Obsessive-compulsive disorder (OCD) can take many forms. While OCD always involves obsessive thoughts and compulsive behaviors, these are not the same for everyone. OCD is often centered around themes, such as contamination or harm. One theme is existential OCD, which typically involves intrusive existential thoughts. Existential obsessions (EO) are an uncommon type of obsessive thought, according to one case report. However, many people do experience them.

While it’s common to wonder about the meaning of life from time to time, this kind of thinking can cause major life disruptions for someone with existential OCD. If you have existential OCD, you may find yourself ruminating about your existence all the time. These thoughts may be distressing, and it might feel impossible to get them out of your head. If you or someone you love is dealing with existential OCD, understanding what it is and how to manage it can make a big difference. 

What is existential OCD?

Existential OCD causes people to become fixated on deep questions about life, reality and the universe. If you have existential OCD, you may feel a need to answer questions that can’t be definitively answered. You may feel determined to reach a state of absolute certainty about things, even when that isn’t possible. Existential thoughts might fill your mind all the time, making it hard to focus on daily life.

Existential OCD is different from regular curiosity or deep thinking. For people who experience existential OCD, their thoughts aren’t just interesting, meaningful ideas to explore. These thoughts feel urgent, overwhelming and very difficult to ignore.

What are the signs and symptoms of existential OCD?

Existential OCD, like other OCD themes, tends to follow a pattern of obsessive thoughts and compulsive behaviors. Here are some of the most common signs:

• Obsessive thinking about existence — People with existential OCD can become stuck in loops of thought about big metaphysical questions. You may have intrusive thoughts about the meaning of life, the nature of reality, what happens after death and other thoughts in this vein. You may worry about whether you’re living in a simulation or whether you have free will. These thoughts can quickly become distressing, leading to anxiety and fear.
• Seeking reassurance — Since existential questions don’t have definite answers, people with existential OCD often look for reassurance from others. They might ask loved ones, religious leaders or therapists questions like “Do you think life has a purpose?” or “How do you know reality is real?” Getting someone’s answers might provide a bit of temporary relief. However, the doubt tends to creep back in, and the cycle repeats. Seeking reassurance can become a more intense compulsion, as you may start to perceive it as a way to get relief. Professional treatment can be key to breaking this cycle.
• Excessive research and analysis — People with existential OCD might spend hours reading philosophy, watching videos about the universe or studying religious texts. Such rigorous studying may come at the cost of keeping up with essential responsibilities like going to work or school. This kind of behavior is generally motivated by the desire to find an answer that will put your mind at ease. Instead of feeling comforted, though, your research may make you feel more anxious and uncertain when you don’t find any satisfying answers.
• Avoiding triggers — Avoidance is a common response to obsessive thoughts. Because existential thoughts feel distressing, some people with existential OCD start avoiding situations that might trigger them. For example, you might stop watching certain movies or reading books that discuss philosophical topics. You may avoid talking about deep subjects with friends or constantly distract yourself with work to avoid thinking about existential questions. Avoidance often makes the fear worse in the long run. Instead of helping you avoid your fears and triggers, professional treatment often centers around facing and challenging your fears.

How is existential OCD treated?

Existential OCD is treatable. With the right approach, you can learn to manage your symptoms and break free from the obsessive-compulsive cycle. OCD treatment options include:

• Medication
• Exposure therapy
• Cognitive behavioral therapy (CBT)
• Imaginal exposure (Exposure and response prevention)
• Habit reversal

A comprehensive treatment plan will typically incorporate one or more of these methods to address your condition.

Lightfully can help you manage your existential obsessions and compulsions

You can get top-notch OCD treatment at Lightfully. We offer multiple levels of care tailored to different needs. Our compassion-based, data-driven and fully personalized Precision Care Model (PCM) forms the framework for all of our programs.

Change is possible. When you’re ready to take the first step in addressing your OCD symptoms, reach out to our Admissions Concierge Team. We’ll take the next steps together, toward the fullest, brightest version of you.