What Is Existential OCD and How to Treat It

Have you ever thought of some existential questions, like “what is the purpose of life?”, “where do we go after we die” or “what is the nature of reality?” Don’t worry. We all come across some philosophical moments in our life. However, if these questions remain repetitive and intrusive in your mind and even cause you anxiety, depression and compulsive behavior, you probably suffer from existential OCD. The patients neither possess an intellectual curiosity about the philosophical question nor do they believe that the answer will improve their lives. In this article, we will discuss the definition, symptoms, causes and treatment of existential OCD. If you or your friends or family are sufferers of existential OCD, this blog may give you some help.

The professional concepts in this blog came from the book Staring at the Sun by Irvin Yalom.


  • What Is Existential OCD?
  • 7 Symptoms of Existential OCD
  • Causes of Existential OCD
  • Difference Between Existential OCD and Philosophical Interests
  • Top 3 Treatments for Existential OCD

What Is Existential OCD

What is OCD?

The obsessional-compulsive disorder (OCD) is a form of anxiety disorder that is characterized by an inability to control thoughts, feelings, or behaviors. 

Obsessions are recurring, unwelcome and upsetting thoughts, ideas, or images.

Compulsions are repetitive mental or behavioral rituals performed to alleviate the stress caused by obsessions.

A person with OCD experiences obsessions that are not the same as those of “worry” or “anxiety.” A person with OCD has little to no control over the intrusive thoughts or images that pop into their heads, and these disturbing images or thoughts often occur without any apparent rhyme or reason. As a way to alleviate their distress, these individuals engage in repetitive mental or physical compulsions to prevent them from happening again. As a result, daily living is disrupted to a great extent. 

What is existential OCD?

Existential OCD is a subset of OCD in which sufferers are preoccupied with philosophical matters. Your brain might create abstract questions like: What is the purpose of life? Why are we here at all? If there is no God, why care about anything? By creating these abstract questions, your brain creates the illusion that you must answer them.

It is normal to wonder about the meaning of life. However, those suffering from Existential OCD can become obsessed with these questions, which interferes with their daily functioning.

7 Symptoms of Existential OCD

There are several possible symptoms of existential OCD, including:

  • Think obsessively about life’s purpose
  • A feeling of derealization or a sense that the world isn’t real
  • An unwillingness to accept uncertainty
  • Having repetitive thoughts about life and death that make you depressed and anxious
  • Seeking reassurance from others or constantly double-checking their decisions to avoid making a mistake
  • Lacking the ability to reason or apply logic to philosophical questions or thoughts 
  • Finding one’s own philosophical answers, but subsequently doubting them 

 Common Obsessions

  • Existential OCD sufferers may obsess over:
  • The purpose and meaning of life
  • The inevitability of death
  • If they are on the right path religiously or philosophically
  • The nature of reality and the universe
  • Doubt whether or not they exist

Common Compulsions

The compulsions are behavioral patterns that people with OCD might engage in in order to ease anxiety. At times, these compulsions can become so severe that they interfere with daily life. The following are some examples of compulsions that may be apparent in existential OCD symptoms:

  • Continually researching philosophical questions without being influenced by logic or the ideas of others when doing so
  • Spending hours pondering existence and reality while neglecting daily tasks
  • Always seeking reassurance from others that you are on the “right” path
  • Having doubts about any logical conclusion

Causes of Existential OCD

A person’s existential OCD may be influenced by their fear of death (and the feelings associated with it) and their questions about the afterlife. Existential dread and anxiety may be the result of the inability to prove the truth or reality of these questions.

A number of researchers consider all forms of OCD manifestations of evolutionary biological preservation instincts. We have evolved belief systems to help us manage the terror we may feel about forces beyond our control, causing things to happen as a result of our primordial fear of the unknown.

Adolescents usually reach a stage in their cognitive development during which they begin to ask questions about the big picture, also known as the formal operational stage or adolescent angst. The concept of death, infinity, identity, and the purpose of life can be emotionally and spiritually overwhelming. Most youths find their way out of overanalyzing these topics, but teens with OCD may become stuck.

  • Difference Between Existential OCD and Philosophical Interests

It is natural for everyone to ask philosophical questions about life’s purpose. The questions might include “Why are we here?” or “Where do we go after we die?” However, with existential OCD symptoms, these questions can turn into obsessions that can interfere with daily life. A person may be driven to perform compulsive rituals. An individual struggling with existential symptoms of OCD may experience depression, anxiety, and compulsive behavior when pondering philosophical questions.

In general, people who are interested in philosophical subjects but do not suffer from OCD usually enjoy learning about this subject. These people can live their ordinary lives without being tormented by intrusive thoughts. They do not feel overwhelmed by the need to solve things and they do not feel incapable of living with uncertainty.

A person suffering from Existential OCD, however, finds research and examination painful, and feels unable to stop. Their motivation is not curiosity, but rather a burning need to alleviate their existential obsessions.

Top 3 Treatments for Existential OCD

The treatment of Obsessive Compulsive Disorder involves a combination of Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and Mindfulness approaches, such as Acceptance and Commitment Therapy (ACT).  

Cognitive Behavioral Therapy (CBT)

As part of the standard treatment for Obsessive Compulsive Disorder, cognitive behavioral therapy can be a double-edged sword with Existential OCD. Typically, therapists and clients begin their work by discussing what is at stake with these questions, and what it will mean for them if a satisfactory answer cannot be reached. In other words, to learn the feared consequences that drive compulsive checking and researching. The client and therapist then work together to challenge the legitimacy of this fear and consider alternatives.

Exposure and Response Prevention (ERP)

A therapeutic approach known as Exposure and Response Prevention involves guiding the client through exercises that are designed to help them confront their fears in a gradual, controlled manner. Clients learn to face their fears without feeling crushed when they face them. Through repeated exposures, clients begin experiencing a gradual reduction of anxiety, a process called habituation.

Exposures can be any activity that helps the individual confront their fears. There are many ways to accomplish this, including watching existential movies, reading the bible or other religious texts, writing stories about being unmoored in reality, or meditating on anxiety-producing ideas. It may be difficult, but it is an integral part of treatment that the therapist walks them through step-by-step.

Mindfulness-Based Treatment (MBT)

Recently, mindfulness-based approaches have been used to complement CBT and ERP for anxiety and OCD. It has been shown that Acceptance and Commitment Therapy, or ACT, is an effective way of helping people with anxiety disorders resist compulsive behaviors and build the strength to experience feared thoughts willfully.

ACT helps patients with existential obsessions stay focused on the present moment, even when they are drawn out of reality into a fantasy world. Furthermore, ACT helps OCD sufferers develop their ability to recognize existential thoughts and obsessions as optional thought experiments that do not have to overtake their life. Obsessions, however, must be dealt with immediately, if ever at all. It is referred to as “Defusion” in ACT, meaning not fusing with the thought as if the thought and the individual were one and the same. It does not mean ignoring or suppressing them, but rather acknowledging them as part of the present moment’s thought cycle, which will eventually be replaced by another.

Leave a Reply

All about Book Summary