Perfectionism and ADHD Can Become Unhealthy for Children

An educator, concerned for the well-being of his students, wrote to a professional journal, seeking advice.

“I can’t fight the forces that lead kids to be hard on themselves or to believe they need to build the perfect resume or go to a highly ranked college, but I’d like to do something to ease their stress and change the culture within my classroom, at least,” the high school teacher writes. “I think their stress is getting in the way of their learning and their emotional well-being. Some will redo an assignment several times for zero improvement in their final grade!”

Teachers and parents have reported that children and teens are displaying more signs of unhealthy perfectionism than previous generations. Many adults feel at a loss when trying to help, especially when academic, social, and parental pressures to “measure up” have also increased. These pressures have increased in both their perception by children and teens and in the heighten competitiveness seen in everything from children’s sports, their grades, and eventual career choices.

For the young person who has ADHD, perfectionism has another characteristic: Many attempt to use it as a way to mitigate their ADHD symptoms and avoid disappointing the adults in their lives. In doing so, these teens and growing numbers of younger children are developing co-occurring anxiety, depression, and maladaptive behaviors such as disordered eating.

ADHD, anxiety, and the quest to be perfect

Children and teens who have ADHD receive, on average, 20,000 more negative messages while growing up than do their peers without ADHD. Children seek their parents’ love and support and take to heart what their parents and other significant adults in their lives say to them. Children with ADHD often seek ways to prevent their parents’ disappointment and to avoid being reprimanded for behaviors related to their ADHD symptoms. Unfortunately, some children will lie to their parents and other adults to prevent disappointment.

Perfectionism comes from this desire to not disappoint, to prove their worth to others, and to avoid causing problems in their lives or the lives of their adults. The “try harder” message leads the child to believe that striving to meet the unmeetable goal of “perfect” is the solution to the discomforts and problems related to ADHD symptoms she’s experiencing. Instead, as the child or teen grows, perfectionism becomes the unresolved condition beneath many of their problems.

“Perfectionism contributes to many psychological conditions, including depression, anxiety, self-harm, and eating disorders,” says Thomas Curran, PhD, an assistant professor of psychological and behavioral science at the London School of Economics and Political Science. He and co-researcher Andrew P. Hill, PhD, a professor of sport and exercise psychology at York St John University (United Kingdom), studied the role perfectionism plays in teen and young adult mental health.

The researchers warn that the rise in perfectionism related to increasing pressures from societal changes in the last thirty years, followed by co-occurring conditions, could become a significant mental health issue in the near future.

“Parental expectations have a high cost when they’re perceived as excessive,” Dr. Curran says. “Young people internalize those expectations and depend on them for their self-esteem. And when they fail to meet them, as they invariably will, they’ll be critical of themselves for not matching up. To compensate, they strive to be perfect.”

The young person with ADHD seeks out a standard of perfectionism as a means of coping, writes Mabel Yiu, a licensed marriage and family therapist. While a short-term goal may be a achieved this way, the longer-term consequences can become impairing.

“When perfectionism is applied, the anxiety is multiplied,” Ms. Yiu writes. “The shared relationship between ADHD and perfectionism tends to be more maladaptive in nature. This means the results of the disorders coming together typically create unhealthy behaviors and perspectives. Perfectionists with ADHD use perfection as a means to measure their own value, both from internal and external pressures.”

When a child or teen fails to be perfect, to research that high achievement, whether it’s a realistic goal or not, her view of her own self-worth falls and often feels her value to others becomes less.

“ADHD perfectionists are harder on themselves for making mistakes and take the notion of imperfection to heart,” Ms. Yiu writes.

How parents can help

Some pressures from the outside world cannot be controlled, such as the competition to be admitted to some universities and colleges or the competition to be the better job applicant. However, parents can help their children recognize unhealthy perfectionism and dial back some of the pressures children and teens may be facing.

Parents can help their children address the perceived pressures to “be perfect” in a healthy way by teaching them that failure, or imperfection, is a normal and natural part of life, says Dr. Curran.

“Focusing on learning and development, not test scores or social media, helps children develop healthy self-esteem, which doesn’t depend on others’ validation or external metrics,” he says.

This refocusing can also include limiting social media and television shows or magazines that present unrealistic achievement or body goals. Talking with your children about how those standards are not real and are digitally created, and putting the images in context can also help children understand these are not healthy or achievable goals.

Sharon Saline, PsyD, is a clinical psychologist and an expert on ADHD, anxiety, learning differences, and mental health challenges and their impact on school and family dynamics. She works with teens and families in addressing perfectionism and ADHD. One of her teenaged patients said to her, “It’s hard to let go of the little stuff because everything is important.”

She encourages parents to reframe goals and expectations when a child has ADHD and struggles with perfectionism. Parents can help their children identify what is “good enough” and understand that achieving “good enough” is a positive.

“Learning to aim for steadiness and ‘good enough’ can relieve pressure that kids with ADHD put on themselves, and that adults set for them as well,” she writes. “Reframing the goals and how to proceed on meeting them reduces perfectionism. There is a difference between accountability (owning and accepting what you do with honesty and calm) and perfectionism (needing everything to be a certain way and judging yourself negatively when it’s not).”

Checking your own sense of competitiveness and feelings of achievement through your child is also important. Letting your child know that bringing home perfect grades, becoming the best player on the team, or getting into the best school are good things, but have no relationship to your child’s value to you and as a person. Reassuring your child that she has value simply because she is your child and a person in society can help to reduce the pressure to be perfect.

Children and teens crave love that’s not the result of academic grades or how well they play a sport, says Simon Sherry, PhD, a clinical psychologist in Nova Scotia, Canada. If children are rewarded only for high achievement, he says, then children associate their value as a person with how perfect they can be.

Those 20,000 negative messages received by children with ADHD can be reduced when parents emphasize their child’s value rather than their child’s mistakes due to ADHD symptoms. Let children know that no matter what happens, what grades they bring home, what team they are chosen to be on, they are valued and don’t have to be perfect to be important to you.

“Parents need to be loving their kids without strings attached,” says Dr. Sherry.

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