It’s got to be perfect! ADHD and perfectionism

It may seem odd to think that ADHD and perfectionism can go hand in hand. What is perfectionism, and do people with ADHD have a tendency to be perfectionists?

Perfectionism is a personality trait characterised by setting high standards for oneself, striving for flawlessness, and having self-critical tendencies. Perfectionism has been linked to a wide range of psychiatric conditions, including obsessive-compulsive disorder (OCD), generalised anxiety disorder (GAD), social anxiety disorder (SAD), depression, and eating disorders. Whilst this may make it seem like perfectionism is a negative thing, perfectionism in some has also been linked to positive outcomes, such as high achievement, self-efficacy (or belief that you can succeed), and adaptive coping.

This means that there may be two manifestations of perfectionism; adaptive (or good) and maladaptive (or bad). Within these two types of perfectionism, it’s been proposed that there are six areas of perfectionism:

Adaptive
– High personal standards
– Organisation

Maladaptive
– Concern over mistakes
– Doubts about actions
– Parental concerns
– Parental expectations

In the past, impulsivity (which the majority of adults with ADHD may have issues with) and perfectionism have been considered as opposite ends of the spectrum (e.g., “under-control” and “over-control”). More recent research has shown that these traits can actually co-exist, especially in areas associated with ADHD like impulsive eating. Even more recent research showed reported that perfectionism may be the most common distorted thought pattern seen in ADHD.

People with ADHD often procrastinate because things aren’t “just right” or because they believe they can’t perform a task perfectly. So for some people with ADHD, perfectionism stops them from ‘doing things’ but for others, it is a coping strategy that actually works, albeit a really bad one in terms of our mental health. The stress and pressure that people with ADHD put on themselves to meet this impossible standard can become a source of motivation for people with ADHD. This pressure can become a substitute for the lack of normal activity of dopamine, a brain chemical that is altered in ADHD, which would be the normal source of motivation for people without ADHD.

Perfectionism can also stem from low self-esteem, negative experiences and rejection sensitivity. If perfectionism holds you back when working on things, remember perfection is the enemy of progress! Doing something well is better than not doing something or doing something so late that it’s not timely. Ask yourself “Do other people worry if it’s perfect?” Sometimes, underpromising and over-delivering can be a good way to manage expectations.

Authors: James Brown PhD and Alex Conner PhD.