Is Perfectionism Hiding Your ADHD?

Ever wonder if your perfectionism is more than just ambition? If it’s not really about getting things “right”—but about holding it all together?

For a lot of our clients at Oak & Stone Therapy—especially those who identify as Asian American or grew up in immigrant households—there’s often a deeper layer under the discipline and drive. Many of them come in feeling confused. Successful on the outside. Exhausted on the inside. They’ve built entire systems to stay organized, meet deadlines, and show up “on point.” But what they don’t talk about as much is what it costs them to keep that up.

And sometimes, what looks like overachievement is actually a way of coping with ADHD that’s gone undiagnosed for years.

If You’re Like Many of Our Clients…

You’ve always functioned well. You’ve figured out how to meet the expectations. You make it work—even when it doesn’t feel easy. People describe you as “dependable,” “driven,” “detail-oriented.”

But behind the scenes? You’re exhausted. You double-book yourself. You procrastinate until the last second and then swing into action under pressure. You re-read emails five times before sending. You have a million tabs open—on your screen and in your mind.

There’s this constant push-pull: you either hyperfocus or zone out. You plan everything down to the minute to avoid the chaos. You might come across as “disciplined,” but deep down, you feel scattered and unsure of how long you can keep this up.

Perfectionism as a Coping Strategy

We hear it all the time in therapy:
“I’ve always been able to get things done… but it never feels easy.”
“I look successful, but I feel like a mess inside.”
“I’m so tired of trying to hold it together.”

Perfectionism often becomes a survival tool. It’s how you manage the anxiety that comes with time blindness, impulsivity, mental fatigue, or emotional reactivity. You start performing stability—checking every detail, saying yes to everything, pushing through until you burn out. And the minute something slips, the shame creeps in.

It’s not that you’re lazy or not trying hard enough. You’ve probably been trying too hard, for way too long.

What ADHD Can Really Look Like

The symptoms don’t always show up the way people expect. Especially in adults. Especially in women. Especially in high-achieving folks who’ve learned to mask really well.

Here are some of the things we hear from clients:

• “I can do amazing work... but only under pressure.”

• “I start tasks and lose interest before I finish.”

• “My brain doesn’t turn off. It just loops.”

• “I’m constantly behind on texts and emails—it’s not that I don’t care. I just get overwhelmed.”

• “I interrupt people even when I don’t mean to.”

• “Even when I accomplish things, it never feels like enough.”

From the outside, everything looks fine. But internally, it feels like you’re juggling ten things while waiting for one of them to drop.

What Therapy Can Help You Uncover

So many clients say, “I thought I just had anxiety” or “I assumed this was normal.” When they finally start connecting the dots, it’s a mix of relief and grief. Relief to know there’s a name for what’s been going on. Grief for how long they’ve been struggling silently.

In therapy, we unpack that. Not in a way that pathologizes you, but in a way that sees you. We talk about how your brain works, where perfectionism started, and what parts of your system are working overtime. We talk about the burnout that’s been lurking beneath the surface, and what might happen if you didn’t have to try so hard all the time.

And we get practical. Whether it’s exploring whether an ADHD evaluation makes sense for you, or building better systems that work with your brain—not against it.

You’re Not Broken. You’ve Been Managing.

If you’re someone who shows up for everyone and gets stuff done—but feels constantly behind, emotionally scattered, or like you're faking it… you’re not alone.

You’ve probably had to be resourceful. Adaptive. Hyper-attuned to expectations. And all of that might have helped you survive school, family, work… but now it’s costing too much.

You’re allowed to want something different.

At Oak & Stone Therapy, we work with high-achieving, neurodivergent adults—especially those navigating cultural pressures, family expectations, and the quiet toll of being “high functioning” in a world that doesn't see the full picture.

Whether you're in Los Angeles, Pasadena, the Bay Area, Seattle, or joining us online from across the world, we're here to support you as you untangle what’s really going on.

You don’t have to keep performing. You deserve to feel like yourself again.

Read more about navigating your relationship with someone with ADHD or as an ADHD partner here.

At Oak & Stone Therapy, our team of ADHD Asian American therapists combines these somatic approaches to help you create lasting change in your brain, emotions, and body. We understand the nuances of ADHD and how it impacts high-achieving people who often mask with perfectionism. Reach out to one of our Restoration Therapy, EMDR, & Brainspotting therapists in Los Angeles, California & Washington today.