Existential OCD: isn't this just being a deep thinker?
Plenty of people find these questions fascinating and sleep fine. The difference is the dread, the compulsion to resolve it, and the hours it takes. Curiosity can be put down.
You have probably been told, or told yourself, that this is just how your mind works. You think deeply. You are interested in the big questions. Other people skate over the surface of things and you cannot, and that is a kind of seriousness, and seriousness is not a disorder.
I want to take that seriously, because there is something in it, and then draw the distinction.
The questions are real
What happens when we die, whether anything is real, why there is something rather than nothing, what consciousness is and why you are you: these are not silly questions. They have occupied serious people for three thousand years, and they will occupy serious people for the next three thousand. Therapy does not make them trivial, and I am not going to tell you that they do not matter.
Plenty of people find them fascinating. Some build careers on them. And those people, for the most part, sleep fine.
The difference is not the subject
What distinguishes existential OCD from deep thinking is what the thinking does to you and what you do in response. Three things, specifically.
The dread. A philosopher considering solipsism feels interest, perhaps a pleasant vertigo. You feel terror, and the terror arrives before the thinking has begun, attached to the question itself.
The compulsion to resolve it. A philosopher can hold an open question, indefinitely, as open. You cannot. Something in you insists it has to be settled before you can go back to your day, and the settling never holds, and you start again.
The hours. A deep thinker chooses when to think and can stop. You cannot stop. The question follows you into the shower, the meeting, the bed, and the day is lost to it whether you wanted to think or not.
Curiosity can be put down. This cannot.
Rumination in the clothes of thought
The compulsion here is almost entirely mental, which is why it is so easy to mistake for thinking. Reasoning towards an answer. Researching. Re-reading the thread. Checking whether the world feels real. Asking someone whether they think about this too, and needing them to say the reassuring thing. Each of these looks like intellectual engagement. Each brings relief for a few minutes. And each teaches the brain that the question was an emergency worth this much attention, so it comes back louder. This is the OCD engine, running on a subject that happens to be profound.
What treatment does not take from you
People with this theme sometimes fear that treatment means giving up the questions, becoming shallow, no longer caring about what is true. It does not. The goal is that the question stops functioning as an emergency. You get back the ability to hold it the way a philosopher does: with interest, at chosen times, and with the capacity to close the book.
Many people find, once the compulsion has loosened, that they can enjoy the questions for the first time in years, because the dread only ever made them unbearable.
What treatment does
The treatment is CBT with exposure and response prevention, and the early work is learning to tell rumination apart from thinking, which people are convinced is obvious and then find is not. Once you can catch the pull in its first few seconds, the practice is to let the question stand unanswered while you carry on with your day. The dread rises, and then falls, and the question loses its charge. We also go back to what has been avoided: the documentary, the conversation about death, the night sky.
I will not debate whether reality is real with you, because that would be performing your compulsion on your behalf. And I will not offer an answer. Nobody has one, and I would be suspicious of anyone who did.
If you have been calling it depth and losing whole days to it, there is more on how I treat existential OCD, and the questions come with you, intact.