Existential OCD
Some Questions
Aren't Meant
To Be Solved.
By Justin La Rose, RP, M.Psy · Registered Psychotherapist (CRPO) · Clinical Director, The OCD Clinic
Evidence last reviewed: October 2026
Existential OCD is a type of OCD where you get stuck ruminating on questions nobody can answer: the meaning of life, whether reality is real, consciousness, death, infinity. The questions themselves are human. What makes it OCD is the urgency. Your mind treats the question like a threat it has to solve, and every round of thinking buys a flicker of relief before the next one starts.
It's like the detective who can't close the case. Every argument turns up a new lead: but what if that's wrong, and how do I know that I know? The more you think, the stickier it gets, and for a lot of people it hits hardest at night, when there's nothing else to hold your attention. Underneath is the same engine as every OCD theme, from relationship OCD to sexual orientation OCD: an uncertainty that feels intolerable, and a compulsion that promises relief and delivers the opposite.
ERP for existential OCD doesn't answer the question. Nobody can, and that's exactly the point. Instead of arguing both sides or chasing one more insight, you practise leaving the question open while you drop the compulsions that feed it: the hours of rumination, the Googling for a definitive answer, the checking of whether you still feel connected to reality. You learn you can carry an open question and still show up for the life in front of you. We treat existential OCD in person in Toronto and online across Ontario.
The short answer
- Intrusive thoughts are common: Unwanted intrusive thoughts are highly prevalent across countries and cultures (Pascual-Vera et al., 2019), so the content of a thought says less than what you do with it.
- Mental compulsions count: In a field trial of people with OCD, most had both mental and behavioural compulsions (Foa et al., 1995), and in my practice rumination is usually the main one in existential OCD.
- Pushing thoughts away: Trying to suppress a thought tends to bring it back more often, with a small to moderate rebound effect across controlled studies (Abramowitz et al., 2001).
- First-line treatment: Exposure and Response Prevention (ERP), a form of CBT, is a first-line treatment for OCD in the American Psychiatric Association's practice guideline (Koran et al., 2007).
What does existential OCD look like?
Existential OCD looks like a question about meaning, reality or death that turns urgent and won't let you rest, and it usually lands on one of these four themes.
The Meaning of Everything
Spiraling on ‘what is the point of any of this?’: purpose, why anything exists at all, whether anything you do matters. The question feels urgent and unbearable, and the mind treats it like a problem that has to be solved right now before you can rest.
Is Any of This Real?
Doubt about the nature of reality itself: whether the world is a simulation, whether other people are conscious, whether you can trust that anything is actually there. This can arrive with a fog of unreality (derealization), which OCD then reads as more proof that something is wrong.
Consciousness, Death, and Infinity
Fixation on what happens after death, on non-existence, on infinity or eternity, ideas no amount of thinking can pin down. The thoughts loop and escalate, often worst at night, and each attempt to 'wrap your head around it' pulls you deeper.
Trying to Think Your Way Out
Endless mental analysis to reach a conclusion that never comes. You argue both sides, chase one more insight, refresh the question to see if the dread has lifted. The thinking feels like problem-solving. It's the compulsion that keeps the loop alive.
What are the common existential OCD compulsions?
The common ones are hours of rumination, searching for a definitive answer, asking for reassurance and checking whether you still feel connected to reality, and every one of them feels like progress. You're thinking, reading, checking, so surely you're getting closer. You never are, because the answer OCD wants doesn't exist.
- Ruminating for hours trying to 'solve' an unanswerable question
- Googling philosophy, physics, or religion for a definitive answer
- Seeking reassurance that life has meaning or that reality is real
- Avoiding triggers like documentaries or conversations about space, death, or time
- Mentally arguing both sides to try to reach certainty
- Checking whether you still feel connected to reality
- Replaying the question to see if the anxiety has resolved yet
- Analyzing your own thoughts about existence to make sure they're 'normal'
How is existential OCD different from normal philosophical thinking?
The difference is your relationship to the question more than the topic: philosophy can be set down, and existential OCD won't let go. Everyone wonders about these things. A few markers:
- Philosophy is curious and can be set down; existential OCD is distressing and won't let go
- The goal is certainty and relief, not understanding
- It arrives with dread, not wonder
- You feel compelled to resolve it, not free to explore it
- It interferes with your work, relationships, and sleep
- ERP doesn't answer the question. It helps you live alongside the uncertainty
Therapy that keeps analysing the question with you can feed the cycle instead of breaking it. That's the difference between the two types of therapy, and OCD needs the kind that changes what you do.
If questions about the point of living ever come with thoughts of ending your life, tell someone today. In Canada, call or text 9-8-8 (Suicide Crisis Helpline), call 911, or go to the nearest emergency department. The page on self-harm OCD and suicidal thoughts covers how clinicians tell the two apart.
Related Resources
FAQ
What Else Do People Ask About It?
Everyone wonders about meaning, death, and reality, and that part is human. What makes it existential OCD is the relationship to the question, not the question itself. Philosophy is curious and you can set it down; existential OCD is distressing, urgent, and won't let go. If the wondering comes with dread and a compulsive need to resolve the unresolvable, and it's eating your sleep and focus, that's worth a proper assessment.
Because your mind is treating a philosophical question like a threat it has to eliminate, and rumination feels like problem-solving. Every time you 'think it through,' you get a flicker of relief, which teaches your brain to come back and think it through again. The loop tightens the harder you try. The thinking isn't bringing you closer to an answer. It's the compulsion keeping the loop alive.
No, and any honest therapist will tell you that. No one can answer whether reality is real or what happens after death. That's the trap: OCD demands an answer that doesn't exist. Treatment doesn't resolve the question; it changes your relationship to it, so you can let it stay open without your day collapsing around it. Relief comes from loosening the grip, not from finally solving it.
Exposure and Response Prevention. Instead of chasing certainty, you gradually practise letting the unanswerable question exist without doing a compulsion to close it: no ruminating, no Googling philosophy, no checking whether you still feel connected to reality. You're learning that an open question doesn't have to be an emergency. We treat existential OCD in person in Toronto and online across Ontario, starting with a free 20-minute consultation.
You Don't Have To Live Like This.
Book a free 20-minute consultation. No commitment, no pressure. Just a conversation about where you are and how we can help.
Book Free ConsultationHow we researched this page
This page draws on a cross-cultural study of unwanted intrusive thoughts (Pascual-Vera et al., 2019), the DSM-IV field trial on mental and behavioural compulsions (Foa et al., 1995), a meta-analysis of thought suppression (Abramowitz et al., 2001) and the American Psychiatric Association's practice guideline for OCD (Koran et al., 2007), alongside what I see in my own practice. Existential OCD has very little research of its own: none of these studies looked at existential themes, and the intrusive-thought study used volunteers without a diagnosis, so the description of how this theme presents is clinical observation, not trial data.
A note on my perspective
I run a private clinic that treats OCD with ERP, and I'm paid when people book with us. Read what I write with that in mind. Public and lower-cost routes exist too, and the Ontario OCD treatment guide lays them out next to ours.
About the author
Justin La Rose, RP, M.Psy is a Registered Psychotherapist with the College of Registered Psychotherapists of Ontario (CRPO) and Clinical Director of The OCD Clinic in Toronto. He has worked in mental health for more than 25 years and treats OCD with Exposure and Response Prevention (ERP). You can confirm his registration on the CRPO public register.
Client stories on this site are composites, with names and identifying details changed. How we write client stories
How to cite this page
La Rose, J. (2026). Existential OCD: Some Questions Aren't Meant to Be Solved.. The OCD Clinic. https://theocdclinic.ca/existential-ocd