How Perfectionism Can Lead to Depression and Anxiety + Tips on How to Stop the Toxic Perfectionism Cycle (Interview with Psychologist Dr. Margaret Rutherford)

We all know we should try our best and strive for excellence in everything we do, but what happens when this desire to do well turns toxic? In this week’s blog and podcast, I speak to clinical psychologist Dr. Margaret Rutherford about how perfectionism can be another manifestation of depression, what to do when our desire to succeed becomes destructive, why we need to learn from our failures, and useful techniques to overcome perfectionist tendencies.

In her new book, Perfectly-Hidden Depression, Margaret notes how many perfectionists often don’t acknowledge or know that they are depressed, or that their desire to succeed in every area of their lives is a coping strategy to deal with past hurts and trauma. Many do not have what are considered “normal” traits of depression, that is feelings of helplessness and hopelessness. Indeed, in a number of cases they do not know how to express uncomfortable or painful feelings and emotions, and tend to talk about what they have gone through in a very detached way.

This type of perfectionism is different from striving for excellence, which is more process-orientated and encourages you to learn from your mistakes. Perfectly-hidden depression, on the other hand, is fueled by fear and shame. Toxic perfectionism tends to be goal-orientated, and sees failure as a sign of worthlessness, which puts intense pressure on someone’s performance, compelling them to constantly do better and hide their mistakes.

Some of the other traits of someone with perfectly-hidden depression are: 

  1. Perfectionists tend to take on new tasks and responsibilities, even if their plate is already full.
  2. They are very analytical, and tend to supress or ignore their emotions.
  3. They tend to worry a lot, as they always feel the need to be in control.
  4. They focus intensely on completing tasks, which makes them feel good about themselves—they do not have an innate sense of worth.
  5. They focus on others. They are generally good friends, but have a hard time being open and vulnerable with others.
  6. They tend to discount their own feelings.
  7. Many people with perfectly-hidden depression count their blessings but don’t see the underbelly of their gratitude, but blessings can also have difficult and negative aspects! For example, celebrity is often celebrated in our society, but it can be emotionally and physically draining.
  8. They are generally very successful work-wise, but their relationships with others tend to be problematic.
  9. They often have concurrent conditions, such as eating disorders or severe anxiety.

Margaret always takes a relationship-centered approach to helping people deal with perfectly-hidden depression. Her job as a therapist is not to fix someone; rather, she believes in listening to their whole story and creating a safe space where they can learn to be open and vulnerable. This is incredibly important since the first step to healing is the ability to acknowledge that there is a problem, which takes a lot of courage and resolve. People need to feel that they can express their feelings without shame or judgment, and recognize that self-awareness is not the same as selfishness.

Once someone is aware of the issue, then they can:

  1. Focus on their commitment: what will get in their way and how can they work on it?
  2. Confront the issue: Go back and look at the rules they have been following. For example, one rule they may have subconsciously been following is that they are not allowed to make mistakes or be sad.
  3. Make the connection through a trauma timeline, which includes listing all the good things and bad things that had a big impact in their life. This helps someone with perfectionist tendencies learn how to connect to their emotions.
  4. Change: this means looking for small, doable ways someone can change their relationship with themselves and others, such as admitting that they are not sure what to do in a particular situation and asking other people for suggestions/ideas. 

When it comes to our children, we also need to show them that it is okay to be vulnerable and express how we feel (for more on this see my recent blog and podcast episodes #144 and #148). Of course, we need to do this in an age-appropriate way, but we should not hide our emotions from our kids. As parents and guardians, we need to model how to acknowledge, express, and connect with our feelings in a safe and healthy way, and be careful that we do not impose our own perfectionist tendencies on our children.

For more information on perfectionism, depression and mental health, listen to my podcast with Margaret (episode #150), check out her website and her book. If you enjoy listening to my podcast please consider leaving a 5-star review and subscribing! And keep sharing episodes with friends and family, and on social media (don’t forget to tag me so I can see your posts!).

Podcast Time Stamps

1:58 What is perfectly hidden depression?

7:25 The role of the therapist is not to fix people

10:49 What is perfectionism? 

17:34, 27:20 The ten main traits of perfectly-hidden depression

19:36 How is this different from other forms of depression

38:00 The first step to healing is acknowledging that there is a problem

42:01 Tips and techniques to deal with perfectionism

40:05 Helping child or teen battling with perfectly-hidden depression  

52:10 Social media and perfectionism

If you would like to learn more about perfectionism, depression and mental health, join me at my Mental Health Solutions Summit in Dallas, TX December 3-5, 2020! This conference is for everyone: teachers, CEOs, students, parents, doctors, life coaches...everyone! For more information and to register click hereEarly bird special pricing end 4/30!

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