Existential OCD
Existential obsessive-compulsive disorder (OCD) is a subtype of OCD characterized by ongoing intrusive thoughts and compulsive behaviors related to a preoccupation with philosophical questions about life and existence. Anyone can be curious about the nature of reality, but for people with existential OCD, these thoughts are not primarily a source of curiosity or interest but rather intense anxiety.
The ongoing spiral of intrusive thoughts someone with existential OCD experiences is uncomfortable and can even be frightening. These questions come with an urgency that demands a person answer them with 100% certainty. In an attempt to relieve themselves of the anxiety these questions cause, the individual often turns to compulsive actions aimed at gaining certainty and relief (e.g., spending hours researching the nature of consciousness).
On the surface, someone with existential OCD may come across as generally curious or a “deep thinker.” After all, entire academic departments, books, and museums are devoted to answering these philosophical questions about mankind’s purpose. However, the main distinction between someone with existential OCD is that these questions cause tremendous anxiety and an urgent need to be answered with certainty in order to experience relief.
For people with existential OCD, these intrusive thoughts interfere with their everyday life. The anxiety a person feels could disrupt their ability to concentrate at work, keep them up at night, or prevent them from feeling connected to family and friends. For example, while spending an evening with their spouse, a person’s mind may be racing with existential questions about the nature of love and connection to the point where they cannot be present with their partner. A person may spend the whole night researching questions about their existence. Even though they know tomorrow is an important workday and they need sleep, they feel they’re only a click away from finding the answer they’re seeking. This urgency will keep them glued to their screen all night, despite their better judgment, and they won’t get a full night’s rest.
Examples of existential OCD obsessions
People with existential OCD experience ongoing intrusive thoughts that may sound like these:
•“What does it mean that I can’t ever experience life as another person? How do I know that I am communicating with someone if I don’t know what they are thinking? What does it mean to be understood? How can love even be possible if I don’t know someone else’s experience? What is the point of communicating with other people if we never know what the other person is thinking?”
•“What if I am not really here? Would I know if I was not really here? How would I know? What if my whole life has been a simulation and no one and nothing around me are actually real? If I am not actually here, then why does anything I do matter? What is the point of my life or anyone’s life if none of us are actually real?”
•“What is my purpose in life? Why am I here? What should I be doing with my time on earth? Why do I have consciousness? What does it mean that I am able to reflect on my own thoughts? Does that mean I am separate from my consciousness? Does this mean I’m more than one person? If that’s the case, then who am I? If there’s no way to know who I am, what is the point of life?”
Examples of existential OCD compulsions
As in most OCD subtypes, people with existential OCD often practice compulsions to try to ease the anxiety caused by their intrusive thoughts. Here are some examples of common compulsions for people with existential OCD:
•Research: A person may spend hours or days researching particular topics they feel will help answer their questions. They may dive into philosophy, psychology, or religious texts in order to gain some relief from the anxiety that comes with their intrusive thoughts. When research is done as a compulsion, it’s not necessarily fun or engaging, but characterized by an urgent need to feel relief.
•Mental reviewing: A person could spend excessive time mentally reviewing questions about existence. They may spend hours and hours trying to come up with answers to questions in their head. This might look like thinking about everything this person has learned that could answer their questions. They may repeatedly replay conversations they had with a philosopher or a religious figure in their head, hoping this will help them come to a sense of certainty about their questions and relieve their anxiety.
•Seeking reassurance: They may ask friends and family members repeatedly for answers to their intrusive doubt. They may also question other people’s beliefs, asking, “What do you think is the purpose of life?” or, “Do you ever wonder about what happens after death?” They may turn to religious figures or experts on philosophy or biology with countless questions. When asking these questions, they hope to receive an answer that can provide certainty and ease their anxiety. Rather than a compelling philosophical debate, the underlying motive here is to experience some relief to the unbearable stress of their intrusive thoughts.
•Excessive prayer: Some people may excessively pray to receive answers on the nature of existence.
•Physical checking: Some people may begin to worry that they don’t actually exist, and seek out physical reactions as a way to verify to themselves that they are real. This could look like pinching oneself or even causing oneself pain in an attempt to answer their intrusive questions. They may conclude, “If I feel this, that must mean I exist. Right?”
•Avoidance: Some individuals may avoid people, places, or subjects that trigger their intrusive thoughts. For example, they might avoid watching specific movies, TV shows, or books that feature themes of unreality, simulations, eternity or alternate universes. Or they may avoid lectures or classes where these questions will be discussed.