top of page

Existential OCD

How Does Existential OCD Present?

People with Existential OCD are preoccupied with questions and worries of an existential nature, and they often fixate on topics such as the meaning of life, the nature of the universe, life after death, reality, and the existence of free will.


There is a lot unknown about these topics and most of them do not have definite answers; however, people with Existential OCD feel intense anxiety and distress about the uncertainties of these topics and feel they must find answers to relieve their distress.


People with Existential OCD can also be preoccupied with worries about the nature of reality. They may question whether their experience of the world is real or if their reality is being controlled in a simulation. They may also worry about “losing their mind” and losing touch with reality.

Lots of people ponder about existential questions at times. However, the difference with Existential OCD is that the questions get stuck and produce intense anxiety and distress.

Existential OCD makes people feel like they cannot move on unless they get answers and resolve their questions. Even if they try to ignore the questions and stop thinking about them, the questions keep coming back, creating a vicious cycle of distress, and compulsions, which are used to try and combat the distress.

Existential OCD Compulsions

Compulsions are anything that people with OCD do to relieve the anxiety and distress brought on by their intrusive thoughts (i.e., obsessions, worries). The variations of compulsions are endless and vary from person to person, which makes it impossible to include examples of all possible compulsions in this guide. Below is a selection of examples illustrating a range of ways Existential OCD compulsions present.

Examples of Existential OCD Compulsions:

Researching about existential topics to find answers.


Excessively practicing mindfulness to ensure that you are present and real.


Touching or pinching your skin to ensure that you are real.


Avoiding books, TV shows, or movies that feature existential topics.

(e.g., alternate universes, life after death, mind control)


Excessively seeking reassurance from others or the Internet regarding existential questions.


Excessively taking photos for proof that you and your loved ones are real.


Needing to do specific rituals to prevent existential worries from happening.

(e.g., I need to brush my teeth for 4 minutes every night using a specific toothpaste, or I might not be real tomorrow)


Testing yourself to do certain actions to ensure that you are in control of mind and actions.

(e.g., jumping up and down three times whenever I get the thought,

“What if I’m not in control of my actions?")


Needing to ask about or explain a situation to reassure yourself that your reality is true.

(e.g., Asking your best friend what you bought for her birthday last year,

even though you remember exactly)


Staring at yourself in the mirror to check if you are real.


Making a list of things you did throughout the day so you can review them later,

and analyze whether they really happened.

Help for Existential OCD

Existential OCD can feel confusing and exhausting for those living with it. Fortunately, help is available, and OCD is absolutely treatable. The gold-standard treatment for OCD is a type of behavioral intervention called exposure therapy. In addition to exposures, there are also other highly effective acceptance-based interventions that complement exposure therapy for OCD. 

We hope that this guide has helped you to better understand Existential OCD.

You do not need to live a life overwhelmed and controlled by OCD. Equipping yourself with practical information for treating OCD and learning how to respond to OCD in an effective way can be life changing. Oftentimes, people unknowingly engage in actions that feed the OCD cycle

If you would like to learn more in-depth information about OCD treatment and recovery, you are welcome to read our Educational Guides on exposure therapy and other acceptance-based interventions for OCD:

bottom of page