Existential OCD: A Complete Guide to the Fixation with ‘WHY’
Existential OCD is characterized by excessive fear, worry, and uncertainty surrounding life and death. People with this OCD subtype find themselves trapped in thoughts about the meaning of life, the purpose of one’s existence, what’s real and what isn’t, and what happens when they die.
Philosophy, as a study, intentionally poses and ponders these questions. This is why existential OCD is sometimes known as philosophical OCD.
Everyone experiences existential thoughts from time to time.
However, people with existential OCD are tormented by these questions and lose tremendous time and energy trying to figure out the why’s and the what’s surrounding life and death.
As with all OCD, the fixation is driven by the desire to gain answers to questions that are ultimately, unanswerable.
In this article, we’re going to deep dive into existential OCD so you can understand how this particular subtype thrives in the OCD cycle and the treatment available to support a full recovery from existential OCD.
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OCD – A Recap
Although the context of OCD may differ (and even change over time), the premise of how this mental health condition thrives remains the same.
The two core components of OCD are obsessions and compulsions.
Obsessions are unwanted and intrusive thoughts, images, feelings, urges, and sensations that trigger immense uncertainty, anxiety, and doubt.
These obsessions are disturbing in nature and become a catalyst for ‘solving’ behaviors in the form of compulsions. Compulsions are the mental or physical rituals done to gain certainty and find relief from the discomfort and distress of those obsessions.
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Everyone on this planet experiences intrusive thoughts.
However, because OCD is egodystonic in nature and challenges our morals and our values, those with OCD struggle to let go of those intrusive thoughts.
The uncertainty and anxiety are so intense, they feel compelled to perform those compulsive behaviors to gain some form of temporary relief.
Keeping the OCD cycle in motion, it is in doing those compulsions that we actually strengthen OCD’s grip.
What is Existential OCD?
Existential OCD involves uncertainty, fear, and doubt surrounding life and death.
The sufferer seeks answers and certainty to looming philosophical questions such as:
What is the purpose of life?
What is the point of living if we die anyway?
Do I even exist?
Is anything real?
What happens when we die?
They might doubt their own existence, fixating on the thought that they’re actually in a coma or a dream, for example.
Non-OCD sufferers experience the same thoughts. However, those with existential OCD experience an urgency to know and find answers to these philosophical questions.
As with any other subtype, such as real-event OCD or religious OCD, these obsessions conjure such distress and disturbance that the sufferer then engages in physical or mental compulsions in a bid to gain certainty.
Sometimes, this condition can be confused with depression, as those who are depressed may also wonder what the point of life is.
However, existential OCD is far more complex than that.
Existential OCD has its own specific set of symptoms which include relentless, ongoing, and repetitive intrusive thoughts surrounding their existence which then consume them with feelings of anxiety, uncertainty, doubt, and severe distress.
For those with this subtype, hours can be lost to compulsive behaviors done in a desperate attempt to alleviate those feelings of intense dread.
Symptoms of Existential OCD
As with all OCD themes, we can look at common obsessions and compulsions that arise within existential OCD to consider whether or not we may be struggling with this particular subtype.
We are also going to consider how existential OCD makes the sufferer feel.
Common Existential OCD obsessions
- Marked anxiety about life, death, existence, and consciousness
- Urgent, intrusive thoughts surrounding the need to know the meaning of life, what your purpose is, whether or not existence is real, etc.
- Intrusive thoughts during times of joy or when you would usually feel very alive, sounding like, “Is this real?” “Am I actually feeling alive?”
- Dissociation, depersonalization, or derealization
- Feeling detached from your body
- Feeling detached from your surroundings
- Feeling disconnected from your loved ones
- Uncertainty about whether you have OCD, or if your thoughts, feelings, sensations, and urges are symptoms of a different ailment or predicament
Common Existential OCD Compulsions
- Mentally ruminating on existential questions, such as the meaning of life, your purpose, etc.
- Extensive research and examination of philosophical subjects
- Avoiding media, places, or people that trigger your obsessions
- Only consuming surface-level, light-hearted media to distract yourself from existential thoughts
- Not wanting to participate in activities that force you to be in your body, such as sexual intimacy or exercise, in order to avoid thinking about your existence
- Googling existential questions
- Seeking reassurance from yourself or loved ones that existence is real, life has purpose, etc.
- Ruminating on whether your dreams are actually real and vice versa
- Hearing stories of near-death experiences and ruminating on what that means for existence
- Self-punishment for the content of one’s thoughts.
How does it feel to live with Existential OCD?
To those who lack the knowledge and understanding of how OCD thrives, those with existential OCD can often be overlooked as being a ‘deep thinker’ or a ‘daydreamer’.
Similar to contamination OCD, sufferers are confused with simply being ‘neat’ or ‘particular’ and their struggles are easily overlooked. But those with obsessive-compulsive disorder get trapped in a loop of disturbing obsessions and solving compulsions that can severely limit their quality of life.
Someone with existential OCD often experiences:
- Feelings of isolation
Due to the relentless nature of intrusive thoughts, someone with existential OCD can lose hours of their days trapped inside their own mind.
Depending on the nature of their thoughts, being around friends and family may be a trigger for those obsessions. Wondering whether or not they are real, what might happen if one of them died, or if their loved ones would care if they died.
Likewise, the excessive reassurance-seeking can often leave them feeling like they are someone no one really wants to be around.
With constant talk of life and death, they may worry that they’re constantly being a ‘downer’ and may avoid social interaction for fear of judgment.
It is not uncommon for the sufferer to isolate themselves from other who don’t understand what it’s like for them to experience these obsessions.
- Existential OCD and Derealization/Depersonalization (DR/DP)
Derealization and depersonalization are common within OCD but are particularly prevalent in this particular subtype.
Derealization is when you feel as though the world around you isn’t real. There’s a detachment from the people, places, and things. Instead of feeling grounded, real, and concrete, things can feel foggy and lifeless.
Depersonalization is when you feel like you’re detached from your body, as though you are on the outside looking in.
For those with existential OCD, DR/DP combined with the intrusive thoughts surrounding their existence makes it difficult to remain grounded in the present moment.
- The sense of not truly living
Unsurprisingly, for those stuck in the cycle of trying to figure out why we’re here and what it all means, they have this overwhelming sense that they are not truly living.
This is because they’re giving endless attention, time, and effort to trying to answer those unanswerable questions and this stops them from being able to fully engage in the present moment.
In a vicious twist, things can feel hopeless and pointless.
Firstly, we have those obsessions and intrusive thoughts that make us question the very reason for living. And because we’re focusing on solving those questions, we struggle to live life to the fullest.
- Lack of joy
It’s difficult to find enjoyment in life when things or people don’t feel real. Or when you’re inundated with worries about life after death.
A lack of joy is common in all obsessive-compulsive disorders as this particular condition is a professional thief of joy.
However, for those with existential OCD, obsessions can feel incredibly morbid which can lead to depression and feelings of hopelessness.
Causes of Existential OCD
We are still not sure about the cause of OCD, however, we do understand that biological and environmental factors are involved.
Studies have shown that there is a hereditary factor involved with OCD. However, it is not simple genetics alone that can cause OCD. For the most part, research suggests that if you are related to someone with OCD you may be more vulnerable to developing the condition but it is not a guarantee.
Environmental factors such as your upbringing and stressful life events are also considered contributing factors.
During treatment, we work towards directing our attention away from the causes of OCD and the reason why they are having these existential thoughts, as that often becomes a compulsion in and of itself.
The good news is that treatment is available that has been proven to yield incredible results in OCD recovery (more on that to come!)
Is existential OCD different from an existential crisis?
To the untrained eye, existential OCD and existential crisis may look very similar.
Both revolve around fears and doubts related to life and death. Both can leave a person questioning their existence, the purpose of life, and why we’re here on this planet in the first place.
The main differentiating factor is that an existential crisis is usually brought on by a stressful or traumatic life event and typically lasts for a shorter duration.
Likewise, those experiencing an existential crisis do not necessarily engage in compulsive behaviors to relieve their uncertainty the way people do when they have existential OCD.
Those with existential OCD, find themselves caught in the same cycle of obsessions and compulsions that characterize all OCD subtypes.
Existential OCD Treatment
The gold-standard approach to treatment is Exposure and Response Prevention therapy (ERP).
ERP is a type of Cognitive Behavioral Therapy (CBT). The cognitive portion of CBT refers to the identification of distorted thoughts and learning to change our relationship toward them so we can respond in a more helpful manner.
The behavioral portion is where ERP comes in.
The practice of ERP involves the creation of a hierarchy, developed together by therapist and client, in which one will slowly expose themselves to their feared stimuli.
The purpose is to practice not engaging in compulsions.
During treatment, our fully licensed and compassionate clinicians will provide psychoeducation in the areas of mindfulness, Acceptance and Commitment Therapy (ACT), and Self-Compassion.
These tools will help you manage your intrusive thoughts, strong emotions, and urges to engage in compulsions. These skills will also help you learn how to resist the mental and physical compulsions that keep you stuck in the loop of OCD.
ACT can be a wonderful supplement to CBT.
ACT helps one to stop avoiding, denying, and fighting against their feelings and instead recognize them as appropriate responses to a given situation. With this in mind, clients start to accept their struggles and commit to making necessary changes in their behavior that contribute to a more fulfilling life.
Examples of ERP for Existential OCD
The IOCDF provides an in-depth list of examples of how we might apply ERP to existential OCD:
- Making a series of gradually more challenging 2-minute recordings on your phone that tell you the fearful thought is true, and listen to them several times daily
- Posting signs or notes around your house stating the feared idea. In the case of existential obsessions, a sign may say something like “Nothing is real.”
- Agreeing with the thoughts as much as possible whenever they occur, and also agreeing that there will be bad consequences because they are true. For example, recognizing “I won’t ever get answers to my questions, and as a result, life has no meaning.”
- Going to places and doing activities that bring on the thoughts.
- Reading articles that seem to agree with the feared thoughts.
- Watching videos or movies that bring on the thoughts (such as films like Inception).
- Writing feared sentences 25x per day until you get bored with them. Then, write new ones.
Don’t feel ready to start treatment?
It is important that you remember that ERP, and many treatment modalities, are hard work. We cannot deny this.
You may feel as though you are not ready to begin this treatment as many of our clients feel this way before we begin working together!
Here is what we would like to say…
You may not ever feel ready. There is no ‘right’ or ‘perfect’ time to do the hard thing but as we like to say, every day is a beautiful day to do hard things.
It takes courage and bravery to start. But the day you muster that courage is the day you begin your recovery toward a life that is not all consumed by existential dread and panic.
You can live in the present moment, and experience joy with the people you love most without the ‘’what if’ thoughts and ‘why’ thinking robbing you of present-day happiness.
As the saying goes, the best time to start was yesterday. The second best time to start is today…
Finding a qualified therapist
Our team of compassionate and highly qualified OCD specialists can provide 1:1 private therapy to those based in California.
We work together with our clients to form a specialized treatment plan that works for you.
We meet you where you’re at.
If you’re struggling with existential thoughts and feelings of dread that you simply cannot shake, and if you notice that it is beginning to impact your quality of life, then please get in touch.
Our warm and friendly team of qualified mental health therapists are committed to your full recovery from existential OCD, it just takes an ounce of courage and one phone call to get the ball rolling.
ERP SCHOOL – Online study
We understand that private treatment isn’t always an option.
If you’re seeking support in the meantime, ERP SCHOOL has been created by top OCD specialist, Kimberley Quinlan, as an affordable and accessible option for those looking to start their recovery journey.
You can find relief from those existential obsessions, and find joy in the present moment again when you no longer feel compelled to find answers to those unsolvable questions.
With that, you will be able to live without fearing what it means to be alive. You will simply be.
You will be taught how to apply the techniques of ERP to your specific existential obsessions and compulsions so you can be one of the many who make a full recovery from OCD.
