Obsessive-compulsive disorder (OCD) is one of the most misunderstood mental health conditions. Often, it’s represented as a someone who incessantly cleans or needs everything to be organized. However, OCD is really about intrusive thoughts and compulsive actions to relieve said thoughts. ¹ With that said, there are a number of OCD types that revolve around these symptoms. Existential OCD is one of the most unique and least discussed.

Simply put, existential OCD is when someone has intrusive thoughts surrounding questions that are impossible to answer. In turn, they’ll act out in manners that hope to relieve these thoughts.

Throughout this article, we’re going to take a deeper look into existential OCD, its symptoms, and how you can go about treatment. At the end, we invite you to ask further questions.

Existential OCD Defined

While OCD is defined by intrusive thoughts and compulsive behaviors, its subtypes are defined by the way in which these thoughts and behaviors play out.

When it comes to existential OCD (sometime referred to as “philosophical OCD”), a person will have intrusive thoughts about questions which cannot be answered. These may include questions such as:

• What is the purpose of my life?
• Does God really exist?
• Is there a life after death?
• What happens when I die?

It’s natural for everyone to have these thoughts from time-to-time. However, people with existential OCD will find these thoughts to be all-consuming. Spending hours at a time contemplating these questions over and over again.

Due to the weight of these thoughts, existential OCD often leads to other mental disorders, such as anxiety and depression.

The compulsions these thoughts produce vary from person to person. However, it’s common for a person to spend hours trying to find reassurance in these thoughts. This may involve research, reflecting on past experiences, or talking about it with others.

Since many of these questions are unanswerable, people with existential OCD are often left doubtful or unfilled, leading them to seek out new philosophical ideas.

Existential OCD Examples

To paint a picture of the intrusive thoughts someone with philosophical OCD may have, here are a few examples of continuing thoughts:

• “What if this isn’t really reality? Would I even know if I were in reality? How would I know? What is my entire existence is a part of a simulation and nothing around me is real? If this isn’t reality, should anything I do matter? What’s the point of my life if this isn’t reality?”

• “What if I was the only person to really exist? And everyone around me was simply a product of my perception? Is there anyway they can prove they actually exist? Can I know anything beyond my own life experience?”

• “Does life really have meaning? Or was it all an accident? Do humans and other living beings have any purpose? Or do we just live briefly and go away when we die?”

As you can see, each thought carries into one another. The question, “Does life really have any meaning?” is followed by another question, “Or was it all an accident?” Since these questions cannot be answered, they’re only followed by more and more questions.

What Causes Existential OCD?

Researchers still aren’t sure what causes OCD, never mind its varying subtypes. Some have theorized it may have to due to the natural human fear of death. Simply put, since we have no way of knowing what happens after death, many feel a sense of dread and anxiety when questioning it.

While this is likely one of the causes of existential OCD, it’s just as certain other risk factors of OCD also play a role, including:

• Brain Function – Since the 1980s, it’s been clear that OCD is caused by abnormal activity in specific regions of the brain. ²

• Environment – Certain factors of your environment play a significant role in whether or not you develop OCD. Most notably, those with previous childhood abuses are more likely to develop OCD out of trauma. ³

• Genetics – If a close family member (i.e. parent or sibling) struggles with OCD, you’re more likely to develop it yourself. ⁴

While none of these causes have been researched for existential OCD specifically, it can be assumed that these causes along with fears of death lead to the condition.

Existential OCD Misdiagnosis

Since everyone has existential thoughts, people with philosophical OCD likely won’t seek out treatment right away. For their behavior doesn’t appear to be out of the ordinary.

However, if these thoughts continue and in a manner that inhibits day-to-day life, finding the right treatment is essential.

Still, it can be difficult even to just receive a diagnosis. ⁵ When discussing your existential OCD symptoms, chances are a doctor will confuse them for another mental health disorder. One of the most common is depression as people with it often have similar questions.

Another common misdiagnosis is a type of anxiety disorder – usually, generalized anxiety disorder (GAD). Since you’re questioning life and death so much, a doctor may assume you simply have fears surrounding the answers to these questions.

Existential OCD is one of the most misdiagnosed forms of the disorder. For this reason, it may be worth consulting your doctor about the topic and whether or not you can be tested for the condition.

Existential OCD Treatment

As mentioned, all forms of OCD involve intrusive thoughts and compulsive behaviors. The only difference being the nature of the thoughts and actions. Therefore, treatment for existential OCD is largely the same as other forms of OCD.

Traditional treatment usually involves both medication and therapy. However, holistic treatments for OCD have also garnered popularity in recent years.

Regardless, there is no one-size-fits-all approach in treating existential OCD. Therefore, you’ll likely have to experiment around with different medication and therapies before finding what’s right for you.

In terms of therapy, the most popular for OCD include:

• Cognitive Behavioral Therapy (CBT) – A form of treatment where a therapist will identify intrusive thoughts, where they’re coming from, and how you can work to overcome them. ⁶

• Exposure and Response Prevention (ERP) Therapy – A form of treatment where you expose yourself to thoughts, objects, images, and situations that cause obsessive thoughts in order to identify how to overcome them. ⁷

In terms of medication, the U.S. Food and Drug Administration (FDA) has approved of antidepressants for the treatment of OCD.

Final Word

Just like other forms of OCD, it’s important not to let existential OCD get out of hand. By intercepting symptoms with treatment, you’re much more likely to overcome this condition and move on with your life.

Still, as mentioned, it can be difficult to find the right treatment path for you. Beyond the fact that existential OCD is often misdiagnosed, there is no single cure for OCD in general. Therefore, you’ll likely need to experiment around with different medications, therapies, and lifestyle changes before finding the best option for you.

Frequently Asked Questions (FAQs)

Your Questions

Still have questions concerning existential OCD?

We invite you to ask them in the comments section below. If you have any further knowledge to share – whether personal or professional – we’d also love to hear from you.

Reference Sources

¹ National Institute of Mental Health (NIMH): Obsessive-Compulsive Disorder

² Yale School of Medicine: What does an OCD brain look like?

³ Health Psychology and Behavioral Medicine: Trauma-related obsessive-compulsive disorder

⁴ Dialogues in Clinical Neuroscience: The genetics of obsessive-compulsive disorder

⁵ Indian Journal of Psychological Medicine: Obsessive Compulsive Disorder Masquerading as Psychosis

⁶ Dialogues in Clinical Neuroscience: Cognitive behavioral therapy of obsessive-compulsive disorder

⁷ Indian Journal of Psychiatry: Exposure and response prevention for obsessive-compulsive disorder

⁸ HHS Public Access: Pharmacological treatment of obsessive-compulsive disorder