What is Existential OCD: the endless search for concrete answers about the future

Existential Obsessive-Compulsive Disorder (OCD) is a unique facet of OCD that transcends age boundaries, affecting children, teens, young adults, and adults. Characterized by intrusive thoughts (obsessions)  and compulsive behaviors (compulsions) related to existential concerns, this variant of OCD searches the profound questions of existence, purpose, and meaning. We'll explore how Existential OCD manifests in different age groups and the challenges faced by individuals at various stages of life. At CalmOCD, clinicians are trained in assisting those with existential obsessions across the lifespan. 

Existential OCD in Children

Children, though often thought of as carefree, are not immune to the complexities of OCD. Existential OCD in children may manifest as persistent questioning about the nature of life, death, and the universe. They may become fixated on the impermanence of things, constantly seeking reassurance about the fundamental aspects of existence. Parents may notice an increased need for philosophical discussions or an intensified fear of death, leading to bedtime rituals or avoidance behaviors.

Warning Signs in Children:

Persistent Questioning:

• Excessive and repetitive questioning about life, death, and existential concepts.
• Intrusive thoughts about the nature of existence.

Reassurance Seeking:

• Constantly seeking reassurance from parents or caregivers regarding existential concerns.

Fear of Death:

• An intense fear of death, often leading to bedtime rituals or avoidance behaviors.

Philosophical Fixations:

• Unusual interest in philosophical topics beyond typical childhood curiosity.

Perfectionism:

• A tendency towards perfectionism, driven by a desire to control existential uncertainties.

Existential OCD in Teens

In adolescent years, teens grapple with the storm of hormonal changes and the quest for identity. Existential OCD in teens can add an additional layer of challenge. These individuals may wrestle with questions of self-worth, the meaning of their actions, and the impact of their existence on the world. The fear of making the wrong choices or the pressure to define their life purpose may intensify OCD symptoms, leading to academic or social challenges.

Warning Signs in Teens:

Identity Crisis:

• Intensified existential angst related to questions of self-identity and purpose.

Academic and Social Challenges:

• Obsessive thoughts impacting academic performance or social interactions.

Fear of Making Mistakes:

• An overwhelming fear of making irreversible life choices or decisions.

Intense Self-Reflection:

• Excessive self-reflection, leading to rumination on the meaning and impact of one's actions.

Compulsive Decision-Making:

• Engaging in compulsive behaviors to alleviate the anxiety associated with decision-making.

Existential OCD in Young Adults

Young adulthood is a time of self-discovery and establishing independence. Existential OCD can cast a shadow on this transformative period, with affected individuals experiencing heightened anxiety surrounding life decisions, career choices, and relationships. The fear of making irreversible mistakes may trigger compulsive behaviors, hindering personal growth and creating a barrier to forming meaningful connections.

Warning Signs in Young Adults:

Career and Life Path Anxiety:

• Obsessive thoughts and anxiety related to career choices and life direction.

Relationship Concerns:

• Fear of making the wrong decisions in relationships, leading to relationship-oriented compulsions.

Comparisons and Self-Worth:

• Constantly comparing oneself to others and questioning personal worth.

Intensified Existential Anxiety:

• An increased awareness of mortality and the fleeting nature of time.

Perseveration on Regret:

• Persistent rumination on past decisions and the fear of regretting choices.

Existential OCD in Adulthood

Existential OCD doesn't necessarily diminish with age; in fact, it can evolve and manifest differently in adulthood. Adults with existential OCD may grapple with the consequences of their life choices, the fleeting nature of time, and the fear of facing their own mortality. Career changes, relationship decisions, and midlife reflections can trigger obsessive thoughts, leading to a continuous cycle of rumination and compulsive actions aimed at finding solace.

Warning Signs in Adults:

Midlife Reflections:

• Existential concerns related to aging, mortality, and the overall meaning of life.

Workplace Anxiety:

• Obsessive thoughts about career achievements, success, and the impact of one's work.

Family and Relationship Obsessions:

• Fear of damaging relationships or making irreversible family-related decisions.

Existential Rumination:

• Persistent rumination on the purpose and significance of one's existence.

Health Anxiety:

• Concerns about health and mortality, often leading to health-related compulsions.

Coping Strategies Across the Lifespan

Regardless of age, the impact of existential OCD can be mitigated through various therapeutic strategies. Working with a therapist skilled in Exposure and Response Prevention (ERP) or Inference-Based Cognitive Behavioral Therapy (I-CBT) allows an individual to learn the strategies they can implement to stop the OCD cycle in its tracks while reducing OCD symptoms and improving daily functioning.  

Support from family and friends can be helpful in the journey to manage existential OCD. Open communication, empathy, and understanding create a foundation for individuals to share their struggles without fear of judgment. Educating loved ones about the nature of existential OCD can also promote a supportive environment that encourages seeking professional help. This is best done working with a therapist trained in SPACE (Supportive Parenting for Anxious Childhood Emotions) in order to help loved ones understand not only OCD, but also learn ways in which others can help reduce OCD symptoms by changing their own communication and behavior patterns. SPACE education and treatment is helpful across the lifespan and is not limited to childhood. CalmOCD offers the SPACE curriculum to families interested in learning how to best navigate their loved ones' anxiety disorder. 

There is HOPE! 

Existential OCD is a complex facet of OCD that spans across the lifespan, impacting children, teens, young adults, and adults. Understanding the unique challenges each age group faces allows for targeted interventions and support systems. By fostering a compassionate and informed community, we can empower individuals grappling with Existential OCD to navigate life's uncertainties and embark on a journey of self-discovery and resilience. Treatment does more than just change lives; it gives someone their life back from OCD.