How Perfectionism Affects Mental Health
At first glance, perfectionism seems like the kind of productive “weakness” you cite in a job interview when asked about strengths and weaknesses. Your friends might remark on how “put together” you are, and maybe your professors and bosses have commented on your attention to detail. But there’s a hidden cost behind the glowing reviews.
Let’s talk about how perfectionism can impact your mental health: how it can fuel anxiety and affect your body, why high-achievers often struggle with it, and how therapy can help you find balance.
What Perfectionism Really Is
Perfectionism doesn’t always look like red pen corrections or alphabetized bookshelves. Sometimes it looks like lying awake at 2 a.m. replaying an email you sent earlier that day. Or spending three hours on a task that should have taken twenty minutes because you couldn’t stop tweaking it. Perfectionism is more than liking things neat and striving for excellence - it often sneaks into your sense of self-worth, tying it to your performance and ability to get things right. While motivating to a degree, your standards also may leave you anxious and exhausted.
In her book The Perfectionist’s Guide to Losing Control (2023), Katherine Morgan Schafler identifies five types of perfectionism, which can show up for the same person in different contexts and relationships. These types include:
Classic perfectionism - These may be what you traditionally think of with perfectionism - reliable, detail-oriented individuals with high standards, who may struggle with changes or spontaneity.
Intense perfectionism - Folks with this type of perfectionism have high standards and are direct and passionate about achieving goals. They can be critical of both themselves and others and may neglect their health and relationships in pursuit of goals.
Parisian perfectionism - People showing Parisian perfectionism are often driven by a sort of relational perfectionism. They care about how they are perceived by others and can tend toward people-pleasing in relationships.
Procrastinator perfectionism - This type of perfectionism shows up in preparation for tasks - these folks can be excellent at preparing but can struggle with indecisiveness and inaction.
Messy perfectionism - Folks showing messy perfectionism often excel at new beginnings and starting new projects. These folks may spread themselves too thin with different projects, often having difficulty actually staying focused on their goals after the initial phase of excitement.
Folks often experience a mix of these different types of perfectionism, and they show up in different ways in different relationships and situations.
The Link Between Perfectionism and Anxiety
Studies consistently show a strong overlap between perfectionism and anxiety. When self-worth depends on performance, every task, interaction, and project carries extra weight of defining not just your abilities, but your worth.
This leads to a pattern of hypervigilance - you scan for mistakes, overthink decisions, and prepare beyond what is necessary, making it perfect to prevent the dreaded catastrophe that anxiety has told you is possible. While a level of anxiety is healthy and helpful, perfectionism aggravates this, making any small preparation “not enough” to prevent the threat.
The perfectionist mindset amplifies anxious thinking, and anxious thinking, in turn, reinforces perfectionist habits - saying, yes, that makes sense to do that, to protect yourself - creating a loop that can feel endless, and honestly, exhausting. And it can feel impossible to step off the treadmill without support.
Perfectionism and Physical Health
Perfectionism tricks you into believing you’re just “pushing through.” But when you’re constantly pushing yourself, your nervous system is on high-alert. You’re constantly prepared for a threat, and over time this stress response can create real physical issues.
This can show up as:
Trouble falling or staying asleep
Jaw clenching, headaches, or TMJ
Digestive issues that flare under stress
Constant fatigue, even after rest
Long term risks like immune suppression and cardiovascular strain
If you’ve ever had the thought, “Maybe if I just push a little harder, I’ll finally feel better,” while your body screams for rest - that might be perfectionism talking. Your body cannot sprint forever.
Why High-Achievers Feel Perfectionism the Most
High-achieving women often carry high levels of perfectionism. Many grew up as the “golden child” - praised for being smart, responsible, or reliable. Achievement wasn’t a bonus - it was the ticket to feeling safe and loved.
As adults, this can turn into:
Pushing yourself harder than anyone asked you to
Feeling like everything will fall apart unless you hold it together
Taking on too much at work because “no one else will do it right” or “it’s just easier if I do it.”
Struggling to rest without feeling guilty
Being hyper-independent and struggling to trust others
And of course, our culture doesn’t help. Hustle culture rewards overworking, and women are often expected to juggle work, home, relationships, and self-care while looking effortless doing it. It’s no wonder so many high-achievers feel like they’re drowning while everyone else calls them “impressive.”
Why It’s Hard to Let Go of Perfectionism
If perfectionism is so exhausting, why is it so hard to stop?
Belief it’s the reason for your success: “I got here because of perfectionism - if it let it go, I’ll lose my edge,” “If I stop pushing, I’ll fall behind,”
Systemic reinforcement: workplaces, schools, and even families often praise perfectionistic behavior without recognizing the toll on the individual
Internal conflict/safety: Part of you knows it’s unsustainable, but another part clings to it because it feels like safety.
Identity: Perfectionism can feel like more than a habit - it can feel like your identity.
This is why simple advice like “just lower your standards” doesn’t work. Perfectionism is deeply tied to identity and self-worth. It takes deeper work to untangle.
Therapy for Perfectionism
Therapy isn’t about making you less ambitious or telling you to “just stop caring.” It’s about creating space where you can finally separate the part of you that wants growth from the part of you that’s constantly running on fear.
In therapy, you begin learning to trust yourself again. Perfectionism can convince you that if you’re not triple-checking everything, you’ll drop the ball or make a mistake. In therapy, we start rebuilding that inner trust. Instead of asking, “what will people think?” the focus shifts to, “what actually matters to me?” This shift toward your own values can help make decisions feel less pressured and more grounded.
Therapy also helps you keep your drive without letting fear run the show. Ambition isn’t the problem - fear is. In therapy, we work together to untangle the part of you that thrives on meaningful goals from the part that says you have to be perfect.
Over time, perfectionism becomes less of the driver and more of a backseat passenger. It’s not about banishing perfectionism altogether, but taking its feedback into consideration and deciding how to move forward from a grounded place.
Moving Forward - Now What?
While perfectionism has its benefits and can be culturally praised, its effects on mental health can be significant. It can fuel anxiety and impact physical health, and for high-achievers it can keep you stuck in cycles of burnout.
The good news is that, despite what it might feel like today, perfectionism isn’t your identity. It’s a set of habits and beliefs you learned to survive and succeed. With support you can learn new ways of living that support your ambition without the constant pressure of never feeling like “enough.”
👉 If you recognize yourself here, you don’t have to keep running on fumes. Learn more about Therapy for Perfectionism & Anxiety in High-Achieving Women and how support can help you create a steadier, more sustainable way forward.