How perfectionism leads to depression and anxiety

©2018 Zoryna O’Donnell

‍My client (let's call her Amanda) had it all by her 40th birthday: a high flying career, a PhD, a successful businessman for a husband, two healthy children, a show-home, the latest model of a car, the best holidays and... anxiety, spiralling out of control.

  “I am working so hard to make everything perfect, but it isn’t!”  Amanda says tearfully. There always appears to be something to sabotage her drive for perfection – children not getting straight “A”s; husband refusing to go to the gym to get rid of that “beer belly”; her own legs too short and chunky for her liking - the list goes on and on.

Amanda is not alone in her despair. Many other women and men of all ages, backgrounds and walks of life are chasing the unattainable goal of perfection. This problem seems to be even worse for the Millennials - those born after 1980.

According to a study of over 40,000 American, British and Canadian college students (ages 18 to 25) published in the Psychological Bulletin in December 2017, the majority of these young people showed signs of perfectionism driven by unrealistically high expectations, or “multidimensional perfectionism”.

The authors of this research Thomas Curran and Andrew Hill pointed out that young people they have studied are noticeably harder on themselves and on others than members of previous generations. They are not only more dissatisfied with what they have, but also seemingly more dissatisfied with who they are.  

From an early age they were conditioned by society to believe that the perfect life and lifestyle - as evidenced by achievement, wealth, beauty, social status and celebrity - are  there for them to grab if they try hard enough (or if they are lucky enough). Social media such as Instagram, Facebook and Snapchat allow users to create a perfect public image – airbrushed and PhotoShopped beyond recognition – reinforcing the message that perfection is all-around them. It is out there. Everyone else has it, but them.

And so their self-perception and self-esteem are eroded by the fear of negative social evaluation, unfavourable comparison with others and failure. They ask themselves – Why? Why is my life not perfect? Why am I not as successful, affluent, lucky or popular as others? Why is my body not even close to the faultless images I see in magazines and social media? Why?.. Why?.. Why?..

When people focus on deficiencies long and hard enough, they often start blaming themselves for any difficulties they experience and any perceived imperfections - whether real or imagined. They soon learn to ignore the good things that are happening in their lives.  These tendencies could provide some explanation towards the high levels of mental health issues such as anxiety, depression and eating disorders in the society preoccupied with the idea of perfection.

And while, according to a recent report of the World Health Organisation, females are more likely to suffer with anxiety disorders than their male counterparts, there is a growing body of evidence  that many men and even young boys increasingly experience psychological distress under the impact of perfectionism, gender role socialisation and the media.

A few years ago, a total of 32,827 people from 172 countries took part in the online stress test, devised by the BBC's Lab UK and psychologists at the University of Liverpool - the biggest study of its kind ever undertaken in the UK. The findings of this study, published in the journal PLOS One singled out rumination (having thoughts stuck on replay in one's head) as the biggest predictor of the most common mental health problems in the country.

According to Professor Peter Kinderman, who led this study, dwelling on negative thoughts and self-blame are crucial psychological pathways to depression and anxiety, with rumination being even more damaging than self-blame.

Dr Ellie Pontin, a clinical psychologist and research associate at the University of Liverpool, pointed out that this is a really positive message to all of us because, while we can't change our past experiences or genetics, the way we think and deal with things can be changed.

Furthermore, helping someone tackle negative thought processes is not something that has to be done exclusively by clinical psychologists. When properly trained, other professionals also can deliver a variety of effective evidence-based interventions, including:

-      mindfulness based therapies;

-      cognitive behavioral therapy (CBT);

-      cognitive hypnotherapy  and

-      coaching.

And this is exactly how I met Amanda who came to me looking for an answer to the dreaded 'Why?” question: Why her life is not picture-perfect despite all her efforts?  

Like many of my clients, both male and female, Amanda found herself in the middle of a perfect storm created by a combination of high aspirations and even higher expectations; challenges of keeping up appearances in all areas of her life; a deeply seated belief that others will value her only if she is perfect; and an ever-increasing fear that she is not good enough to meet all those challenges and expectations.

But this was some time ago. Since then, Amanda has re-discovered herself and her true values, and learned how to appreciate her life – with all its imperfections. She had learned how to think of, and deal with, things she can control and those that she can't. Her self-esteem is growing and her anxiety is greatly reduced. She has changed. And so can you.

This article was first published on http://www.psychreg.org on 02/02/2018

Image credit: geralt via Pixabay