Perfectionism, when it’s become your only option, can feel like its own prison.
Let me introduce you to three very real people who entered therapy with little awareness of what was happening beneath their carefully controlled – and perfect-seeming – persona.

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Janet…
First, there’s Janet, a professionally successful young woman who once woke up alone and naked in a hotel room with no memory of how she’d gotten there. And she knew she’d been raped. She quickly found her clothes, went home, and never spoke of it again. Why? The shame and fear were overwhelming, and she’d learned early in life that pain should be sealed away.
“I put it out of my mind,” Janet tells me now, smiling. “And it was so long ago.”
So why did she come to therapy?
She’d been throwing up at least twice a day for years.
Vanessa…
Then there’s Vanessa, impeccably dressed, deeply involved in her community, a devoted wife and mother. She’s admired and relied upon. What no one sees is the growing panic she feels before social gatherings. She swallows Xanax and wine to cope. When I ask when her depression began, she looks genuinely surprised. “Oh, I’m not depressed. I don’t cry or anything. I have far too many blessings in my life to be depressed.”
Jay…
And then there’s Jay, the man you can always count on. An internationally successful lawyer, divorced but remarried and quite close with his kids, always willing to go the extra mile.
Old wounds had been buried deep. Jay had been sexually abused by an older sibling… for years. That sibling was his dad’s “favorite,” often being chosen for special activities. His kids are now the age he was when all that chaos was happening. But he doesn’t understand why he feels compelled to stay constantly busy or why stillness feels so unsettling.
Janet, Vanessa, and Jay learned early on that their emotional survival depended on appearing in control, showing no pain, projecting success and strength. And the most recent research on perfectionism shows that this trap of, “The better I do, the better I’m expected to do” can become dangerous, even at a young age.
Five steps to escape the prison of destructive perfectionism…
Do any of these stories sound familiar? Do you recognize parts of yourself here?
I’ve termed this way of being “perfectly hidden depression.” When your life seems perfect. Yet inwardly, the pain you silently feel can grow ever stronger.
And if so, how do you change? How do you stop hiding?
Here are five steps that can help you acknowledge vulnerability, cultivate self-acceptance, and begin healing; these are antidotes to the shame and fear you’ve carried for years.
1) Become aware that your need to seem “perfect” is a problem.
Striving for excellence is not unhealthy. But when shame and fear become the driving force behind how you live, something is wrong. When you can’t “not” be in control…. that’s too frightening.
If you don’t recognize that perfectionism is eroding your joy, if you do not notice you’re own growing loneliness or despair, it becomes difficult to see it as something you need to change.
Awareness is the first step.
2) Commit, or set an intention, to change.
This can be especially hard with perfectionism. On the surface, everything looks fine. No one checks in to ask if you are okay. There’s no external alarm. So hiding becomes easy. Another smiling selfie. Another accomplishment. Another quiet dismissal of what hurts.
But you can change. You will stumble. You will slip back into old patterns. That does not mean you have failed. It means you are human.
3) Confront the rigid rules you live by and the beliefs beneath them.
You have followed these rules for a long time. The should’s, the musts, the never’s.
For example, “My needs should never come first. That would be selfish.” What belief lies underneath that rule? Perhaps, “If I admit my needs, I will not be loved or safe.”
That belief keeps fear alive and quietly shapes your life.
4) Safely reconnect with painful feelings.
Many people tell me, “If I start talking about what I am sad or angry about, the pain will never stop. It will overwhelm me.”
That fear is real. And if you have been disconnected from your emotions for a long time, reconnecting can feel impossible. This process requires patience, compassion, and often support.
There’s frequently something in your personal history that got all this started. You adapted. But now, that original trauma or dynamic that created the need to hide needs to be identified, talked about and worked through gently and compassionately. That may take some time and working with a therapist might be in order.
5) Grow into change and practice safe transparency.
You can learn to find your strength in opening up about who you are to others and being slowly more transparent with those you trust But not everyone in your world is safe. Those who love you may have been concerned about how much you take on, or how you never seem to flinch. Yet others may have counted on your need to seem always in control.
Good givers can attract good takers. So you need to assess your relationships carefully.
Taking these steps is more than worth it.
Simply but honestly put – they may save your life.
By the way…
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It’s so heart breaking to me that depression creates both internal and external isolation, thus making it so much harder for the individual experiencing it to see that getting help can lead to getting real tools to liberate them from being in that stuck mode.
By “internal isolation”, I am assuming you mean the idea that they struggle to feel emotions themselves. Yes, that’s what I hear all the time. It’s as if there is a wall there that they can’t get beyond. We have to work at it brick by brick to take it down, very carefully. It’s been erected over the years for a reason. Thanks for commenting Elin.
This is an important post to write and get out there. I’ve seen depression up close and it’s frightening and disturbing. I hope that your words hit home with those who need it. We need to continue this conversation in order to cope and, hopefully, move on. Great post, Margaret.
You bet it is Cathy. It can turn someone’s life completely into something they don’t identify with anymore. Or connect with in any meaningful way. It’s implosive. Thanks for helping me with your own words and actions.
Thanks for this, Margaret. I believe I am depressed….situational or short term….still grieving I’m sure. I’ve tried hard to be strong and gain confidence this past year…..and everyone told me so. But I am sadder now, tired and sick of giving and smiling and carrying on. Why is it suddenly harder? Is it survivor’s guilt or dishonoring what we had to be enjoying life? Your suggestions grabbed me…..maybe look at myself and vulnerablility rather than helping others cope. Thanks, my friend.
Joan thank you for sharing so personally. I would like to hear more. I am glad this struck a chord and of course, you are welcome.
I come from a long line of people who suffer from chronic depression. The impact that it has had on our family is devastating as not one person is close to the next. I’ve been able to recognize that the this is going on currently, however, not everyone has had this realization and still suffer, or make those around them suffer, from their day to day detriment.
I am sad hearing that but perhaps with your realization you can stop the legacy. Michael Yapko has a wonderful book entitled “Hand Me Down Blues”. It’s about familial depression. I would highly suggest it to you or any of his books. Thank you for such a personal comment.
I am sad hearing that but perhaps with your realization you can stop the legacy. Michael Yapko has a wonderful book entitled “Hand Me Down Blues”. It’s about familial depression. I would highly suggest it to you or any of his books. Thank you for such a personal comment.
It also sounds very lonely actually. So I hope you have others support.
It also sounds very lonely actually. So I hope you have others support.
Everyone, I mean everyone is fighting some sort of battle…it’s important to be kind, especially to yourself. I used to think depressed people were just not trying or not seeing the positive until it happened to me. It has been a journey for me, and your weekly posts have really helped me get through the most difficult years of my life. Depression is a nasty beast but if you do the work and make it a daily habit you can get through it. I am so thankful for your help Dr Margaret.
What a kind response Michelle. I’m honored and delighted to be of help. Warmly Dr. M.