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What is OCDOCD SubtypesWhat can cause an existential crisis? A therapist’s view

What can cause an existential crisis? A therapist’s view

8 min read
Grant Stoddard

By Grant Stoddard

Reviewed by April Kilduff, MA, LCPC

Aug 22, 2023

Possibly related to:

What’s the meaning of life? 

What’s my greater purpose? 

What happens when we die? 

Who even am I?

Who among us hasn’t entertained these questions from time to time? Indeed, asking these questions is at the very heart of what it means to be human. However, an extreme preoccupation with these inquiries can often be a sign of a phenomenon that many of us may struggle with at some point in our lives: an existential crisis. 

A profound and introspective period in a person’s life, an existential crisis is typified by a pressing need to make some sense of the reality we inhabit. While confronting these unknowables can provide an opportunity for personal growth and self-discovery, an existential crisis can often lead to complicated feelings of isolation, uncertainty, and crippling distress that can significantly impact many areas of our lives. 

Exploring the underlying causes of an existential crisis can help us gain insight into the psychological and philosophical factors that shape our lives. Unraveling these triggers can lead to a more empathetic and compassionate understanding of people experiencing such crises.

This article will examine the factors that can cause an existential crisis. From major life events and transitions to philosophical and psychological influences, we’ll explore the multifaceted nature of this common phenomenon. We’ll also discuss one particular cause that often goes unrecognized—existential OCD. It’s a subtype of obsessive-compulsive disorder (OCD) that can significantly impact an individual through relentless doubt, intense anxiety, and draining compulsions.

Understanding existential crises

Let’s begin by acknowledging that there’s nothing inherently wrong with thinking about life’s bigger questions. However, the following signs might indicate that you aren’t merely contemplating the mysteries of the universe on your terms, but are in the thick of an existential crisis: 

  • Relentlessly questioning the meaning of life: You constantly ponder deep existential questions such as the purpose or meaning of life and the significance of your actions and choices.
  • Feelings of emptiness and disconnection: You might feel a sense of emptiness or detachment from the world around you, leading to feelings of isolation or disconnection from others.
  • Loss of interest and passion: Activities or hobbies that once brought joy and fulfillment may lose their appeal as you struggle to find satisfaction in daily pursuits.
  • Increased anxiety and uncertainty: The overwhelming contemplation of existential concerns can lead to heightened anxiety levels and a general uncertainty about the future.
  • Identity crisis: You may question your identity, values, and beliefs, leading to a search for a more authentic sense of self.
  • Changes in behavior: Changes in eating habits, sleeping patterns, or social interactions might occur as you grapple with the internal turmoil of an existential crisis.

What causes existential crises? 

Various factors can trigger an existential crisis, each influencing an individual’s perception of their existence and place in the world. Some common causes of an existential crisis include:

  • Loss and grief: Experiencing significant loss, such as the death of a loved one or the end of a relationship, can shatter one’s sense of stability and provoke existential questioning.
  • Major life transitions: Events like graduation, career changes, or becoming a parent can lead people to reevaluate their life choices and question what they’ve been doing until then. 
  • Lack of fulfillment: A dead-end job, an uninspiring relationship, dreary surroundings. Feeling unfulfilled in some way can lead to a sense of emptiness and the search for deeper meaning and kickstart a crisis.
  • Being acutely aware of your mortality. Memento mori is a Latin phrase roughly saying, “Remember that you have to die.” The phrase is invoked because it’s all too easy to forget that we’re only here for a short time. People with an existential crisis, however, don’t need to be reminded of their mortality, as they often struggle to keep their attention or awareness anywhere else.
  • Moral and ethical dilemmas: Struggling with questions of right and wrong and the ethical implications of one’s actions can challenge core beliefs and values, creating an existential crisis.
  • Identity crises: Challenges in understanding one’s identity, sexuality, or cultural background may lead to questioning one’s place in society and lead to an all-encompassing reckoning. 
  • Philosophical exploration: Great works of literature, music, art, film, and even video games have made lasting impacts on our culture, dealing with some of the big questions identified above. While timeless works can make people reflect on the nature of reality and human existence, they can also be destabilizing for some. 
  • Spiritual exploration: Disconnection from religious or spiritual beliefs can lead to uncertainty and a search for new spiritual perspectives.
  • Societal and environmental concerns: Global issues like climate change, social injustice, and geopolitical instability may raise existential worries about humanity’s future.
  • Loneliness and isolation:  According to a major survey, three in five Americans feel lonely. Feeling disconnected from others can trigger contemplation about the purpose of relationships and social bonds, creating an existential crisis. 

Another cause of an existential crisis is OCD, a subtype of the condition known as existential OCD. 

Existential OCD

Often incorrectly thought of as a relatively benign preoccupation with cleanliness or order, OCD is a chronic mental health condition characterized by intrusive, distressing thoughts, images, urges, and/or sensations (obsessions), and repetitive behaviors or mental acts (compulsions) performed in response to those thoughts in order to feel relief from doubt, anxiety, or other distress. 

Common obsessions include fears of contamination, harm to self or others, or doubts about safety. Compulsions may involve avoidance, reassurance-seeking, checking, rumination, or physical behaviors intended to alleviate the anxiety caused by the obsessions.

Existential OCD is a specific subtype of OCD that centers around profound existential concerns like the ones we’ve been discussing. People with this variant experience obsessive thoughts revolving around the nature of existence, the meaning of life, mortality, and uncertainty about the future or the afterlife. These thoughts lead to an overwhelming sense of existential dread, as people may question the purpose of life and fear the lack of control they have over their destiny. Compulsions in existential OCD may manifest as constant rumination, seeking reassurance about life’s meaning, excessive prayer, or engaging in philosophical debates internally or with others to find answers. In the words of April Kilduff, MA, LCPC, LMHC, “For those without OCD, these questions can lead to interesting conversations that can be enjoyed for a few hours then left behind without any resolutions. For someone with Existential OCD however, they often can’t leave these unanswerable questions alone due to a perceived need to make sense of things.”

“The relationship between OCD and existential concerns lies in how OCD exploits a person’s deepest fears and anxieties,” says NOCD’s Chief Clinical Officer, Dr. Patrick McGrath

“Existential concerns are common and certainly don’t need to be pathologized. But in people with OCD, these concerns become obsessive and all-consuming. 

“For example, I recently worked with someone who wanted to go out and support the Black Lives Matter movement and participate in marches and protests. At the same time, she was extremely worried about unwittingly giving her fellow protesters COVID. She was grappling with this existential question about her purpose and how she was contributing to society. On the one hand, she wanted to support her fellow human beings. On the other hand, she felt like she could be putting them in danger. 

“She spent weeks pondering this to the point of this dilemma interfering with her ability to work and go to get day-to-day tasks done. The fear of uncertainty inherent in existential questions fed into her compulsive behaviors as a futile attempt to gain certainty or control over the unanswerable. The obsessions and compulsions in existential OCD often create a paradox, intensifying the anxiety instead of providing relief.” 

Unlike existential crises caused by the death of a loved one, a major life change, etc, existential OCD will not be soothed effectively by adopting strategies like self-reflection, getting support, or practicing mindfulness or gratitude. It is, however, likely to respond to a type of therapy designed to make managing OCD symptoms possible and sustainable—exposure and response prevention therapy (ERP)

Exposure and response prevention therapy (ERP)  

Exposure and Response Prevention (ERP) is a widely used and highly effective therapy for all subtypes of OCD. ERP helps people confront distressing thoughts while resisting compulsive behaviors. This practical approach exposes you to anxiety-provoking situations while resisting the urge to engage in the compulsions you use to temporarily relieve your anxiety, such as rumination or reassurance-seeking.

ERP therapy involves several steps, including assessment, creating a fear hierarchy, goal-setting, gradual exposures, response prevention, and homework assignments to reinforce skills. Throughout the process, a therapist provides guidance, support, and feedback to help you navigate challenges. Numerous studies have shown that ERP is effective in helping around 2 in 3 people loosen OCD’s grip on their lives long-term.

With existential OCD, potential exposures could include things like:

  • Purposely reminding oneself that life has no absolute answers about what is right and wrong
  • Watching films with an existential theme and sitting with the thoughts and emotions that occur without seeking reassurance from others
  • Saying or writing out things like:
    • Life isn’t real
    • I’ll never know what meaning my life has
    • I’m just randomly floating through time and space
    • This may or may not be a simulation
    • Visiting funeral homes or cemeteries

The ERP process is graduated. It starts with more mild exposures and progresses to more challenging scenarios that trigger greater distress. Equally important is the “response prevention” aspect, in which you practice resisting compulsions, recognizing them as an unhelpful way to deal with the temporary distress triggered by existential dilemmas. 

Over time, your brain & body learn to habituate to these triggers & that these natural uncertainties of life are indeed acceptable & do not require compulsions to manage. In the short term, ERP is a challenging process that requires facing fears without using compulsions or safety behaviors to get relief. In the long term, engaging in that temporary distress is what will lead to more continued relief from OCD. By building your ERP toolbox, you can regain control over your life and experience relief from OCD symptoms. 

Getting the help you need

If you think you might be struggling with existential OCD and want to learn how it’s treated with ERP, schedule a free 15-minute call with the NOCD Care team to learn how we can help you. 

All of our therapists specialize in OCD and receive ERP-specific training. You can also get 24/7 access to personalized self-management tools built by people who have been through OCD and successfully recovered.

NOCD Therapists specialize in treating OCD

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

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