At 22, Nikki Bank's accomplishments are exhaustive and exhausting.
She graduated among the top 10 in her class at the elite Latin School of Chicago, where she played soccer, ran cross-country, played the lead in The Diary of Anne Frank, led the Environmental Club, served as president of the Student Academic Board, and won the Erasmus Award for intellectual curiosity and academic excellence.
The summer before college, Bank tutored children, planted trees, and learned Spanish on a community service trip to Guatemala.
Accepted to five of the colleges she applied to and wait-listed at the other four, she chose Tufts University, where she has made the dean's list every semester.
"I understand it is perfectly fine to get a B on a test," she said, but her instinct for excellence is deeply ingrained. Anything less than an A, she said, causes a "subconscious, visceral reaction. Like a punch in the gut."
Physically, emotionally, and intellectually spent by the end of her freshman year, Bank took a leave of absence.
Perfectionism, a cruelly false premise for life, seems to be on the rise on college campuses nationwide.
"It's hard to compare across decades," said Kathryn Fletcher, associate professor of educational psychology at Ball State University. Since the 1990s, Fletcher said, university counselors across the country have noted many more students setting impossibly high standards for themselves.
"As more and more people go to college, the value of a degree becomes more commonplace," said Ben Locke, executive director of the Center for Collegiate Mental Health, a research network of 250 college counseling centers. "So there is this real push to stand out from the crowd."
Locke, who is also the associate director of the counseling service at Pennsylvania State University, said anxiety and stress were common in college students, who are increasingly showing perfectionist tendencies.
To some extent, Locke said, perfectionism can help motivate people to do their best work. Those who take it too far, however, sentence themselves to perpetual dissatisfaction and put themselves at risk of serious mental health problems.
"It's hard to really celebrate an accomplishment," Bank said, "when you feel there's just another test, another paper, another project that you have to do well on. I was anxious, I had trouble sleeping, I felt as if I was on a treadmill."
Like many who breathe the thin air in the highest academic circles, Bank believed that if she tried hard enough, perfection was in reach and that anything short of 100 percent was abject failure.
"One of the challenges of perfectionism," Locke said, "is that some of the same qualities that make you an acceptable applicant to college and make you successful are not that far away from what will make you into a nervous wreck. It's a fine line."
People who cross that line may treat themselves harshly. The lack of "self-compassion" often leads to a black-and-white worldview. As a consequence, the bruising young adults inevitably suffer - romantic betrayal, flubbed exams, untimely skin breakouts - take on outsized importance.
"Perfectionism can magnify small failures into life-ending crises," Locke said. Penn State counselors have seen students who contemplated killing themselves over the prospect of having to withdraw or fail a class.
Many factors lead to suicide, now the second-leading cause of death for college students.
But one of those factors is clearly the pressure to perform at extremely high standards, beginning in early childhood, Locke said.
"From kindergarten on up . . . if they have to be on the best travel team or they can't play, if they have to get the best grades or they won't get into the best schools, if they have to get into the best schools or they won't have the best career, you can see where the mentality of all-or-nothing would develop," he said.
A gifted Ivy League doctor who was also a Juilliard-trained musician agreed to a lengthy interview about how her perfectionism has plagued her. But as this article was about to go to print, she panicked and backed out, fearing her reputation would be stained.
"Perfectionists tend to overpredict the catastrophic consequences of making a mistake," said Katherine K. Dahlsgaard, lead psychologist at the Anxiety Behaviors Clinic at Children's Hospital of Philadelphia. "They also overpredict how badly they will feel if they don't measure up to whatever standard. So they go to great lengths to avoid the subjective feelings of anxiety."
Psychologists have long blamed perfectionism on overly demanding parents.
"It tends to run in families," said researcher Gordon Flett of the University of York in Toronto. Flett, who has written widely on perfectionism, said the trait was often biologically hard-wired. And even when they are not overly demanding, perfectionist parents who push themselves too hard may be teaching their children to do the same.
"We really need an anti-perfectionism campaign," he said.
Bank's parents are accomplished lawyers. She does not recall their putting pressure on her or expecting her, implicitly or overtly, to follow in their footsteps.
"They were always really proud of me and supported me," she said. "But there was an unspoken pressure, maybe from them, but probably from myself."
Maria Pascucci, 34, also believes her perfectionism was largely self-imposed. She founded Campus Calm in 2007 to help young people avoid suffering from perfectionism as she did at Canisius College in Buffalo.
"I'm one of the first in my extended family to go to college," she said. "In my all-or-nothing thinking, I told myself that if I wasn't perfect, I wasn't successful, and I wasn't going to be an inspiration to my younger siblings and cousins."
She double-majored in English and history and maintained a 3.92 grade-point average.
"I became addicted to the high of getting perfect grades," she said. "I started getting anxious, sacrificing sleep."
At the end of her senior year, she reached the breaking point.
"I was on my way to take a final," she said. "I heard classmates quizzing each other on their notes. Everything went blank and cloudy. I was thinking, 'What if I don't graduate summa cum laude?' When my professor passed out the exam booklets, I ran to the bathroom and had a panic attack. It was really scary. I curled up on the floor, hyperventilating, crying hysterically."
When she found the strength to get up, Pascucci recalled, "I washed my face and looked in the mirror. I was pale and exhausted."
She apologized to herself. "I'm sorry I did this to you," she said. "Then I finished the exam, went home, and stared at the ceiling for three days."
Now on the lecture circuit, Pascucci said she finds everyone blaming someone else for the problem. Parents say teachers assign too much homework. Teachers point the finger at administrators who complain they are under pressure from parents and the demands of No Child Left Behind.
"This is the war that students are growing up in today," she said. "They're told that getting perfect grades leads to the perfect college, which leads to the perfect career, and that is supposed to lead to perfect happiness. It can lead to a really nice mirage." Pascucci, whose TED talk on the subject is set to air in January, wants to expose a problem as hidden as it is dangerous. Perfectionists do not want anyone to see them sweat, she said, let alone admit they are on the verge of a breakdown.
Social cues are surely contributing, with constant online messages urging everyone to measure up.
"People rarely go on Facebook and tell about their terrible day and how terrible they feel about themselves," Ball State's Fletcher said.
It is normal to compare yourself to others, she said. And it has always been futile to size yourself against models and film stars.
But on the Internet, as the famous New Yorker cartoon shows, no one knows you're a dog. On Facebook, most users post only the most flattering photos and updates on how successful they are.
Often, the truth is much less brag-worthy. Many are faking it. The new term for this is "fronting," said Flett, the York researcher.
Efforts are underway to help avoid perfectionism and ease its effects.
Mindfulness, meditation, yoga, and self-compassion training can lower anxiety and depression, Fletcher said. "People can learn to say to themselves, 'Everybody has problems, not just me.' That they aren't responsible for everything."
During her leave from school, Bank worked in an art studio, took art courses, coached young girls in life skills, then spent three months in India tutoring, traveling, and seeking inner peace.
The time gave her a better perspective, said Bank, now a junior.
After years of entering into relationships with an excess of caution for fear of being judged, she said, she has become more trusting. And she is getting better at focusing on the things that matter most to her.
"I know there are no life-altering consequences from not being perfect. Life goes on. People you love still love you, hopefully," she said. "I'm trying to learn to wake up and be OK with where I am this day."
From Greg Eells, director of counseling at Cornell University
1. Everyone needs a supportive social structure. When you are comforted by others, you experience physical and emotional benefits.
A mere hug can release oxytocin and relieve distress. Allow yourself to be taken care of by friends. If you see them as competitors, it will be hard to feel supported by them. Choose people you trust and, if necessary, shift your perpective, not framing others as rivals.
2. Seek role models who are resilient. Good listeners who, in their better moments, are respectful, patient, humble, and grateful.
3. Reflect on your coping style. Try to focus on what you value rather than on what other people think you should care about. If you set your own priorities, you are less likely to be depressed. Do what is important to you.
4. Your thoughts and emotions are like muscles and joints. Rigidity creates discomfort and suffering. Cultivate cognitive and emotional flexibiilty. Listen for red-flag words like always, never, should, have to, and but, and try alternative ways of thinking.
Be more forgiving. Ordering yourself to stop being a perfectionist will not work.
Although striving for excellence can lead to valuable goals, perfectionism is only one tool, with limited utility. Think of it as a sledgehammer, ineffective and counterproductive when you need to pry open a window.
Remember that you are not your thoughts. You have your thoughts.
5. Consider the teaching of Buddha: You will not be punished for your anger. You will be punished by your anger.
Emotions are slippery. You cannot control them. So don't keep fighting a fight you can't win. Instead, be willing to accept and experience your emotions, observe them with some detachment, and let them go.
Remind yourself that it is human nature for emotions to spike, making you feel bad, but, like tides, feelings always subside.
When you are going through a rough time - a relationship ends, for example - keep in mind that you have options. You can get drunk. Exercise. Have sex with other people. Some of these choices may help. Some will create more suffering.
6. Look for nuance. It is more accurate than absolutes.
7. Seek a spiritual and moral compass. If you do not have religious beliefs, choose your own meaning and purpose in life.
8. Life requires us to make choices. Many college students feel those choices have been made for them by others - parents, administrators, society.
Make conscious choices about the direction you want to take in your life.
It might be useful to read Man's Search for Meaning, Viktor Frankl's 1946 book about surviving Auschwitz. In it, he describes his experience helping other prisoners cope with imprisonment. The work was so rewarding he passed up the chance to escape.
At that moment, he felt enormous power. The concentration camp had become chosen rather than imposed.
9. Practice mindfulness. Stop for a moment to concentrate intensely on eating, savoring a cup of coffee, breathing deeply, or listening to the cadence of a classmate's snoring in the back of the lecture hall.
10. On that note, do not take yourself too seriously. Laugh at yourself. Permit yourself to join the rest of the world as a perfectly imperfect human. We are inconsistent. We feel joy and sorrow.
And that's OK.