Perfectionism isn't just high standards. Here's what researchers mean by it, how it links to anxiety and depression, and what helps.
You finish the project, it meets every requirement, and your manager likes it. You still spend the evening on the one slide that could have been tighter. The relief lasts about an hour before the next thing needs to be flawless.
Perfectionism is more than high standards. Psychologists describe it as setting standards that can't realistically be met, then judging yourself harshly when you miss them. Often it comes with a sense that your worth depends on getting it right. It's linked with anxiety and depression, and there's a well-tested therapy for it.
The Three Kinds of Perfectionism
One of the most widely used models comes from psychologists Paul Hewitt and Gordon Flett, whose 1991 scale measures three dimensions of perfectionism. Self-oriented perfectionism is the standard you hold yourself to. Other-oriented perfectionism is the standard you hold other people to. Socially prescribed perfectionism is the belief that other people expect you to be perfect.
That last one is the version many women recognise without having a name for it. It's the sense that your family, your workplace or your feed is grading you, and that slipping will cost you their approval.
Perfectionism also seems to be rising.
A 2019 meta-analysis by Thomas Curran and Andrew Hill pooled 164 samples covering 41,641 college students in the US, Canada and the UK. It found that all three kinds of perfectionism rose between 1989 and 2016, with socially prescribed perfectionism rising the most. About seven in ten participants were women, the average age was about 21, and the research measured students, not working adults. It also shows a trend across generations rather than anything about one person.
How Perfectionism Affects Your Mental Health
A 2017 meta-analysis led by Karina Limburg pooled 284 studies on depression, anxiety disorders, OCD and eating disorders. It concluded that both main dimensions of perfectionism were linked with various forms of mental ill health. Those are "perfectionistic strivings" (aiming very high) and "perfectionistic concerns" (fear of mistakes and of other people's judgement).
Most of these studies are correlational. They show perfectionism and these conditions travel together, not that one always causes the other. But the pattern fits what perfectionism feels like from the inside. The work never gets to count as done, so the stress never gets to switch off.
Rest gets hard too. Taking a break can feel like falling behind, and handing a task to someone else can feel like lowering the bar. Sleep suffers when you lie awake replaying the day's mistakes, which is rumination more than planning. And people-pleasing can become a way of keeping the image intact.
What Actually Helps With Perfectionism
The best-tested approach is cognitive behavioural therapy aimed at perfectionism itself. A 2022 meta-analysis of 15 randomised trials with 912 participants found CBT for perfectionism reduced perfectionism and symptoms of depression, anxiety and eating disorders. The trials included both self-help and face-to-face CBT, though the authors noted there weren't many of them.
The exercises those programmes use are things you can start yourself:
- Pick one low-stakes task and deliberately finish it at "good enough," such as an email sent after one read-through. Then notice what actually happens.
- Write down the rule you're following ("if it isn't perfect, people will think you're incompetent") and ask what evidence you have for it.
- Set a time limit for a task before you start, and stop when it's up.
- Measure what you did, not only what went wrong with it.
When you slip, answer yourself the way you would a colleague. Self-compassion isn't lowering your standards. It's refusing to make one mistake into a verdict on who you are.
If perfectionism comes with low mood most days, panic, rituals you can't stop, or rigid rules about food and your body, see a GP. Those can be signs of depression, anxiety, OCD or an eating disorder, and each has effective treatment.
Frequently Asked Questions
What Is the Difference Between Perfectionism and High Standards?
High standards let you feel satisfied when you meet them. Perfectionism keeps moving the bar and ties your worth to not making mistakes. That constant self-judgement is what makes it so tiring to live with.
Does Perfectionism Cause Anxiety and Depression?
Studies consistently link perfectionism with anxiety and depression, but most are correlational, so they can't show cause and effect. What's clearer is that therapy aimed at perfectionism also tends to ease anxiety and depression symptoms.
How Do I Stop Being a Perfectionist?
Start with small experiments, such as finishing a low-stakes task at "good enough" and noticing that nothing bad happens. Question the rules you're running on and set time limits for tasks. If it's affecting your health or work, CBT for perfectionism has the strongest evidence.
This article is for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making changes to your health routine.
