Key Points: Individuals with perfectionist personalities may be at increased risk for depression, new research finds, and depression may in turn worsen perfectionistic tendencies. Focusing on self-esteem and self-compassion in therapy could help someone manage both.
by Emma Newman
Perfectionism is defined as a personality trait characterized by efforts toward and desires for flawlessness. Perfectionists set unrealistically high standards for themselves, others, or both. Although perfectionism can boost performance in some cases, it often undermines the achievement of goals when people succumb to highly critical attitudes.1
Understanding Different Types of Perfectionism
In a recent study entitled "Is Perfectionism a Vulnerability Factor for Depressive Symptoms, a Complication of Depressive Symptoms, or Both?" (2021), Smith and colleagues conducted a meta-analysis of a multitude of studies on perfectionistic concerns and perfectionistic strivings to determine in what way perfectionism and depression feed off of each other. Perfectionistic concerns center on the belief that perfection is required of oneself, shading into obsession.
Those with high perfection concerns overreact to errors, often second-guess their actions, experience discrepancy between their actual self and their ideal self, and fear disapproval from others. On the other hand, perfectionistic striving is associated with self-oriented perfectionism. This person typically holds lofty goals and has internalized expectations of success and productivity; this may be associated with higher achievement.
Unpacking the Links Between Depression and Perfectionism
Although there have been previous studies investigating links between perfectionism and depressive symptoms, it’s unclear exactly in what ways they connect.
A meta-review was conducted in order to reveal how these two factors are linked. Is perfectionism a vulnerability for depressive symptoms? A complication? Both? Many of the studies that have been done on perfectionism and depressive symptoms have assumed the way in which the two are linked instead of testing how they are linked.
Vulnerability for depressive symptoms means that perfectionism could increase the risk of clinical depression, whereas perfectionism as a complication of depressive symptoms means that perfectionism may overlap with and be amplified by depression symptoms. Awareness of the effects that perfectionism and depressive symptoms have on each other, which can lead to a vicious cycle, is of benefit for better understanding and coping with both depression and perfectionism.
The study found key relationships between various aspects of perfectionism, and depression, including:
1. Perfectionistic concerns can lead to increased depressive symptoms over time.
Perfectionist concerns conferred vulnerability for increased depressive symptoms over time. Perfectionist concerns lead people to think, feel, and behave in ways conducive to depressive symptoms. Perfectionistic concerns—including being overly critical towards the self or overreacting to mistakes—create the opportunity for depressive symptoms to creep in and take over.
2. People higher in perfectionistic concerns perceive and encounter more negative social interactions.
People with elevated perfectionist concerns perceive and encounter more negative social interactions, which often leads to social disconnection and, in turn, depressive symptoms. They also are at risk for depressive symptoms due to a propensity to generate—and respond poorly to—stress. Overall, expecting nothing less than perfection from yourself can set you up for failure; this translates to how stress is handled and can negatively infect interactions with others.
3. People high in perfectionistic concerns may see themselves as having less emotional control.
For many people with high perfectionistic concerns, experiencing depressive symptoms itself may be seen as a failure of emotional control. This translates into additional pressures to meet expectations and heightened concerns about failures and making mistakes. Depression can easily influence the person and their emotions, translating into a loss of control over the self which goes against the notion of being perfect.
4. Unrealistic goals can lead to a higher frequency of perceived failures.
Failure doesn’t seem like an option to many perfectionists—and if it does happen, it can alter the perfectionist's view of themself. Unrealistic goals that people high in perfectionistic striving strive towards, such as needing to be the best at everything, can lead to a higher frequency of perceived failures and a lower frequency of perceived successes.
5. People with self-oriented perfectionism are more vulnerable to depressive symptoms.
The study found that self-oriented perfectionism was associated with an increased vulnerability for depressive symptoms. On the other hand, perfectionism did not appear to be a complication of depression. In other words, those who fit the "perfectionistic striving" definition of perfectionism may be vulnerable to depressive symptoms, but the reverse did not appear to be true: that is, it's unlikely to develop perfectionistic striving as a result of depression.
How to Break the Cycle of Perfectionism and Depression
Smith et al (2021) found that perfectionism and depression often constitute a destructive vicious cycle. Perfectionistic concerns leave us both vulnerable to depression and are driven by depression.
As with any research, there are limitations. There is a lack of research on the role perfectionism takes in diagnosed depressive disorders. This study used self-report measures that could be inaccurate or distorted; this is especially true when studying perfectionistic people. Prospective studies with different treatment arms, looking at interventions and outcomes rather than looking back at self-report measures, are likely required to understand more fully what might bring relief.
People with perfectionistic concerns become locked into a cruel loop in which obsession drives depression and especially low self-esteem and helplessness, which in turn intensifies maladaptive perfectionism coping strategies. Learning strategies to reduce self-criticism and ease unrealistic expectations, including psychotherapy and meditation-based approaches including self-compassion practice, can help to interrupt maladaptive thought patterns and shift toward a kinder, gentler attitude toward oneself and others.
Treating depression, likewise, can ease perfectionism by removing many of the drivers of perfectionistic concern. Generally shifting one's mindset over time, with broad attitudes and values as well as changing day-to-day habits, can change the world and the way we live in it.
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1. Learn more about clinical correlations of perfectionism:
Smith, M. M., Sherry, S. B., Ray, C., Hewitt, P. L., & Flett, G. L. (2021). Is perfectionism a vulnerability factor for depressive symptoms, a complication of depressive symptoms, or both? A meta-analytic test of 67 longitudinal studies. Clinical Psychology Review, 84, 1–49. https://doi.org/10.1016/j.cpr.2021.101982
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