contact Justine

Takeaway: Perfectionism and anxiety are two sides of the same coin. One often serves as both a cause and a symptom of the other. In this article, I explain the symptoms of high functioning anxiety and perfectionism and how to deal with your perfectionism.

Are You an Anxious Perfectionist? Here’s How to Know – And How to Deal

Are You an Anxious Perfectionist? Here’s How to Know – And How to Deal

It’s normal to strive to do a good job in life. Almost everyone wants to be seen as helpful, kind, and knowledgeable. But for the high-functioning anxious perfectionist, the desire to be perceived as the very best can start to take over all aspects of someone’s life. It’s no secret that high-functioning people tend to have anxiety. I see a lot of symptoms of high functioning anxiety in my clients.There’s also a common need among people with anxiety to be seen as flawless in life – at work, at home, and among friends and family.

As a therapist for teens and young adults, many of the clients I work with struggle with high-functioning anxiety and perfectionism. What they don’t often realize is that perfectionism and anxiety are deeply connected. They form a cycle that, when left untreated, can cause a lot of problems. So what is the connection between the two? And how can you start to break free from that cycle? 

Perfectionism and Anxiety: Two Sides of the Same Coin

Perfectionism is the urge to be perceived as flawless by everyone around you. Perfectionists understand theoretically that perfection is impossible to attain. But they are driven toward perfectionism in order to try and “make up for” their perceived flaws. If you’ve ever spent hours “improving” an already decent essay for school or felt incredibly upset by constructive criticism, you can understand what perfectionism looks like in action.

Anxiety, on the other hand, is a physical response to stress. Some symptoms of anxiety include restlessness, increased heart rate, inability to concentrate, and feelings of impending doom. These feelings can be incredibly uncomfortable and cause distress.

Perfectionism and anxiety are two sides of the same coin. One often serves as both a cause and a symptom of the other. This is in part because perfectionism is one way people try to cope with their anxiety. It’s tempting for people who experience a lot of anxiety to want to control or minimize the discomfort of that anxiety – and one way to do that is by aiming for perfection at all times.

Being “on” all the time and not allowing for mistakes might seem like a good way to dispel anxiety, but the opposite is actually true. Perfectionists are likely to set super-high standards for themselves and work very hard to try and reach their goals. But the more impossible your standards are for yourself, the more likely you’ll fall short in reaching those goals. Anxious perfectionists might consider this failing. If you feel like you’ve failed, you may experience burnout, depression, increased anxiety, or other struggles. 

Failure isn’t always a bad thing, of course. People with a growth mindset understand that failure is part of learning, and everyone undergoes failure in order to become better at a skill or behavior. But for anxious perfectionists, failure is the worst possible outcome. It confirms their fears that they’re not good enough. They take failure as a sure sign that they’re unworthy, unloveable, or unacceptable. And this further fuels both their anxiety and perfectionism. 

Symptoms of High Functioning Anxiety and Perfectionism

Here are six ways to know whether you’re experiencing symptoms of high-functioning anxiety and perfectionism. 

  1. Fear of failure. The pain and anxiety of failure can keep many anxious perfectionists from even trying. It also prevents perfectionists from ever truly relaxing, even if they feel like they have done a good job at something. The next thing or deadline is always looming, and the stakes always feel very high.

  1. Comparison to others. Anxious perfectionists compare themselves constantly to other people. They keep track of who’s doing what and whether they’ve “fallen behind” somehow. They feel like they have to keep up (and surpass) anything anyone else does. This includes people who have much more experience than them, and whose full stories they don’t know or have access to. Comparison with others is exhausting, especially because there will always be someone who looks like they have it together more than you.


  1. Belief that mistakes indicate personal flaws. Mistakes don’t feel okay for anxious perfectionists to make, because they feel like evidence of unworthiness. Anxious perfectionists have to get everything right – and get it right the first time. This, of course, puts an incredible amount of pressure on every task and interaction in life. 

  1. Repetitive body-based behaviors. Behaviors such as skin picking, nail biting, or hair plucking are common among anxious perfectionists. The anxiety often is so strong within the body that it needs to be expressed somehow. These are coping mechanisms that help people channel their anxiety and soothe themselves, but of course can lead to other problems. 

  1. All-or-nothing thinking. Success or failure feel like the only two options to an anxious perfectionist. They see situations they struggle with as direct indicators of their low self-worth and value. They also tend to view small mistakes as huge failures, and are more likely to focus on those failures than the good things they’ve done. 

  1. People -pleasing. Perfectionism, anxiety, and people pleasing are frequently a trifecta. People pleasing is another coping mechanism to soothe anxiety or fear. It is usually established in childhood and helps make you feel safe from the opinions and negative feelings of others – at least for a while. But people- pleasing increases both anxiety and perfectionism, because there’s no way to make everyone happy all the time. 

As you can see, perfectionism can be quite destructive and harmful to mental health. The anxious perfectionist often believes they’ll never be good enough, no matter how hard they try. And they have a core fear that their mistakes and imperfections will cause them to be rejected in life.

How to Deal With Your Perfectionism

Aiming for perfection, not being able to reach perfection, feeling guilt and shame, and then striving once again for perfection is a self-reinforcing cycle. It continues to feed itself and grow stronger. At its core, anxious perfectionism is about fear. It could be the fear of uncomfortable emotions, or it could be the fear of being rejected. 

Dealing with perfectionism is a long game. It requires patience and practice. But with time and compassion, you can do it. Here are three of my favorite ways to break the cycle.

  1. Reframe negative thoughts into neutral ones. Shifting negative thoughts to positive or neutral ones is a key way to break the habit of perfectionism. It’s also helpful for breaking out of all-or-nothing thinking. For example, if you didn’t do as well as your friends on a test in class, you might think, “I’m so stupid! Everyone else did so much better than me. I’ll never amount to anything.” Instead, try thinking something like this: “I didn’t do as well as I hoped, but it’s okay to have off days. This material was hard for me, and I’ll work with my teacher to try and understand it better for the next test.” This type of self-talk changes your experience from beating yourself up to an opportunity for self-compassion. 

  1. Separate outcomes from self-worth. Remind yourself that outcomes don’t affect your inherent worthiness. If you make a mistake, practice being gentle and compassionate with yourself. Know that failure is not a death sentence; if you mess up, you can try again. You’re already worthy – and enough – exactly as you are.


  1. Therapy. A trained therapist can help shed light on your negative self-talk, suggest gentle ways to redirect, and work with you to come up with new healthy coping mechanisms for your anxiety and perfectionism. 

Want Support With Your Perfectionism and Anxiety? I Can Help

If you want help figuring out how to break out of the cycle of perfectionism and anxiety in your life, consider my mini course for anxiety management called “The Path to Peace.” My course can help you understand the symptoms you’re experiencing, reframe difficult thoughts and beliefs, embrace your inherent self-worth, and learn healthy coping tools for your anxiety. You can learn more about this 7 day course here.

Meet the author

Justine Carino

Justine is a licensed mental health counselor with a private practice in White Plains, NY. She helps teenagers, young adults and families struggling with anxiety, depression, family conflict and relationship issues. Justine is also the host of the podcast Thoughts From the Couch.