Existential OCD: Things You Need To Know
You're making dinner, and out of nowhere: "what if none of this is real?" Now you can't stop thinking about it. You try to reason it out, and every answer brings two more questions. That could be existential OCD.
By Nathan Peterson, LCSW, OCD therapistWhat is existential OCD?
Existential OCD is a type of OCD where the obsessions are big questions with no clear answer, like the meaning of life, whether reality is real, or what happens when you die. The questions themselves aren't the problem. The problem is that OCD needs a certain answer, and these questions don't have one.
Symptoms of existential OCD
Common obsessions
- "What if nothing is real?"
- "What's the point of anything?"
- "What happens when I die?"
- "Am I really me? How do I know?"
- "What if the universe is a simulation?"
Common compulsions
- Thinking in circles trying to reach an answer (more on OCD rumination)
- Researching philosophy, science, or religion for certainty
- Asking others what they believe to feel settled
- Checking whether things feel real
- Avoiding movies, books, or conversations that bring the thoughts up
If this sounds familiar, it could be existential OCD. A therapist who treats OCD can tell you for sure, and the free OCD test is a quick place to start.
How is existential OCD treated?
The treatment with the most research behind it for OCD is exposure and response prevention, or ERP. Instead of trying to answer the question or change the thought, you practice letting the question be there without solving it. That might mean saying "maybe, maybe not" and going back to what you were doing, or reading something that brings up the question without researching afterward.
I know, leaving a question like "is any of this real?" unanswered sounds impossible. It isn't. Everyone lives with it unanswered. OCD won't let you notice that yet.
Medications called SSRIs are also often prescribed for OCD, and that's a conversation for your doctor.
Next time the question shows up, say "that's a good question, and I don't need an answer right now." Then go back to what you were doing. (Your brain will want one more minute to figure it out. Don't give it the minute.)
If you want help building the whole plan, that's what Master Your OCD is for.
Common questions about existential OCD
Is existential OCD the same as having deep thoughts?
No. Thinking about life and death and then moving on with your day is normal. With existential OCD, the question gets stuck, brings dread, and comes with a need to find an answer right now.
Can existential OCD be treated if the questions have no answer?
Yes, and that's the point. Treatment isn't about answering the questions. It's about living alongside them without needing an answer first.
Is existential OCD the same as depression?
They can feel similar and can happen together. Existential OCD is driven by doubt and the urge to figure it out. If you feel hopeless or low most days, talk to a doctor or therapist, since depression is treatable too.
