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Psychiatry & Psychology--General/Recurring existential thoughts that won't go away


Hi, 21-year-old male college student here. First off, I know that labels don't really matter and that I should probably go see a therapist no matter what. But I thought I'd at least get some kind of opinion on the matter before I go do that, just to prepare myself.

Anyway, here's my story, I'll try and keep it short. For the past eight years, I've had on-and-off, recurring obsessions with various existential/philosophical/metaphysical ideas. Some of them are common and semi-understandable—"What's the point of life if we're all going to die," or "emotions aren't real, they're just chemical reactions," for example. (I'm pretty much over those two, btw.) But a lot of others get pretty weird. I've spent long periods of time obsessing over concepts like free will, eternalism, strict average utilitarianism, animal consciousness, and parallel universes—and all the frightening implications that come with these concepts. Most notably, I occasionally get caught up in the idea of solipsism—that my entire life has been an elaborate, self-consistent dream I created, and that I'm the only person in the universe. (Until recently, I had a legitimate fear of even the most minor coincidences, thinking they could be "signs" that my reality is a fabrication. I'd consciously avoid them—I'd never partake in raffles, I'd never put my iPod on shuffle mode, I'd avoid trying to correctly guess certain things, etc.)

These thoughts will vary in their duration and severity. Many weeks (or months, or even years) in a row have gone by with me being mostly stress-free about them, but there have been long stretches of time, days or weeks, in which I believe these thoughts with 80% certainty. Usually, I don't obsess over more than one thought at a time—a few weeks will pass with one before I either feel better or switch to a different theme. And invariably, the emotion most associated with these obsessions isn't fear or anxiety, but just depression.

This all might sound really odd, but a quick Google search of "existential OCD" or "existential anxiety" will bring up a whole lot of forum posts about the themes I mentioned, including solipsism, which is the weirdest one. So I know I'm not alone here. However, I can't find any solid evidence that it's a mental disorder that's causing these thoughts; the only evidence I've found is mostly anecdotal and from people who have self-diagnosed. My working theory right now is that I have "pure-O" (purely obsessional OCD, i.e., no compulsions), which is the closest thing I could find to my experiences. However, there are significant differences between me and the typical pure-O sufferer that give me pause. My thoughts, weird and unwanted as they are, seem to occur naturally. They don't really seem to match the general definition of "intrusive thoughts," which usually involves images "flashing" randomly into your head. Furthermore, my thoughts are almost purely of the existential variety—nothing sexual, violent, or any of the other common themes. (Again, I've only seen "existential OCD" mentioned in forums, very rarely in anything more legitimate.) I've never had any obsessive fear that I will do something bad or "uncharacteristic of myself." I've been using the word "obsess" above, but I'm not sure that my thoughts actually qualify for the medical definition of that word. And unlike most OCD sufferers, I genuinely think my fears are at least somewhat rational, even when I'm feeling completely normal and obsession-free. I'm concerned that there's perhaps nothing medically wrong with me, and that I simply see the world differently from the way other people do. I'll concede I worry a disproportionate amount about these things, but it still doesn't feel like "magical thinking" in the traditional sense. (I'd go into more detail as to why I feel like my seemingly bizarre ideas make logical sense, but this message is already way too long.)

My "obsessive"-ish worries aren't all existential. For the past year or so, I've had trouble enjoying almost any movie, even though I once considered myself a cinephile. I'll spend ENTIRE movies thinking "What if I don't enjoy this critically-acclaimed film? What if the people who I took to see it with me don't like it? What if I lose interest? Oh no, I'm losing interest, aren't I?" And I've done enough movie-watching to know that at this point, it's definitely not as simple as "I just didn't like the movie." The first time I watched The Force Awakens, I barely enjoyed it because I spent much of the movie trying to force myself to stop thinking about whether I was enjoying it or not. The second time I watched it, since I knew what to expect, I loved every second of it and wondered why I was so stressed about it the first time. This sort of thing has happened many times, all in the past year. Sort-of-similarly, I've been having trouble enjoying college the past few months, since I keep thinking about how I feel I've wasted my first three years, and about whether I'm even able to enjoy myself, even though I have a full year left. I don't know if this paragraph is at all connected to everything else I've told you, but I thought I'd throw it out there.

Dang, every time I write something like this, it always ends up three times longer than I thought it would be. Ah well. Thanks for reading it all. So, yeah... thoughts? You cannot, of course, give me a diagnosis just based on these few paragraphs, but do my experiences sound at all familiar to you? Is my "pure-O" self-diagnosis way off-base? I'm guessing you'll probably say "Talk to a professional," which I'd tend to agree with. I just feel more comfortable asking online about this before I jump into therapy. I have been feeling a lot better the past few months, anyway. Definitely not perfect, but way better than I was six months ago.

Hi Will, thanks for your questions. You asked

"do my experiences sound at all familiar to you?"
---- it's not that unusual, no

"Is my "pure-O" self-diagnosis way off-base?"
--- really no way for me to know, based on a single email. Even if you were my patient, it would not be an important question to me.

Not sure if that answers your questions, but if not, ask some follow ups

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Bruce Borkosky, Psy.D.


any related to psychology, especially related to forensic psychology


15 years as a licensed psychologist, 15 years in private practice. My practice began primarily doing individual and group psychotherapy, is now devoted to assessments, but I occasionally do take on clients in therapy.

American Psychological Association

B.A. psychology, B.A., music, Ohio Wesleyan U., 1978 MCS, computer science, University of Dayton, 1984 MA, psychology, Miami Inst. of Psychology, 1991 Psy.D., psychology, Miami Inst. of Psychology, 1993 post doctoral training in Neuropsychology, Fielding Institute, 1995-1997

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