This article discusses the symptoms and treatment for existential OCD.
What Is Existential OCD?
Existential OCD symptoms are when repetitive and intrusive thoughts about the purpose of human existence cause symptoms of anxiety, depression, and compulsive behavior.
These thoughts might include:
Questioning the purpose of lifeFeeling death anxiety (fear of your own death or the dying process)Wondering what’s real and what isn’tFeeling a sense of impending doom
Someone with existential OCD symptoms might also refuse to tolerate uncertainty about questions that are impossible to answer.
Existential OCD vs. Philosophical Questions
Everyone has philosophical questions about the meaning of life. These questions might include “Why are we here?” or “Where do we go when we die?” But with symptoms of existential OCD, these thoughts can turn into obsessions that interfere with daily life. They can drive a person to compulsive rituals, like:
Constantly seeking validation about one’s pathObsessing over philosophical ideas (like the nature of reality and the universe) for hours a day
When dwelling on philosophical questions causes symptoms of depression, anxiety, and compulsive behavior, a person might be suffering from existential symptoms of OCD.
Signs and Symptoms of Existential OCD
Symptoms of existential OCD might include:
Obsessively thinking about the reason for existenceDerealization, or a feeling that the world isn’t realRefusing to tolerate uncertaintyFeeling depressed and anxious because of repetitive thoughts about life and deathReassurance seeking, or constantly double-checking decisions with others out of fear of being on the wrong pathNot having an ability to reason with or apply logic to philosophical thoughts or questions Finding one’s own answers to philosophical questions but then doubting those answers
Common Obsessions
Those with existential OCD might obsess over:
The purpose of livingThe inevitability of deathWhether they’re on the right path in a religious or philosophical senseThe nature of reality and the universeWhether or not they even exist
Common Compulsions
Compulsions are repetitive behaviors that people with OCD might engage in to ease anxiety. At times, these compulsions can interfere with daily life. In the case of existential OCD symptoms, they might include:
Constantly researching philosophical questions without being affected by logic or others’ ideasPondering one’s existence and reality for hours while neglecting daily lifeConstantly asking others for reassurance about being on the “right” pathDoubting any logical conclusions
How Existential OCD Is Treated
Treatment for existential OCD symptoms might include therapy or medication. The following are ways a specialist might approach the disorder.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a form of psychotherapy (talk therapy) that focuses on thoughts that lead to unhelpful behavior. These thoughts are challenged with the help of a therapist and then replaced with more supportive ideas. CBT also includes learning how to manage emotions and reactions to daily life.
For example, a CBT session might include exercises like role-playing or reviewing larger belief systems a person has and helping determine whetherthey are helpful.
Exposure and response prevention (ERP) and mindfulness are two CBT techniques advised for existential OCD.
Exposure and Response Prevention
Exposure and response prevention (ERP) is a type of therapy in which a person is repeatedly exposed to thoughts and ideas that scare them so that they build tolerance. ERP might include “homework” assignments from a therapist, such as researching existential questions, listening to recordings from the therapist, and watching videos about the topic.
ERP also includes experiencing the emotions and anxieties that thoughts create and learning how to manage them without responding. ERP in someone with existential OCD might mean not asking others for reassurance and, instead, sitting with their doubts about reality, no matter the anxiety it might cause, or letting it pass.
Practicing Mindfulness
Mindfulness can be taught as an adjunctive calming skill (added on as a supplement) but is not necessarily a treatment.
Mindfulness is becoming aware of one’s emotional reactions without judgment. This can lead to accepting passing thoughts and “riding the wave” of emotions that they cause without engaging in compulsive behavior.
Over time, an intrusive thought becomes less critical and easier to manage. With existential OCD symptoms, mindfulness might mean feeling the anxiety or dread of more important life-and-death questions without acting on them or fearing the emotions they cause.
Summary
Existential obsessive-compulsive disorder (OCD) symptoms are marked by repetitive, intrusive thoughts about philosophical questions, such as the meaning of existence, the nature of reality, and ideas about life and death.
A Word From Verywell
Everyone has pondered the more significant questions about life, death, and the universe. However, when these thoughts become obsessions you can’t seem to escape from, they could harm your mental health and well-being.
If you find yourself ruminating over the more significant questions of existence to the point of depression, anxiety, and disruptions in work and relationships, existential OCD may be the cause. If you can’t find a therapist in your area or don’t have access to therapy, finding online help or a local OCD support group might help you cope.
