Existential OCD

Existential OCD - Chicago Counseling Center– Carolyn Moriarty, LCPC

In the post below, you will learn more about what obsessive-compulsive disorder (OCD) is and how it is characterized. This post will focus specifically on “existential OCD”, just one of the many unique subtypes of the disorder. Read on to learn about what it means to have existential OCD, common symptoms and treatment options. 


What is OCD?

Obsessive-compulsive disorder (OCD) is an anxiety disorder that is characterized by the presence of obsessions and compulsions. 

  • Obsessions are thoughts, ideas or images that are unwelcome, upsetting and recurrent. 
  • Compulsions are repetitive mental or behavioral rituals done to alleviate the distress caused by obsessions 

It is important to note that the obsessions a person with OCD experiences are different than “worry” or “anxiety.” Individuals with OCD have little to no control over the intrusive thoughts that pop into their head, and these disturbing thoughts or images often occur with no logical rhyme or reason. To alleviate their distress, these individuals engage in repetitive mental or physical compulsions in an attempt to “push away” the and/or prevent them from happening again. This causes major disruption to daily living. 

While all people with OCD experience obsessions and compulsions, the ways in which they manifest in day-to-day life varies from person to person.  The nature of the symptoms experienced can generally be categorized into one or more of the several subtypes of OCD.  


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Subtypes of OCD include the common themes of:

  • Contamination/Mental Contamination 
  • Harm 
  • Relationship
  • Pedophilia  
  • Symmetry/Orderliness  


Characteristics of Existential OCD and how it is different than other types of OCD

Existential OCD - Chicago Counseling Center

One lesser-known subtype is called Existential OCD. This particular subtype focuses on abstract and philosophical questions such as “Why am I here?” “Why is anyone here?” and “What does it all mean?” it is true that these are questions that many thoughtful people experience at some point in their lives. These kinds of questions have driven some of the greatest philosophers, scholars, scientists, and leaders throughout history. They are natural curiosities many of us have. 


However, the person with Existential OCD does not posses a healthy intellectual curiosity about the philosophical question, nor do they believe the answers will give their life new meaning.  For the person with Existential OCD, these questions can actually cause great anguish and torment. This is because Existential OCD, like other forms of OCD, make it very difficult to tolerate uncertainty and the many intrusive thoughts that come along with it are ultimately unanswerable. These ideas turn into non-stop obsessions that can fill the individual with confusion, fear, and dread. For instance, people with Existential OCD may experience extreme, disconcerting thoughts.


Common Existential OCD obsessions include constant and intrusive thoughts such as: 


  • “Do I even really exist?” 
  • “What if I never find my purpose I life?”
  • “How do I know if my life is real or if I am dreaming?”
  • “How do I know everyone experiences the same reality?”
  • “What if I’m completely forgotten after I die, and everything I did meant nothing?”


Common Existential OCD compulsions:

Research/answer seeking: looking for “evidence” to provide legitimacy to thoughts. 

Reassurance seeking: compulsively seeking support in an effort to get someone else to tell you that you have nothing to worry about


Treating Existential OCD

People with OCD understand that their thoughts are irrational, their compulsions are unnecessary, and that both cause a disproportionate amount of anxiety. As a result, individuals with OCD often seek treatment to alleviate their symptoms.

As mentioned previously, many people with OCD have difficulty tolerating uncertainty, triggering a compulsive need to “figure it all out.” With Existential OCD, these compulsions might manifest in continual analysis of their own thoughts and scrutinizing what it means about them as a person to even have such thoughts 

A key aspect of helping someone manage this kind of OCD is practicing acceptance. Rather than attempting to suppress these thoughts, push them out of one’s mind, or answer them, people have to learn to accept that these thoughts may continue to run through their minds indefinitely but they don’t have to “do” anything about them. 

A combination of Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and Mindfulness techniques can help people reach that place of acceptance necessary to overcome Existential OCD. Using these therapeutic methods under the guidance of a specialist can help someone with OCD reduce and manage their fears and compulsive behaviors.

Next steps: Ask for help

It can sometimes be challenging for medical and mental health professionals to properly identify Existential OCD and well as other sub-types as OCD, which can lead to misdiagnosis and improper treatment. If you experience thoughts or behaviors that are causing distress or affecting your personal life, it is best to seek treatment from a mental health professional that specializes in working with OCD and anxiety to learn more about your unique symptoms and options for treatment.     


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Additional Resources Related to Existential OCD:

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