Ask the Experts

Q: Is ADHD or Anxiety to Blame for My Perfectionism?

“There is no perfection. If you think someone is perfect, then you’re comparing your insides to their outsides, which may look very different from what they experience internally. Real is better than perfect.”

Businessman holding five gold stars for rating, quality and business concept. Vector, illustration, flat style. Client's Review, Customer Feedback or Satisfaction Level concept for Website
Businessman holding five gold stars for rating, quality and business concept. Vector, illustration, flat style. Client's Review, Customer Feedback or Satisfaction Level concept for Website

Q: “My intense perfectionism holds me back in my personal and professional life. I need coping strategies, but how do I figure out if it’s related to my anxiety or my ADHD?”


A: Perfectionism shares many similarities with ADHD. Perfectionists are often driven by the fear of disappointing themselves or others. They are “all-or-nothing” thinkers; if it’s not completely right, then it must be a failure. Setting unreasonable standards and constantly comparing themselves negatively to others are common issues for perfectionists, just as individuals with ADHD  often compare themselves critically to neurotypical peers.

Perfectionists tend to over-focus on the end result, not the process of getting there. They discount the learning that’s happening, and fixate on the accomplishment. Without meeting the end goal, there’s a perception of failure. Low self-worth, sensitivity to feedback, defensiveness, and sadness stem from incomplete goals and are also common.

Perfectionism can manifest in one of three different types of procrastination in adults with ADHD.

  • Perfectionism procrastination refers to being immobilized by worry about messing up. This form or procrastination attempts to limit mistakes and reduce future shame: “I’m not going to get started on this because I don’t know if I can do it perfectly, so instead, I’m going to avoid doing it.”
  • “Avoidance procrastination” is related to a fear of failure or an expectation of failure based on past experience: “I’m going to avoid doing this thing because, in the past, I haven’t succeeded. Why do I think I’m going to succeed now?” or, “I’m going to avoid trying this because I don’t know how to get started, and I’m afraid of how it’s going to turn out.”
  • “Productive procrastination” is a delay tactic that feels really good. “I’m going to do these other things that I know I can do pretty well and get short-term relief, but I’m not going to do that big thing because I don’t know if I’m going to do it well enough.”

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Perfectionism stems from underlying issues of shame and low self-confidence. Perfectionist adults with ADHD live in fear of failing to meet the standards they set for themselves in comparison to neurotypical peers, especially if they’ve struggled to meet those goals in the past. Often these expectations are unrealistic based on “shoulds” instead of what folks actually can do.

Perfectionism and Anxiety

Perfectionism is one way that adults with ADHD try to control outcomes, a fundamental aspect of managing anxiety. Living with ADHD means experiencing moments when you’re aware that you are struggling or have messed up, but you don’t necessarily know why or how to fix it. This develops into a persistent worry, “When is the next time I’m going to receive negative feedback when I wasn’t expecting it?” This mentality feeds the desire to be perfect and fosters the effort to eliminate the scenarios where you can be criticized.

Al-Anon teaches a helpful strategy, which is Q.T.I.P.: quit taking it personally. When someone gives you feedback, part of it has to do with them but part of it might be something you can learn from. We’re all living and learning. Feedback is an opportunity for us to grow and improve ourselves. It’s not a manifestation of failure.

Anxiety acts as a coping mechanism for tolerating disappointment (yours or someone else’s) and reflects an ineffective way to manage this. It’s also a signal that you feel uncomfortable or insecure. Learning how to support yourself when feelings of discomfort arise, how to reassure yourself, and how to rely on the learning you’ve gleaned from past successes allows you to nurture the resilience that will carry you forward. This is your path toward less worry and stress.

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Self-Compassion in the Midst of Perfectionism

How do you build self-compassion in light of the unreasonable standards you might be setting for yourself by comparing yourself to peers? How do you break an unhealthy cycle of perfectionism?

Start with the things you actually do well. Write them down on a Post-It and put it on your refrigerator or bathroom mirror for daily affirmations. “I like when I…”, “I think I do a good (or good enough) job at…”, “I’ve never been perfect, and I’ve made it this far.”  Otherwise, the negative self-talk will outweigh your positive attributes and weaken your hopeful outlook.

Keep a list or journal of three things that went well, or three things that you liked about your day. It might be making an excellent cup of coffee, or speaking up at the work meeting, or showing up for a friend in need. Learning to enjoy the small achievements is a challenge for a perfectionist, particularly a person who sets high and likely unreachable goals for themselves.

Notice the progress you’re making with mindfulness. Take a moment to reflect, let this in, breathe and congratulate yourself for what you actually accomplish. It’s not only okay to feel good about yourself, warts and all — it’s actually a necessity. Tomorrow is another day. Something may happen that might bring you down a notch. But right now, pause, look at what you did that worked and enjoy it.

I have struggled with perfectionism myself. One of my mentors taught me that real is better than perfect. I love this saying. Nobody is perfect, so let’s stop using that as the gold standard. If you think someone is perfect, then you’re making a huge, false assumption. Stop comparing your insides to their outsides. Underneath their seemingly perfect exterior is a person just like you with strengths and challenges, trying to be the best they can.

The content for this article came from the ADHD Real-Time Support Group session hosted by Dr. Saline, titled “Roots of Perfectionism.”

ADHD and Perfectionism: Next Steps


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Updated on April 1, 2021

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