You searched this at 1 a.m. after rewriting the same paragraph for the fourth time, half hoping the answer was yes, so the problem would have a name and a pill.

**The short answer: no, perfectionism is not a mental illness, and there is no diagnosis called perfectionism. What researchers call clinical perfectionism is a process: worth that depends on meeting demanding self-imposed standards, pursued despite real costs, with self-criticism when you miss and a moving bar when you hit. That process is found inside several conditions, most strongly depression, anxiety and OCD, and it has its own treatment with randomized-trial evidence. So the useful question is not "do I have it?" but "is it running my life, and what does it sit on top of?"**¹ ² ³

What it is, in the research definition

Shafran, Cooper and Fairburn defined clinical perfectionism in 2002 as "the overdependence of self-evaluation on the determined pursuit (and achievement) of self-imposed personally demanding standards of performance in at least one salient domain, despite the occurrence of adverse consequences."¹ Two features make it clinical rather than a personality style: the self-worth dependence, and the persistence despite harm.

Why it is called transdiagnostic

A meta-analysis of 284 studies concluded that both dimensions of perfectionism, strivings and concerns, relate to a range of psychopathology, supporting "the notion of perfectionism as a transdiagnostic factor."² A 2024 meta-analysis of 416 studies and 113,118 adults put numbers on it: perfectionistic concerns correlated at r = .38 to .43 with anxiety, OCD and depressive symptoms; perfectionistic strivings at r = .10 to .21.³ Transdiagnostic means it is not a condition; it is a mechanism that several conditions share.

Why that is useful, not disappointing

A mechanism can be treated directly. A 2022 meta-analysis of 15 randomized trials found that cognitive behaviour therapy built for perfectionism produced medium-to-large effects on clinical perfectionism (g = 0.87) and concern over mistakes (g = 0.89), and medium effects on depression (g = 0.60) and anxiety (g = 0.42) at the same time.⁴ Treating the process moved the symptoms that sat on it.

When to stop reading and call someone

Perfectionism, especially the socially prescribed kind, is associated with suicidal thinking in a meta-analysis of 45 studies.⁵ If any version of I would rather not be here than fail has been in your head, call or text 988 today. The rest of this can wait until tomorrow.

Q&A

Q: Is perfectionism in the DSM? A: Not as a diagnosis. Perfectionistic traits appear as features within some conditions, and perfectionism is a named feature of obsessive-compulsive personality disorder, which is a different thing from OCD.⁶ Perfectionism or OCD? →

Q: Can medication treat perfectionism? A: There is no medication for perfectionism itself. Medication may treat a condition it sits inside, such as depression or OCD; the perfectionism work is psychotherapy.⁴ Who prescribes what in California →

Q: How do I know whether mine is the clinical kind? A: Answer the four questions on the topic page for the one area of life where it bites hardest, or run the two-week ledger. The four-question test → · The cost ledger →

Ready to choose a therapist who treats perfectionism directly? Filter by approach and payment route →

In crisis? Call or text 988 — free, 24/7.

Sources

  1. Shafran R, Cooper Z, Fairburn CG, "Clinical perfectionism: a cognitive-behavioural analysis," Behaviour Research and Therapy 40(7), 2002 — doi.org.
  2. Limburg K, Watson HJ, Hagger MS, Egan SJ, "The Relationship Between Perfectionism and Psychopathology: A Meta-Analysis," Journal of Clinical Psychology 73(10), 2017 — doi.org.
  3. Callaghan T, Greene D, Shafran R, Lunn J, Egan SJ, "The relationships between perfectionism and symptoms of depression, anxiety and obsessive-compulsive disorder in adults: a systematic review and meta-analysis," Cognitive Behaviour Therapy 53(2), 2024 — doi.org.
  4. Galloway R, Watson H, Greene D, Shafran R, Egan SJ, "The efficacy of randomised controlled trials of cognitive behaviour therapy for perfectionism: a systematic review and meta-analysis," Cognitive Behaviour Therapy 51(2), 2022 — doi.org.
  5. Smith MM, Sherry SB, Chen S, et al., "The perniciousness of perfectionism: A meta-analytic review of the perfectionism–suicide relationship," Journal of Personality 86(3), 2018 — doi.org.
  6. MedlinePlus (U.S. National Library of Medicine), "Obsessive-compulsive personality disorder," reviewed October 20, 2024 — medlineplus.gov.

Paid for by participating therapists. Inclusion is computed from availability data — never purchased. No ads, no data sold.