twitter and send a direct message if you wish to explore this option. What ever you decide to do, I wish you to get the outcome you want. Kind regards, Zoryna

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