Let’s say you’re a self-identified perfectionist. You’ve read about perfectly hidden depression (PHD) and you identify with it. You’ve taken the questionnaire and scored fairly high. You’ve either contacted a therapist or you’ve decided to take the bull by the horns and begin to risk some changes yourself.
What could potentially get in your way of getting better? What are potential stumbling blocks to commitment you might encounter along the way?
Here are six situations that might make you quit the work. Most of them are unique to the perfectionist. Others are more about the challenges of change in and of itself.
1) Having too rigid a commitment — so if you fail, shame is waiting for you…
You pride yourself on getting the work done that you’re focusing on. If you’ve set something as a goal, a task you want to complete to know you’re changing, then if and when that goal isn’t easy to attain, you’re uncomfortable with that feeling. You should be able to do it – no problem.
What you may be forgetting is your perfectionistic behaviors have kept your life orderly, organized, and running smoothly (at least from your perspective — others might have another idea.) Let’s say you decide you want to take more time for self-care, so you’ll get a massage every month. You book it and enjoy it the first month. The second? Well, that’s the week your boss is going on vacation — or the kids are home from summer camp — or your best friend is having a mastectomy. So you don’t do it. Shame begins to creep in and to avoid it, you begin rationalizing and justifying. The third month rolls around and your perfectionistic voice says, “Well, that didn’t work. It’s simply not do-able.” The work stops because you weren’t perfect.
2) Beginning with a goal that’s too hard.
Practice makes perfect. Yet you may choose a goal for yourself and greatly discount how difficult it’s going to be to alter your thinking or behavior. If, for example, the goal you’ve chosen first is to open up more to your friends, or at least to one other person. But you can’t think of anyone that you might trust. Accepting that is a far better response than hating that fact, or wasting energy trying for weeks to come up with someone. Then the shame factor from the above reason will seep in as well.
Choose a goal that’s truly do-able — that won’t challenge you too much initially. Then celebrate the heck out of achieving it. Don’t wear makeup to the grocery store. Take a nap. Go to a movie instead of being productive. It doesn’t matter where you begin — it matters that you begin.
3) Not asking for what you need along the way…
Whether you’re doing this work with the guidance of a counselor or by yourself, asking for help is a challenge for you. Let’s say your therapist has asked you to begin journaling about your emotions, trying to feel them as you go. You’re finding that to be very difficult. You can avoid the topic of journaling if she asks you how it’s going, or you can say it’s fine. Or you can bring the topic up yourself, and ask for help. That’s hard for you, but you can choose to learn that it’s okay to do.
So you risk. You ask, “How exactly do I get in touch with my feelings? I can write about them, but I can’t feel them.” An experienced therapist can help you find strategies for that — from mindfulness exercises to meditation to looking at how you’re going about it, and adding in other components that might help the feelings to surface – maybe writing in letter form instead of free form.
Asking for help is very freeing.
4) Facing your fear of giving up familiar coping strategies while stress increases…
The very characteristics — the behaviors and believes — of PHD have served a purpose. They’ve kept you safe. They’ve given your life order. They’ve become how you know yourself and others know you.
“Jean is simply a born leader.”
“I don’t know how Melanie gets everything she does done.”
If you begin to allow others to take the lead – if you don’t get everything done on your list for the day or week and take time for you — if you begin realizing that you’ve kept painful emotions at bay but they’re there waiting for you — then your stress level is going to increase. Positive change is stressful as well. You’re not going to know quite what to feel or how to feel it. It’ll be awkward and may bring out sudden emotions, like anger or fear. You’re giving up what you know hasn’t worked long-term, but it’s certainly been the short term answer. It’ll take time to let new habits become as familiar as the older ones were.
5) Other mental illnesses or issues growing worse due to stress…
You may have actual diagnosable mental illnesses along with your perfectionism and PHD. It could be an eating disorder, obsessive-compulsive disorder, or anxiety. You could be trying to escape your depression and anxiety through the use of alcohol, sedatives, shopping too much, or other addictions. These problems can easily worsen as you begin to challenge the old system, get help and start to feel emotions that you’ve been suppressing — perhaps for a lifetime. The need to escape from them can feel paramount.
So it’s important to get the support you need. Contacting your treating therapist or doctor to let them know what’s going on. Making sure, if you take medication, that it’s still effective. You may need to pause work on your PHD to deal with what can be serious consequences from some of these issues. That’s not failure. You’re learning along the way.
6) Pushback from others…
Tied in with Number 4 is pushback — or perhaps better stated — change back behavior from others. My mother once said, “I’m going to start taking better care of myself and stop doing so much for other people.” My fairly quick 15 year-old answer was, “Good for you, Mom. But please stay the way you are with me.”
Your family and friends may support you in your change — they may even have been concerned for you. But you making serious changes in your own choices will cause their lives to change as well. And sometimes, that’s not anticipated and isn’t so welcome.
Talking with others about what these changes mean for you — compromising when necessary if the change is happening too fast — doing some couples work on how to frame your new relationship — all of those can happen. And change can be incorporated into the entire family system.
Good luck to you. This change, as difficult as it may be, is so worth it.
If you want to take a questionnaire to see where you might fall on the spectrum of PHD, please click here.
Please confidentially email me at firstname.lastname@example.org if you experience or have questions about Perfectly Hidden Depression. Or you can read more of my posts here on Psych Central or on my own website.
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You can hear more about PHD and many other topics by listening to Dr. Margaret’s new podcast, SelfWork with Dr. Margaret Rutherford.