You finish a piece of work and instead of feeling proud, you feel flat, already scanning for what you got wrong. You reread an email four times before sending it. You have started saying no to things you would normally enjoy, because doing them properly feels like too much effort right now.
If this sounds familiar, you may be dealing with perfectionism anxiety, the anxious, self-critical state that builds when high standards stop feeling like ambition and start feeling like pressure. This article looks at what perfectionism anxiety actually is, how it develops, the signs to watch for, and what support looks like here in Australia, including how Medicare can help with the cost.
What perfectionism actually is (and where it comes from)
Perfectionism is a personality pattern, not a mental illness. It involves setting extremely high standards for yourself, then judging your own worth by whether you meet them.
Psychologists usually describe three types. Self-oriented perfectionism is the pressure you put on yourself. Other-oriented perfectionism is the pressure you put on the people around you. Socially prescribed perfectionism is the belief that other people expect you to be perfect, and will judge you if you are not.
This pattern often has an origin story. It may have started as a way to feel safe, to earn approval, or to keep some sense of control during a stressful time. Psychodynamic and schema-informed approaches to therapy tend to look at these origins directly, rather than only focusing on the current behaviour.
The table below shows the difference between healthy striving and the kind of perfectionism that starts to hurt you.
How perfectionism anxiety develops: the “unrelenting standards” pattern
Perfectionism turns into anxiety when your mind starts treating an ordinary task, like sending an email or finishing a report, as a genuine threat. In schema therapy, this pattern is sometimes described using the term Unrelenting Standards, a belief that you must always strive to meet extremely high expectations, no matter the cost.
Once this belief is in place, a familiar cycle tends to follow. You set a very high standard, worry about whether you will meet it, feel your anxiety rise, then either overwork the task or avoid starting it altogether.
Research backs this up. A 2025 study from UNSW Sydney and St Vincent’s Hospital found that perfectionism is significantly associated with anxiety severity, and that both the striving and self-critical sides of perfectionism are uniquely linked to generalised anxiety disorder (Source: UNSW Sydney and St Vincent’s Hospital, 2025). The same study found that CBT reduced perfectionism even when perfectionism was not the direct focus of treatment, which is a useful thing to know if you are weighing up whether therapy could help.
Signs your standards have tipped into perfectionism
Perfectionism can be hard to notice in yourself, because from the outside it often looks like diligence or care. These signs point to standards that have become rigid rather than helpful.
- You rewrite or recheck work long after it is already good enough
- You feel relief rather than pride when you finish something
- Small mistakes feel like proof that you are not good enough
- You put off starting tasks you are worried about getting wrong
- You brush off compliments or move straight to what could have been better
- You hold yourself to standards you would never expect from a friend
- You feel tense, anxious or flat without an obvious cause
You do not need every item on this list for the pattern to be worth paying attention to. Even a few of these, if they are frequent, are worth noticing.
Who this shows up in most, and why it’s easy to miss
Perfectionism anxiety is common among high achievers, carers and students, partly because the underlying behaviour is often praised rather than questioned. A colleague who reworks a report five times is called thorough. A parent who cannot sit down until the house is spotless is called on top of things.
Anxiety itself is widespread in Australia. According to the ABS National Study of Mental Health and Wellbeing, 17.2 per cent of Australians aged 16 to 85, around 3.4 million people, had a 12-month anxiety disorder, and 28.8 per cent will experience one at some point in their life (Source: ABS, 2020 to 2022).
Anxiety remains the most common mental health condition in the country, affecting around 17 per cent of the population (Source: AIHW, 2025).
Perfectionism appears to affect women in particular. Data from Australia’s Biggest Mental Health Check-in, a national corporate mental health program, found that one in three women scored in the high range for perfectionism, compared with 21 per cent of men (Source: MediBio’s Australia’s Biggest Mental Health Check-in).
Separately, the Jean Hailes for Women’s Health national survey found that 66.9 per cent of women had felt nervous, anxious or on edge for several days or more in the past four weeks (Source: Jean Hailes for Women’s Health Survey, 2018).
Students are not immune either. A Curtin University study found that perfectionistic concerns were directly linked to all three elements of academic burnout: exhaustion, feelings of inadequacy and cynicism (Source: Curtin University, 2018).
The hidden cost: burnout, relationships and never feeling done
Perfectionism anxiety rarely stays contained to one part of your life. Over time, it tends to spread into how you work, how you rest and how you relate to the people around you.
At work, it can look like burnout: exhaustion that does not lift with a weekend off, a creeping sense that nothing you do is quite enough, and less patience for tasks that used to feel manageable. In relationships, it can mean struggling to ask for help, or feeling irritated when other people do not hold themselves to the same standard.
Perhaps the hardest part is the lack of an endpoint. Because the standard keeps moving, there is rarely a moment where you get to feel genuinely finished, or genuinely proud.
How therapy actually helps: CBT, EMDR and understanding where it started
If you decide to work with a psychologist on perfectionism, therapy usually looks different depending on what is driving the pattern for you.
CBT can help you notice and gradually shift the thinking that keeps your standards so high and so rigid. EMDR may be useful where the pattern seems tied to an earlier experience, such as growing up feeling that approval depended on performance.
Psychodynamic and schema-informed work looks at where the belief that you must not fail first took hold, rather than only addressing today’s behaviour. You can read more about how we work with you in sessions if you want a sense of how these are used together.
These approaches are not mutually exclusive, and a psychologist may use them together or move between them over time, depending on what feels right for you. Results vary and individual circumstances differ, so it is worth talking to a registered psychologist or your GP about what might suit your situation.
Getting support in Australia: Medicare, referrals and what it costs
In Australia, support for perfectionism-related anxiety usually starts with your GP, not directly with a psychologist. The table below outlines the general process.
Sessions can be booked in person or through telehealth appointments, depending on what suits you. This process runs through the Better Access initiative, which allows eligible clients to access up to 10 Medicare-rebated psychology sessions per calendar year with a valid Mental Health Treatment Plan (Source: Medicare, Better Access initiative, 2025).
Your out-of-pocket cost will depend on the practice’s fee and which type of psychologist you see, so it is worth asking about this upfront.
When to reach out for support
There is no perfect moment to address perfectionism anxiety, and you do not need to be in crisis to ask for help. Many people wait until things feel urgent, when reaching out earlier often means a smaller, more manageable problem to work with.
It is worth speaking with a GP or registered psychologist if perfectionism anxiety is starting to affect your sleep, your relationships, your ability to start tasks at all, or your general sense of wellbeing.
If you are having thoughts of self-harm or are worried about your immediate safety, contact Lifeline on 13 11 14, available 24 hours a day, or Beyond Blue on 1300 22 4636.
If you would like to talk through your situation with a registered psychologist in East Fremantle, the team at Sage Psychological Services is happy to help. You can book a consultation or read more about our approach to anxiety therapy on our website.
Frequently asked questions
- Perfectionism itself is not a mental illness. It is a personality trait involving very high personal standards. It becomes a concern when it is linked to ongoing anxiety, low mood or burnout that affects your daily life. If this pattern is meaningfully affecting your wellbeing, it is worth checking in with a GP or registered psychologist.
- High standards are flexible and tied to effort and values, not just results. Perfectionism is more rigid: falling short of the standard feels like a reflection of your worth, rather than a disappointing outcome. Healthy striving leaves room for mistakes. Perfectionism often does not.
- Perfectionism anxiety is well documented, and research shows both the striving and self-critical dimensions of perfectionism are linked to anxiety severity, including generalised anxiety disorder (Source: UNSW Sydney and St Vincent’s Hospital, 2025). Some people also notice panic-like symptoms when facing tasks tied to their standards. A registered psychologist can help you understand and work with this pattern.
- Perfectionism often develops through early experiences, such as feeling that love or approval depended on performance, or growing up in an environment with very high expectations. Psychodynamic and schema-informed therapy looks at these origins directly, rather than only addressing the current behaviour. Understanding where the pattern started can make it easier to work with.
- There is no fixed number, because it depends on your history, circumstances and what you are hoping to work through. Some people notice shifts within a handful of sessions, while others need longer-term support. Results vary and individual circumstances differ, so it is best to discuss a realistic timeframe with your psychologist once you have started working together.
- Medicare does not fund therapy for a specific behaviour like perfectionism on its own. However, if your GP assesses that related anxiety or mood symptoms meet the criteria for a Mental Health Treatment Plan, you may access sessions under the Better Access initiative, which allows up to 10 rebated sessions per calendar year (Source: Medicare, Better Access initiative, 2025).
- Yes. Therapy for perfectionism is not about lowering your ambition. It is about easing the anxiety and self-criticism that make achieving feel exhausting rather than satisfying. Many people find they can hold high standards without the constant fear of falling short, once the underlying pattern has been addressed. Results vary and individual circumstances differ.
This article is general information only and is not a substitute for individual advice from a registered health practitioner. If you are concerned about your mental health, please speak with your GP or a registered psychologist.
