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Perfectionism & Anxiety: Why They’re Commonly Linked

Katelyn Hagerty

Reviewed by Katelyn Hagerty, FNP

Written by Our Editorial Team

Published 12/05/2022

Updated 12/06/2022

Not meeting your own expectations or the expectations of others can be overwhelming. And if you’re anxious about not being your “best self” or feel an intense and unrealistic pressure to be “perfect,” it could be a sign you suffer from perfectionism and anxiety.

Striving for perfection — either by personal standards or what others deem “perfect” — can cause anxiousness. The worry and fear produce anxious behaviors, which interferes with everyday actions.

If you feel like your anxiety and perfectionism are connected, you’re not alone — and there are ways to break the cycle.

What Is Anxiety?

A good place to start before diving into perfectionism and anxiety is knowing what anxiety is. Feeling stressed or anxious from time to time is natural — it’s your body’s way of protecting itself by heightening your awareness as part of the “fight-or-flight” reaction.

But when stress and anxiety start interfering with your enjoyment of life, career or relationships, you could be dealing with an anxiety disorder and may want to seek help from mental health professionals.

Common anxiety symptoms include:

  • Feelings of panic and excessive worry

  • Obsessive thoughts you can’t control

  • Inability to stay calm

  • Heart palpitations

  • Trouble sleeping

  • Chest pain

  • Shortness of breath

  • Excessive sweating

  • Muscle tension

While there are many possible causes of anxiety, one potential factor is perfectionism.

What Is Perfectionism?

Perfectionism is when someone constantly tries to reach high yet rigid personal standards. Sometimes called self-oriented perfectionism, this mindset can be either positive, like motivating criteria for success, or toxic and unhealthy, leading to unhappiness and potentially anxiety.

Internal pressure, as well as external factors like professional or academic competition, can fuel perfectionism.

Healthy vs. Unhealthy Perfectionism

Striving for perfection may have positive outcomes. Known as adaptive perfectionism or healthy perfectionism, it can help people set ambitious goals, work hard, be driven by success and use their perfectionism as a strength.

On the other hand, maladaptive perfectionism (also called neurotic perfectionism or unhealthy perfectionism) is the negative side of aiming for perfection.

Maladaptive perfectionism means you’re focused on failure and is typically driven by adverse childhood experiences, low self-esteem or feeling unworthy.

Signs of Unhealthy Perfectionism

Someone with an unhealthy level of perfectionism might:

  • Set unrealistic expectations

  • Easily find faults

  • Be highly critical of mistakes

  • Procrastinate projects out of fear of failure

  • Ignore compliments

  • Look for approval or validation from specific people

There are three dimensions of perfectionism (or three different ways perfectionism can occur). They include:

  • Self-oriented perfectionism. This is when you unrealistically expect yourself to be perfect.

  • Other-oriented perfectionism. This form of perfectionism involves putting high personal standards of perfectionism on others.

  • Socially prescribed perfectionism. This means someone has unrealistic standards of success set by others.

Can perfectionism and anxiety disorder be connected? And if so, why are anxiety and perfectionism commonly linked? 

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Does Perfectionism Cause Anxiety?

Although perfectionism isn’t considered a mental illness, this personality trait can impact your mental health and has been found to make anxiety worse

A study involving almost 400 students found that clinical perfectionism — namely concern over mistakes, personal standards, parental expectations, doubts and organization — was significantly connected to anxiety sensitivity.

Anxiety sensitivity is the belief that anxiety symptoms can have harmful results and be a risk factor for anxiety disorders.

Perfectionism can be a common factor in many other mental health disorders, especially those based on compulsive thoughts and behaviors, such as obsessive-compulsive disorder (OCD). 

Maladaptive perfectionism has been linked to mental health conditions, such as:

  • Depression or depressive manifestations

  • Eating disorders

  • Suicidal impulses

  • Generalized anxiety disorder (GAD)

Perfectionism and anxiety can make each other worse. For instance, if a perfectionist’s self-worth is tied to performance or used as criteria of success, they may experience anxious thoughts when they don’t meet their high expectations.

Managing Anxiety and Perfectionism

While the relationship between perfectionism and anxiety may seem like a vicious cycle, there are ways to break out of it and manage both.

If you’re facing perfectionism and anxiety disorder, you may find yourself struggling to engage in everyday activities. The good news is various treatments can help you cope with anxiety and manage your perfectionism.

Therapy

Psychotherapy (or talk therapy) is a good place to start if you deal with anxiety and perfectionism. It’s a common treatment for anxiety but can provide several additional benefits, like building self-esteem and learning coping mechanisms.

Therapy for treating anxiety can involve cognitive behavioral therapy (CBT), exposure therapy and interpersonal therapy, among others.

Talking about your anxiety symptoms, why you feel the need to strive for perfection or anything else that contributes to your perfectionism and anxiety can help you manage these conditions. 

You can get started with online sessions with a licensed therapist or take a look at our guide to finding a therapist.

Self-Compassion

Self-compassion means being kind to yourself and allowing yourself to be human and imperfect. It can also reduce levels of anxiety.

If you struggle with anxiety and perfectionism, try resting, eating nourishing foods, taking a walk or encouraging yourself.

Mindfulness

By learning to let go of perfectionist tendencies, you can lower your stress and anxiety levels. Practicing mindfulness can help you be fully present in the moment, learn that not every task has to be perfect and let go of a comparison mindset.

Stress Reduction

Being a perfectionist may increase levels of stress and add to your anxiety. Lowering your stress levels can benefit not only your mental health but also your physical health.

You can reduce stress by learning to manage your time, practicing relaxation techniques, exercising, getting enough sleep and more.

Medication

If you’ve been diagnosed with an anxiety disorder or experience frequent anxiety, medication may help. Or if your perfectionism heightens your anxiety so much that you have panic attacks often (a symptom of panic disorder, a type of anxiety disorder), your healthcare provider might recommend medication.

Types of medication used for anxiety include benzodiazepines and antidepressants.

Benzodiazepines are generally a short-term treatment, as long-term use significantly increases the potential for tolerance, dependence and abuse.

Antidepressants used to treat anxiety include selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft®) and citalopram (Celexa®) or serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta®).

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Next Steps for Perfectionism and Anxiety

Whether you struggle with one of the three dimensions of perfectionism (and anxiety, as a result) or have anxiety nearly every day due to perfectionism, both conditions are manageable.

Reducing stress in your daily life, working with mental health professionals or practicing mindfulness are all methods of managing your perfectionism and anxiety.

10 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Anxiety. (2020, May 22). MedlinePlus. Retrieved from https://medlineplus.gov/anxiety.html
  2. Frost, R.O., Marten, P.A. Perfectionism and evaluative threat. Cogn Ther Res 14, 559–572 (1990). Retrieved from https://link.springer.com/article/10.1007/BF01173364
  3. What Causes Perfectionism? (n.d.). Psychology Today. Retrieved from https://www.psychologytoday.com/us/basics/perfectionism
  4. Erozkan A. (2016). Understanding the role of dimensions of perfectionism on anxiety sensitivity. Retrieved from https://files.eric.ed.gov/fulltext/EJ1106267.pdf
  5. Mantar, A., Yemez, B., & Alkın, T. (2011). Anxiety sensitivity and its importance in psychiatric disorders. Turk psikiyatri dergisi = Turkish journal of psychiatry, 22(3), 187–193. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21870308/
  6. Handley, A. K., Egan, S. J., Kane, R. T., & Rees, C. S. (2014). The relationships between perfectionism, pathological worry and generalised anxiety disorder. BMC psychiatry, 14, 98. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234287/
  7. Psychiatry.org - What is Psychotherapy? (n.d.). American Psychiatric Association. Retrieved from https://psychiatry.org/patients-families/psychotherapy
  8. The power of self-compassion. (n.d.). Harvard Health. Retrieved from https://www.health.harvard.edu/healthbeat/the-power-of-self-compassion
  9. NIMH » Anxiety Disorders. (n.d.). NIMH. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders#part_2225
  10. Managing Stress. (n.d.). NAMI. Retrieved from https://www.nami.org/Your-Journey/Individuals-with-Mental-Illness/Taking-Care-of-Your-Body/Managing-Stress

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

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