Perfectionism Is Linked With Depression

Plenty of famous people wrestle with perfectionism. Elite athletes, gifted actors, hard-charging entrepreneurs: many of them refuse to settle for anything short of excellence, chasing both their own internal demands and what the world seems to expect of them. But setting high standards for yourself and the people around you is not the same thing as being paralyzed by perfectionistic traits. When Michael Jackson sat down with Oprah Winfrey in 1993, he described himself as a perfectionist who was never happy with any of his work. The investigations after his death, and the trial of Dr. Conrad Murray, pointed to a stack of underlying problems that included anxiety and depression. That same drive for flawlessness pushed him toward extreme behavior, and he eventually over-medicated to force himself to sleep, which killed him.

People with a perfectionist style tend to be intense and relentless. Researchers describe three forms of this thinking: self-oriented perfectionism, other-oriented perfectionism, and socially-prescribed perfectionism. The demand for flawlessness gets applied to themselves, to the people around them, and to an imagined society that they believe expects the same. Perfectionism isn't classified as a disorder on its own. Still, how common and how severe it gets can open the door to clinical depression, anxiety, and other psychiatric conditions.

Because errors feel intolerable to them, perfectionists are rarely satisfied with any part of their lives. That dissatisfaction can spill into damaging behavior: disordered eating, broken marriages, thoughts of suicide. The readiness to sacrifice health, relationships, and even one's own life ties back to what Gordon Flett, a psychology professor at York University, calls the 'just right' phenomenon. When something or someone fails to match the exact template of expectations, the perfectionist would sooner abandon the whole thing than patch up the flaws.

Flett has studied perfectionist traits and their fallout for years. His more recent work looks at suicide risk among perfectionists specifically. He argues that the pressure people feel from socially-prescribed perfectionism, combined with that 'just right' reflex, can end in tragedy. A sense of hopelessness builds up when someone keeps falling short of what they think society demands. And the inability to sit with one's own potential flaws may make a person more willing to act on suicidal thoughts.

Working with Paul Hewitt of the University of British Columbia and Marnin Heisel of Western University, Flett has named perfectionism as a standalone risk factor for suicide. Their findings suggest that socially-prescribed perfectionism puts certain people at higher risk, particularly those in careers built around expertise where mistakes carry heavy costs. Attorneys, physicians, architects, and people in demanding leadership roles fall into that category. The three researchers also found that perfectionists are often skilled at hiding their emotions and projecting different public selves, which can raise the danger further because there are no visible warning signs. They want this work folded into clinical guidelines for assessing suicide risk, and they ask clinicians to build individual treatment plans aimed at changing the behaviors tied to a perfectionist style.

Change, as with most personal problems, starts with acceptance. Holding yourself and others to high standards is a healthy thing. The trouble starts when those standards become impossible to meet, and at that point a perfectionist may need to take an honest look at their own feelings, thoughts, and actions. When anxiety, depression, and anger keep getting in the way of any peace, professional help becomes worth seeking.

Beyond the emotions, a handful of thought patterns show up again and again in the perfectionist mind. There's absolute thinking, the belief that anything less than perfect cannot be accepted, or that needing help is weakness. There's catastrophic thinking, an inability to face disappointment or humiliation. There's exaggeration, where the worst outcome is assumed no matter what the facts say. And there's the thinking built around expectations, placing impossible ideals on oneself and everyone else.

These patterns, braided together with a lingering hopelessness, can push people toward obsessive and harmful habits: checking the same thing over and over, procrastinating, keeping an excessive guard up, refusing to try anything new. When ordinary daily tasks turn into agony and the self-talk stays toxic, life can grind down to something crippled and small.

Getting past perfectionism is hard, and many people will need both professional help and a solid circle of support to do it. For anyone capable of starting on their own, writing personal mantras that repeat the plain fact that no human is perfect is a reasonable first move. You may never fully convince a true perfectionist of that fact, but positive thinking still carries real weight. Other useful shifts include looking at events from someone else's vantage point and practicing the habit of asking what actually matters.

Becoming more realistic about what failure would really cost, keeping in mind that failure is itself a subjective call, can loosen the grip of fear. Since perfectionism runs mostly on fear, therapy that leans on behavior modification may be necessary. Small experiments help: changing up a routine, or deliberately allowing a mistake, like sending an email you know has errors in it. The core task is spotting and reworking the bad feelings, negative thoughts, and destructive behaviors so that daily life can feel more normal again.

- Melissa Lavery, M.S.

References: Drapkin, J. (2005, September 1). The Pitfalls of Perfectionism. Psychology Today. Duke, A. (2011, October 5). 'I hurt,' Michael Jackson says 6 weeks before death. CNN.com. How to Overcome Perfectionism. AnxietyBC. Melrose, S. (2011, May 29). Perfectionism and Depression: Vulnerabilities Nurses Need to Understand. Flett, G., Hewitt, P., & Heisel, M. York University. (2014, September 25). Perfectionism is a bigger than perceived risk factor in suicide: Psychology expert. ScienceDaily.