Perfectionism & Anxiety: 4 Ways to Cope

There’s nothing wrong with having high standards. But when perfectionism and anxiety start to creep in, it can take a toll on your mental health. 

We all know nobody’s perfect. Yet perfectionism often sneaks into various parts of our lives. Maybe you feel a wave of shame every time you make a mistake. Or perhaps, deep down, you worry you won’t be loved if you’re not perfect.

People with anxiety disorders often share these perfectionistic traits. The self-imposed pressure can make you anxious. Then, to combat that anxiety, you strive for perfection — which only adds more pressure and ramps up your anxiety levels. It’s a vicious cycle.

Thankfully, there are ways to break the cycle. Below, we outline the connection between anxiety and perfectionism and ways to cope when it becomes too much.

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.

According to the American Psychological Association (APA), perfectionism is about setting super high, often impossible, standards for yourself or others. 

Sam Laura Brown, a perfectionism coach and host of the The Perfectionism Project podcast, says many perfectionists don’t even know they’re perfectionists. People often think perfectionism involves being tidy and organized. But Brown suggests perfectionism is really about dealing with shame. 

Brené Brown, an expert in shame and vulnerability, explains that perfectionism is often an unconscious strategy to avoid shame.

In her book The Gifts of Imperfection, she says, “Perfectionism is the belief that if we live perfect, look perfect, and act perfect, we can minimize or avoid the pain of blame, judgment, and shame.”  

Simply put, perfectionists set impossibly high standards for themselves to dodge feelings of shame, a possible root cause of perfectionism. 

Researchers have identified three distinct types of perfectionism:

• Self-oriented perfectionism. This is when you expect yourself to be perfect, even though it’s an impossible goal. 

• Other-oriented perfectionism. Do you have high standards for everyone around you? That’s this type of perfectionism.

• Socially prescribed perfectionism. This form of perfectionism involves unrealistic standards set for you by someone else. 

Both internal pressure and external factors like school or job competition, can fuel perfectionism and lead to perfectionist anxiety.

Healthy vs. Unhealthy Perfectionism

Striving for perfection can have perks. This positive drive is known as “adaptive” or “healthy” perfectionism. 

However, there’s a flip side. “Maladaptive”, “unhealthy”, or “neurotic” perfectionism involves a fear of failure that can seriously impact your daily life. 

It’s not entirely clear what causes perfectionism, but it may stem from tough childhood experiences, low self-esteem, or feelings of unworthiness. 

Signs of Unhealthy Perfectionism

Someone with an unhealthy level of perfectionism might:

• Set unrealistic expectations 

• Be highly critical of mistakes

• Regularly overthink 

• Procrastinate out of fear of failure

• Ignore compliments

• Engage in negative self-talk and self-criticism

• Look for approval or validation from specific people (people-pleasing)

• Avoid trying new things out of fear they’d be bad at it

Ironically, perfectionism can hold you back from reaching your full potential. It can cause you to procrastinate, impact your time management, and result in less-than-greater outcomes.

Is perfectionism a mental illness? No. But it can worsen your mental health. 

One study of nearly 400 students found a strong link between clinical perfectionism and anxiety sensitivity. These types of perfectionists are constantly chasing ambitious goals and tie their self-worth to their success. 

Anxiety sensitivity is the belief that feeling anxious can lead to harmful results and might even be a risk factor for anxiety disorders.

Not all perfectionists have anxiety disorders and not everyone with anxiety is a perfectionist.

However, perfectionism often ties into other mental health conditions like: 

• Depression 

• Eating disorders

• Suicidal thoughts 

• Obsessive-compulsive disorder (OCD)

Whether or not you think you have a mental health disorder, it's important to get help if your perfectionism is affecting your well-being.

Perfectionism and anxiety often go hand in hand, creating a challenging cycle. Everyday tasks might even feel overwhelming. 

The good news? It’s possible to break free and manage both. 

There are effective treatments that can help you tackle your anxiety and keep perfectionism in check. 

1. 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 and offers a few additional benefits, like boosting self-esteem and teaching you valuable coping skills.

When it comes to treating anxiety, there are several types of therapy available, including:

• Cognitive behavioral therapy (CBT)

• Mindfulness-based therapy

• Exposure therapy

• Interpersonal therapy  

For more information, check out our guide to finding a therapist. 

2. Self-Compassion

Self-compassion is all about being kind to yourself and accepting your human imperfections. It can even help lower anxiety.

Try adding the following to your self-care, self-compassion routine:

• Rest when you need to

• Nourish your body with nutritious foods that make you feel good

• Go for walks

• Practice positive self-talk

• Try mindfulness strategies 

As you engage in self-compassion, try to remind yourself that you don’t have to be perfect and let go of comparing yourself to others. 

3. Stress Reduction

Being hard on yourself is bound to skyrocket your stress levels, which can, in turn, trigger anxious feelings.

Finding ways to lower your stress levels can benefit your mental and physical well-being. 

Here are a few stress management strategies to try:

• Practice relaxation techniques

• Exercise regularly

• Make sure to get enough sleep

And remember, perfectionism itself can be stress-inducing. Addressing it through therapy is another way to help break the cycle of stress, anxiety, and perfectionism. 

4. Medication

There’s no specific medication for perfectionism, but if you’re living with an anxiety disorder, the following anxiety medications may help:

• Benzodiazepines: Healthcare professionals typically prescribe benzodiazepines for short-term use since taking them long-term increases the risk of dependence and other serious negative outcomes. 

• Selective serotonin reuptake inhibitors (SSRIs): This type of antidepressant medication works by blocking the reuptake of serotonin, a neurotransmitter that plays a role in mood regulation. Examples include sertraline (Zoloft^®), escitalopram (Lexapro), citalopram (Celexa^®), fluoxetine (Prozac^®), and paroxetine (Paxil^®) 

• Serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs like duloxetine (Cymbalta^®) or venlafaxine (Effexor^®) block the reuptake of both serotonin and norepinephrine. 

• Other medications. Drugs like bupropion XL (Wellbutrin XL), buspirone (Buspar), or propranolol can also help with anxiety. 

These medications require a prescription. Think they might help you? Start by talking with a healthcare professional about your anxiety and depression medication options.

Perfectionism and anxiety can often fuel each other, creating a stressful cycle. Thankfully, it’s possible to manage both. 

Here’s what to keep in mind:

• Perfectionistic tendencies can be unhealthy. Aiming high? Great. Thinking you always need to be perfect? Not so much. 

• Perfectionism and mental health issues often go hand in hand. There’s a link between perfectionism and various mental health conditions, including anxiety, depression, eating disorders, OCD, and more. 

• Therapy can help.  A mental health professional can give you the tools to cope with perfectionism and anxiety. 

Ready to take charge of your anxiety and manage your perfectionist tendencies in a healthy way? We can help you connect with a therapist. To get started, take our free mental health assessment.