The Hidden Cost of People-Pleasing

By Susannah Beier, MSN, APRN, PMHNP-C

At first glance, being a people-pleaser might seem like a harmless—or even kind—trait. You say yes, avoid conflict, and work hard to make others happy. But behind the polite smiles and constant accommodating is often a deep well of emotional exhaustion, anxiety, and self-neglect.

People-pleasing isn’t just about being nice. It’s often a coping mechanism rooted in trauma, low self-esteem, or fear of rejection. Research shows that individuals who engage in excessive people-pleasing behaviors are at increased risk of anxiety, depression, and burnout (Linton et al., 2022). Over time, consistently putting others’ needs above your own can erode your sense of identity and leave you feeling resentful, depleted, and unseen.

Why Do We Do It?

People-pleasing is often a learned behavior. Many grew up in environments where love or approval was conditional—based on performance, perfection, or peacekeeping. This pattern can follow us into adulthood, especially if we struggle with setting healthy boundaries. According to psychologist Dr. Gabor Maté, this pattern may reflect early attachment wounds where the child learned it was safer to be compliant and “good” than risk abandonment or disapproval (Maté, 2019).

The Mental Health Toll

Constantly suppressing your own needs can lead to emotional dysregulation and chronic stress. The pressure to keep everyone happy can trigger hypervigilance, perfectionism, and difficulty saying no—even when overwhelmed. A 2021 study in the Journal of Affective Disorders found that chronic self-silencing behaviors are linked with greater symptoms of depression and anxiety (Jack & Ali, 2021).

It’s also a fast track to burnout. Especially in caregiving roles—like parenting, healthcare, or teaching—people-pleasing can make it nearly impossible to preserve your own mental well-being. When your internal worth is tied to external validation, even minor disapproval can feel devastating.

How to Break the Pattern

Healing starts with awareness. Begin to notice your automatic “yeses.” Are they based on genuine desire, or fear of disappointing someone? Learning to tolerate discomfort—like guilt or disapproval—is key to boundary-setting.

Therapy can be especially helpful in unpacking the roots of people-pleasing and building self-worth from the inside out. Practicing small “no’s” and honoring your needs without apology is a powerful form of self-respect—and a step toward reclaiming your energy and peace.

You don’t have to set yourself on fire to keep others warm. Let’s talk.

https://growtherapy.com/provider/kv4ru0i1bi5n/susannah-beier

References

• Linton, M. J., Dieppe, P., Medina-Lara, A. (2022). “People-pleasing and its impact on mental health: A behavioral perspective.” Frontiers in Psychology, 13:837298.

• Jack, D. C., & Ali, A. (2021). Silencing the Self Across Cultures: Depression and Gender in the Social World. Oxford University Press.

• Maté, G. (2019). When the Body Says No: Exploring the Stress-Disease Connection. Vintage Canada.