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5 Ways Perfectionism and Depression Are Related

August 3, 2023
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Perfectionism and depression might not seem related at first glance. After all, perfectionism is about having overly high expectations of yourself. Depression is about a loss of pleasure and joy in the world. What’s so similar about those things? As it turns out, they have more in common than you might think.

The types of thinking that lead to and perpetuate perfectionism are frequently the same types of thinking that lead to and perpetuate depression. Dr. Zacharias is a psychiatrist who helps people understand and cope with both perfectionism and depression. Recognizing the similarities between the two issues can help you better navigate your mental health and find the support you need.

The Underlying Factors of Perfectionism and Depression

Perfectionism and depression have surprisingly similar underlying factors. While the two can be very different experiences and stem from different life challenges, they share many common traits, beliefs, and patterns of thinking.


Perfectionism is defined as having unrealistically high standards for your own achievements and performance. People with perfectionistic tendencies are frequently unhappy with their accomplishments, no matter how outwardly successful they are. Perfectionists tend to have highly self-critical thoughts, low self-worth, and high levels of shame. By default, perfectionism is impossible to achieve and maintain in the long run, because perfection itself is unachievable.

Underlying factors of perfectionism vary. They can include internalized pressure to succeed, trauma, early childhood experiences, and equating your worth with certain types of achievements.

Having standards for yourself that are ultimately impossible to attain can lead to mental health problems, including distress, overthinking and anxiety, and depression. While depression isn’t always a direct result of being a perfectionist, it can be caused in part by the same types of thinking that cause perfectionism.


Depression, unlike perfectionism, is categorized as a mental health disorder by the DSM-IV. It can be caused by a multitude of different factors, including trauma, brain chemistry, external circumstances, thoughts, and a sense that you don’t have control over your life.

In order to be diagnosed with depression, several of the following symptoms must be persistent and present in your life:

If you’re experiencing thoughts of death or suicidal ideation, don’t delay seeking help. Get support from a doctor or psychiatrist right away.

5 Things Depression and Perfectionism Have in Common

Depression and perfectionism share many common similarities. Here are five ways perfectionism and depression are related.

1. Unrealistic expectations

Having unrealistic expectations for yourself is a hallmark of both perfectionism and depression. Setting unreasonably high standards for yourself and then falling short of those standards feels awful, and it’s the cycle of perfectionism. Not meeting the standards you think you should be living up to – in other words, having expectations that don’t match the reality of your situation – also often causes hopelessness and depression.

2. Ruminating and brooding over past mistakes

Have you ever made a mistake that you can’t stop thinking about? If so, you know how agonizing it feels to keep repeating the situation in your head over and over, powerless to change it. This is known as ruminating, when you cycle through memories and situations from the past. Sometimes it feels involuntary, but sometimes people do it as a way to atone for something they feel they’ve done wrong.

As a perfectionist, you might find yourself doing this because of your overly self-critical tendencies. Brooding over past mistakes can make you feel helpless, out of control, and stuck. It can also factor into depression because your thoughts may cause feelings of low self-esteem, worthlessness, and guilt.

3. Lack of flexibility in thinking

Lacking flexibility in your patterns of thinking means you have a specific idea of the way things should go. This mindset can decrease your ability to cope with unmet expectations and standards. Thinking things can only look one particular way (or else they’re wrong) can increase perfectionism and depression because when things turn out differently than you thought, you internalize it. You might feel like a failure, or blame and criticize yourself, or feel helpless to navigate the change.

4. Internalized shame

Internalized shame plays a large role in both perfectionism and depression. Shame is the feeling that you as a person are inherently wrong or bad. Perfectionism often exacerbates these feelings, because you’re likely to feel ashamed when you fall short of your expectations. Many perfectionists use shame as a motivator to achieve their goals. While this can sometimes work in the short term, it ultimately does more harm than good.

Depression and internalized shame also frequently go hand in hand. Depression often involves outsized feelings of worthlessness and guilt, which are closely tied to shame. The more worthless you feel about yourself, the more likely you are to feel deep shame and depression.

5. All-or-nothing thinking

Also known as black and white thinking, all-or-nothing thinking is a type of cognitive distortion that refers to being rigid and extreme in your thoughts and beliefs. You tend to jump to unfounded conclusions based on how you’re feeling in the moment. These types of thoughts are usually unconscious and habitual. You may not even realize you’re engaging in all-or-nothing thinking. However, it can greatly impact your mental health and reduce your quality of life.

Some examples of all-or-nothing thoughts include:

The rigidity of all-or-nothing thinking can make you feel like you’re never good enough and that things won’t ever change. Feeling resigned to living with less-than-ideal circumstances can both cause and be exacerbated by depression. If you’re a perfectionist, this might be your greatest fear. Never feeling good enough is a symptom and cause of both depression and perfectionism.

Therapy Can Help You Cope With Perfectionism and Depression

If you’re looking for support in understanding and overcoming your depression and perfectionism, Existential Psychiatry is here to help. With over 20 years of experience in healthcare, Dr. David Zacharias provides professional, individualized psychiatric care for all his patients. Together, you’ll learn how to dial down the types of thought patterns that lead to your struggles and uncover long-term solutions to end perfectionism and depression.

Curious about how psychiatric support can improve your situation? Get in touch for a free consultation to see whether Dr. Zacharias is a good fit for you. Let’s help you start a better life.

Written by Existential Psychiatry Staff