Living with Existential OCD

What’s going on?

Existential OCD is a subset of OCD in which sufferers are preoccupied with the philosophical aspects of life. You might obsess over questions like What’s the meaning of life? Why are we even here? If there’s no God, why should I care about anything? Your brain creates these abstract questions and creates an illusion that you need to solve them.

Being curious about the meaning of life is normal. However, for sufferers of Existential OCD, their obsessions with these questions can be overwhelming and get in the way of daily life.

Common Existential OCD obsessions:

• Constant questioning about the nature of self or reality.
• Constant wondering about the meaning of life or your purpose.
• Constant wondering about the universe.

Common Existential OCD compulsions:

• Answer seeking: Establishing legitimacy and determining answers to your thoughts.
• Reassurance: Going to church or temple and talking with clergy members or getting reassurance from family members that you’ve reached the right conclusion.
• Research: Looking online to find answers to your questions.

Common misconceptions about Existential OCD:

• OCD only comes in one, general type. Subsets like Existential OCD don’t exist.
• You’re actually interested in the philosophical question.
• You believe the answers to these questions will give your life a new or better meaning.

How Do I Know it’s OCD?

Having existential thoughts is normal, but for those with Existential OCD, these thoughts can be debilitating, causing extreme anxiety and discomfort. No matter how hard you try to get rid of them, they won’t go away. Unlike someone who thinks about these questions and moves on, you’re desperate to find answers and will fixate on them until you do. And even then, you might wake up tomorrow and start all over with a new curiosity.

Examples of Existential OCD:

• Your friend mentions wanting a job with “purpose.” You fixate on the word “purpose” and obsess over figuring out yours.
• You can’t stop thinking about why any of us are here on Earth. Your thoughts morph into the idea that one day you’ll be dead and no one will remember you.
• You spend hours in front of a mirror wondering if the reflection that you see is really you.
• You’re fixated on the idea that we’re just a tiny speck in a vast universe. You think that because humans are so small, everything is meaningless.

How can my family help with my Existential OCD?

Existential OCD can be challenging for family members and friends to tolerate and understand. To them, your constant questions seem like the only thing you want to talk about. It’s important for loved ones to understand where your thoughts are coming from and to not provide reassurance. As a way to help minimize anxiety, they may want to lighten up the mood by shifting the conversation to everyday topics.

Is Recovery Possible for Me?

Yes! Recovery is possible and treatment can help. This subtype of OCD is best treated with Exposure Response Prevention Therapy (ERP). ERP is when you voluntarily expose yourself to the source of your fear over and over and over again, without acting out any compulsion to neutralize or stop the fear. By repeatedly facing something you’re afraid of, you force your brain to recognize how irrational it is.

Examples of ERP treatment:

• You may be asked to write down questions that your brain is naturally thinking about and carry those questions around on an index card.
• On an hourly basis, you’ll take out the card, read the questions and remind yourself that it’s OK if you don’t know the answer.

There are other treatment options as well. Mindfulness-based Cognitive Behavioral Therapy, also known as CBT, teaches people to identify, understand and change negative thinking patterns and behaviors. Patients are taught problem-solving skills during therapy lessons and then instructed to practice them on their own time in order to build positive habits.

Can medication help?

Medication can help alongside ERP, but it shouldn’t replace it. Doctors should always be consulted before considering medicinal options.

The main family of medicines used to treat OCD are known as Selective Serotonin Reuptake Inhibitors, or SSRIs. SSRIs enhance your natural serotonin activity and are used to treat major depressive disorders and anxiety conditions. Examples include Lexapro, Prozac, Paxil and Zoloft.

What is the goal of therapy?

In order for you to get better, you need to feel comfortable with uncertainty. This takes time and is a difficult thing to adjust to. Some people with Existential OCD recover completely through ERP. But for many, their obsessions never fully go away. OCD recovery has more to do with managing the condition, than it does with eliminating it. However, that doesn’t mean you can’t lead a healthy, happy life. By prioritizing treatment and positive lifestyle habits, sufferers often gain confidence and freedom. Even if some anxiety is still present by the end of therapy, you’ll no longer feel debilitated by the condition.

If you suffer from OCD, you have a severe anxiety disorder. But it can be treated. Start by getting educated and making healthy living choices. Then find a clinical psychologist in your area who specializes in OCD and Exposure Response Prevention (ERP).