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Perfectionism and mental health are closely linked

Perfectionism in College Students: The Mental Health Consequences of Trying to Be Perfect

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Wouldn’t it be nice to be the top athlete, the best student, the most attractive person in the room, the most valuable employee—in a word, perfect? But the irony of perfection is that it’s unattainable. And striving to achieve it can be detrimental to health and happiness. That’s why perfectionism in college students is so closely linked to depression and anxiety.

It’s not a coincidence that as mental health issues among young adults have increased, so has perfectionism. According to a study by the American Psychological Association (APA), rates of perfectionism among college students have been rising over the past three decades. “Increases in perfectionism have the potential to explain some of the increase in the prevalence of psychopathology,” wrote the APA researchers Thomas Curran and Andrew P. Hill. “Perfectionism is a core vulnerability to a variety of disorders, symptoms, and syndromes.” 

What Is Perfectionism?

Perfectionism is not simply a matter of having high standards. Rather, it has three elements: First, someone holds standards that are impossibly high. Second, they judge their own efforts (and other people’s) with fierce criticism. And third, they base their sense of worth on whether or not those standards are met. They dismiss their achievements and focus only on their flaws.

Perfectionism in college students is sometimes thought of as a positive trait, if it drives them to do well. But Curran asserts that perfectionism is always a problem. He states that perfectionist symptoms should not be confused with healthy traits like conscientiousness, perseverance, and diligence. It is never healthy to link one’s sense of self-worth to the unattainable goal of perfection.

Is perfectionism a disorder? No. Rather, it is a tendency that underlies numerous mental health disorders. As the researchers state in the APA study, “Although perfectionists have an excessive need for others’ approval, they feel socially disconnected and such alienation renders them susceptible to profound psychological turmoil.”

Perfectionism and mental health are related in the sense that perfectionism plays a role in the development and continuation of many serious mental health conditions.These include:

Consequently, recognizing and addressing the connection between perfectionism, anxiety and depression and other conditions is an important part of the recovery process. 

Know the Facts

Perfectionism in college students motivated by social and family expectations increased by 33% from 1989 to 2016.

Types of Perfectionism 

Experts distinguish between three different types of perfectionism:

Self-Oriented Perfectionism

“I demand nothing less than perfection of myself.”

A self-oriented perfectionist strives to meet unrealistically high standards that they have set for themselves. This form of perfectionism is strongly related to inherited personality traits. Yes, it can contribute to high achievement and success. However, it is also associated with high levels of stress, along with the negative physical and mental health effects that accompany chronic stress.

Socially Prescribed Perfectionism

“My family expects me to be perfect.”

This type of perfectionist strives to meet unrealistically high standards that they feel others expect of them. This form of perfectionism is driven by family and cultural values and assumptions. Perfectionism in college students is often particularly high when a student is the first person in their family to attend college. According to the APA study, the number of young adults with socially prescribed perfectionism showed the largest increase among the three types. It went up by 33 percent between 1989 and 2016. Socially prescribed perfectionism is the form most closely linked with serious mental health disorders. The study’s authors point to a parallel increase in anxiety, depression, and suicidal ideation among young people over the same time frame.

Perfectionism Imposed on Others 

“The people who matter to me should never let me down.”

This type of perfectionist holds the people around them to extremely high standards. They tend to blame and criticize friends, family, or colleagues who fall short of their expectations. Hence, their perfectionism interferes with relationships and creates issues such as mistrust, conflict, and loneliness. It is also a component of narcissism. This form of perfectionism increased by 16 percent over the past three decades, according to the study.

The findings indicate that recent generations of young people perceive that others are more demanding of them, are more demanding of others, and are more demanding of themselves.

Thomas Curran and Andrew P. Hill
APA researchers

Causes of Perfectionism in College Students

There is no simple answer to the question, “Why am I a perfectionist?” The “need to be perfect disorder” arises from a variety of pathways, and is unique to every individual. The following factors impact the likelihood of developing perfectionism and mental health issues related to perfectionism.

Biological factors

There is a moderate genetic component to perfectionism, more pronounced in girls than in boys. Studies of twins suggest that genetics account for between 25 and 40 percent of perfectionism. That correlation likely reflects small effects contributed by many different genes, rather than a “perfectionism gene.” Certain personality traits and disorders linked with perfectionism are also inheritable. These include low tolerance of distress, anxiety, and depression.

Relational factors

The quality of a child’s relationships with their primary caregivers early in life can set the stage for the development of perfectionism. If a child’s needs for belonging and self-esteem are not met—due to abuse, neglect, or uncontrollable circumstances—they may unconsciously feel they have to be perfect to get the love and approval they crave. Even without trauma, a parent’s rigidly high expectations and perceived criticism may become internalized in the form of perfectionism.

Cultural factors

A child absorbs cultural messages about standards and values from society at large. These days, that includes the pervasive influence of social media and the 24-hour news cycle. But the study’s authors point to broader cultural influences as well. They cite the competitive individualism and market-oriented economies that have dominated Western societies over the past several decades. Those trends also underlie the rise of a more anxious and controlling parenting style, which can contribute to a child’s perfectionist tendencies. 

Cognitive factors

Humans have evolved to optimize our chances of survival. That means all of us are naturally inclined to take mental shortcuts that favor detecting and avoiding threats. And sometimes we make assumptions about potential threats that are not accurate. These cognitive distortions tend to be especially pronounced for someone with a history of trauma. That can produce the cognitive distortions that are the hallmark of perfectionism. They include catastrophic thinking, selective attention to the negative, and all-or-nothing thinking.

Learned behaviors 

Having high standards is often rewarded with positive attention, reinforcing perfectionistic behavior. Feeling criticized for a mistake, on the other hand, feels like punishment. That’s why perfectionism in college students often centers around getting good grades or, on the other hand, being terrified of a low or failing grade. Perfectionistic behaviors reinforce themselves and make it difficult for a perfectionist to give them up. 

Perfectionism in college students can lead to mental health issues

Symptoms of a Perfectionist

Perfectionism can show up very differently from individual to individual, depending upon the above factors. Perfectionist symptoms include behaviors that fall generally into two categories: those that help the perfectionist maintain their high standards and those that help them avoid situations that remind them of their need to be perfect. 

Examples of perfectionism range from a rigid need for control to excessive anger, depression, and suicidality. Perfectionists may spend needless amounts of time on a term paper or work project, or they may avoid challenging situations completely. Moreover, a person may be a perfectionist in some situations but not in others. For example, perfectionism in college students typically focuses on academic and athletic achievements. 

Some areas of life in which young adults are most commonly affected by perfectionism are:

  • Academic perfectionism
  • Work performance
  • Neatness, cleanliness, and organization
  • Writing
  • Speaking
  • Food choices
  • Physical appearance
  • Health and grooming

5 Ways to Be Okay with Being Good Enough

  1. Check your beliefs. Rigidly held beliefs underlie the behaviors of many perfectionists. But they may not always be true. Awareness is the first step in loosening their grip. First, notice what areas of your life are affected by perfectionism. Then take some time to examine what beliefs drive those perfectionist behaviors. 
  2. Experiment with relaxing your standards. Even if a belief is generally true, it may not require 100 percent adherence. Conduct your own experiments to investigate the true consequences of relaxing your standards. Try doing things “well enough” rather than perfectly. Is the result significantly different?  
  3. Question what you’re afraid of. What bad thing might happen if you weren’t “perfect”? Sure, the worst-case scenario might result. But how likely is it really? Consider the costs of constantly striving to avoid that scenario. Are the benefits of your perfectionistic behavior outweighing the negatives?
  4. Aim for efficiency instead of perfection. What is the right amount of effort to expend to achieve the desired result? Too much effort can backfire by slowing you down, exhausting you, and interfering with your relationships. Too little effort can keep you from achieving what you want to achieve. Again, you will need to experiment to find the sweet spot that is right for you and your circumstances.
  5. Neutralize your inner critic with self-compassion. Above all, be kind to yourself. A study with adolescents found that the perfectionist students who had more self-compassion were less likely to experience depression. Self-compassion can help in recovering from perfectionism. You don’t have to shake these habits and beliefs all at once. Take small steps, and get support from people you trust or from a professional.

Perfectionism Treatment at Newport Institute

Newport Institute’s philosophy of care addresses both symptoms of perfectionism and mental health issues underlying perfectionist tendencies. Through addressing childhood trauma, family expectations, and cultural factors, young adults unpack their perfectionism. And they learn to identify and shift the thoughts, feelings, and behaviors that keep them locked in a cycle of perfectionism. Contact us today to learn more about our approach to care and our specialized treatment for young adults.

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J Clin Psychol. 2017 Oct;73(10): 1301–1326.

Psychiatry Res. 2015 Dec 30;230(3): 932–9.

Hewitt, P.L. (2017). Perfectionism: A Relational Approach to Conceptualization, Assessment, and Treatment. The Guilford Press.

Co-Occurring Disorders / June 3, 2022

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