Perfectionism's Role in Depression

How our expectations sustain our struggles with mental health

• Perfectionism often underlies depression and anxiety.

• Our expectations, as well as the world, can make us feel hopeless.

• Separating the search for justice from receiving it from specific others can help.

Our expectations are intertwined with our imaginations and our innate tendencies to idealize our futures. The famed absurdist philosopher Albert Camus noted that life is absurd and that it’s up to us to find a way to overcome it; but, I wonder if we aren’t the absurd ones, with our romanticized expectations and unwillingness to accept ourselves, and life, for what it is.

It’s become cliche to note that depression and anxiety aren’t just ailments; they’re also messengers indicating that something about our lives and even the world is off. Yet, what’s rarely noted is that both can, and often do, mean that something is off about us and the way we approach the world. For perfectionists, both indicate not only a flawed world but flawed expectations and perceptions, too.

“What can we reasonably expect?” is an important question to ask ourselves.

Many of our patients seek treatment because, unbeknownst to them, they remain stuck in abstract concepts, like justice, fairness, and order; all three are integral parts of obsessive-compulsive personalities. As you can imagine, it’s easy to feel defeated when the world fails to embody them, which it frequently does. Philosophically speaking, these conversations are difficult, whether in therapy or outside of it. Questions arise with full force: “Shouldn’t I expect my partner to treat me well?” The battle is then set: Reality vs. idealism. And, being on the side of reality can easily make one feel like a bad person, especially when having to inform someone in a difficult relationship that expecting change, with no steps taken by the other party, contributes to their happiness.

The question of what we deserve is a difficult one. But it may be helpful to separate it into two parts. The first: What do I deserve from the world at large? And the second: What do I deserve from someone who’s seemingly incapable of change? Perfectionists lump the two together, demanding justice from the entire world, especially those closest to them. And, at least in part, it’s due to the fear of having to make difficult choices, to accept and sit with failure and loss, and to acknowledge mistakes.

Because perfectionists are keen on thinking and doing, they often have exaggerated self-conceptions, believing that they’re smart enough to change minds in significant ways. Thus, they remain in unsustainable relationships, perfecting their arguments, believing that, eventually, others will note their own errors. They expect a mystical-like epiphany, which seldom arrives. And they suffer when parents, partners, friends, and bosses don’t budge. As their moods deteriorate, they cling to their ideals and plead for sympathy while shouting, “Don’t I deserve better?”

As children, we need our parents to be good enough; we don’t have much of a choice in where we operate. Therefore, the belief that, through effort, we can influence our environments is strongly linked to hope and emotional well-being. With no progress, hope aids survival. However, this form of it, which can be considered extreme, becomes problematic as we age and becomes associated with rigidity and lower moods, seesawing between extreme optimism and hopelessness. For some, just as in childhood, to feel worthy, they depend on their ability to create a world wherein their dismissive partner, parent, friend, or boss sees the light. This implies that justice, fairness, order, and the lack thereof are all markers for self-value. “If I’m treated poorly, it must mean that I don’t deserve better, even though I know I do.”

While all of us live with some degree of ambivalence, perfectionists deeply struggle with conflicting thoughts, preoccupied, again, with order. It’s either everything makes sense, or nothing does. If their partners, or whoever, aren’t just or fair, then maybe justice doesn’t exist. Or, even worse, maybe it doesn’t exist for them. We separate the above-noted questions because doing so aids in exploring a relationship’s potential without the interference of our ideals and our ideals without the interference of our all too human relations.

In treatment, patients may learn that while they deserve justice, they may not receive it from specific others. And they may come to accept that understanding the reason isn’t all that important. They may discontinue to perceive poor treatment as a reflection of them, but think of it more as symbolic of the other’s unwillingness to subscribe to those concepts or even care about another’s well-being. One of the worst parts for many of these people seems to be feeling invalidated, as though asking for justice, truth, and order is a silly request. But if the first question is sufficiently answered, we can eat our cake and have it, too. We can resolve to align ourselves with those who at least attempt to embody our values while acknowledging that many won’t, even those whom we so desperately wanted to change. This is worth fighting for.

If you were to ask me now whether Camus was right, I’d tell you no, at least not completely. Life is absurd, but so are we. And often, we’re the ones who stand in the way of our ourselves, at least to an extent, precluding any semblance of a happy life.

Leon Garber - Website - Blog -