Existential Crisis
and Drug Addiction

Existential Crisis

An existential crisis happens when you question whether your life has meaning, purpose, or value. Purpose and meaning are the major focus for philosophers and experts studying existentialism.  Let’s start by defining some key terms before digging into the details of existential crisis.

Crisis

A crisis is typically defined as a time of intense difficulty, trouble, or danger.1 For example, witnessing violence, the death of a family member, or a natural disaster, are all considered to be crises.
An existential crisis is a crisis that involves the inner conflicts and anxieties that accompany the existential concerns of human responsibility, independence, freedom, issues of purpose, and commitment.

Despair

Despair is generally considered to be the complete loss or absence of hope.2 Existential despair is the loss of hope in response to the breakdown of defining qualities in a person’s self-identity.
For example, a dancer who suffers an accident that prevents them from ever dancing again may have feelings that self-identity has been destroyed. This can lead to the loss of hope that they will be able to authentically live their life.

Fear

Fear is the unpleasant emotion that comes from the belief that something is dangerous, likely to cause pain, or is threatening.3 Existential fear is the fear derived from the possibility of nonexistence or death.

Ennui

Ennui is described as the feeling of listlessness and dissatisfaction arising from a lack of occupation or excitement.4 In other words: a feeling of utter weariness and discontent.
Existential ennui is the absence of interest or desire to do anything at all. This includes the idea that since existence is fundamentally empty, all actions are futile, and there’s no point in wanting to do anything.

Nihilism

Nihilism can be most simply defined as extreme skepticism maintaining that nothing in the world has a real existence.5 Existential nihilism is the philosophical theory that individual human life has no intrinsic meaning or value, that such an individual or the human race as a whole is insignificant and without purpose, and unlikely to change in the totality of existence.

Angst

Angst is a feeling of deep anxiety or dread about the human condition or state of the world; a feeling distinct from fear or worry.6 Existential angst is the feeling that arises from the conception of being lost, have a purposeless existence, being abandoned, and other existential concerns.

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Co-Occuring Disorders

Major Existential Concerns

Having an awareness of our own existence enables us to think about ourselves existentially.  In the 1980s, Irvin Yalom brought existential psychology to the forefront of the field of psychotherapy aimed at addressing existential concerns. Yalom posited that there are four basic concerns, described in the following section: death, freedom, existential isolation, and meaninglessness.

Death and Mortality

At some point, all human beings become aware that their death is inevitable. This awareness, known as mortality salience, forces us to balance the natural instinct to avoid death with the intellectual understanding that any activity motivated by this instinct is ultimately futile. Such forced reckoning may lead to an existential crisis if coping with the immutability of death is a problem. In addition, having no control over the timing, circumstances, or processes of death can contribute to ‘death anxiety’.7

Personal Freedom and Responsibility

Personal freedom and responsibility in existential thought refer to the concept that human beings have an existential obligation to ‘create’ their own lives. When you become aware of your existence, and the finiteness of this existence, you might realize that there is no external framework governing fate.8 Every individual is forced to make choices about their life, to determine priorities by which to live and to act upon these choices and priorities. In other words, the ability to be aware of our own existence endows us with the burden of responsibility and freedom to make life as we desire.

Authenticity

Charged with balancing responsibility and freedom, the most important element to utilize in guiding one’s actions is authenticity. Authenticity is the idea that you are acting in correlation to your desires, motives, ideals, or beliefs.9 Truly authentic actions not only belong to the actor but sincerely express who that individual really is.

As in colloquial usage, ‘authenticity’ typically indicates that something is what it is reputed to be. If you do something because of outside pressures, it is not authentic. Feeling as though one cannot live authentically, and therefore cannot fulfill one’s fullest potential, can lead to feelings of hopelessness and despair.

Isolation and Connectedness

Feeling alone and separate from others can contribute to the onset of an existential crisis. Existential isolation is the idea that isolation is inherent in the human condition and can never be fully overcome, no matter the intimacy or strength of the relationship.10 Existential isolation may manifest as a feeling that others (particularly in relatively close social circles) do not or cannot understand your experience.

For example, the realization that others do not hold the same cultural worldview may diminish the meaning or validation of your worldview and lead feelings of existential isolation. Existential isolation is not simply a form of ‘loneliness’, but a feeling of insurmountable disconnectedness—an isolation from every creature and element of the world. It’s the knowledge that one is born alone and will die alone.

Meaning and Meaninglessness

It’s common to be concerned that life is without meaning. In existentialism, the absence of a given meaning leaves you solely responsible for the creation and experience of any meaning in life.11 The only meaning to be found is subjective and created through ownership of your choices. Authentically meaningful activities provide a reason to live.

Emotions and Existence

Emotional and behavioral reasoning is unique to human beings, and awareness of our existence may produce the emotions of awe and dread.12 For instance, while to be alive is awesome, to recognize that death not only will arrive but may arrive at any time, is dreadful.

Guilt

Referring to the concept of authenticity— that every individual is charged with creating a life, particularly a life unique to each individual, as well as aspiring to live life to its fullest potential—it’s possible to feel existential guilt if you have not lived an authentic life. Existential guilt may manifest as anger, anxiety, and, when directed inward, as depression or shame.

Existential Aspects of Living with Addiction

How Can an Existential Crisis Lead to Addiction?

An existential crisis often involves unanswerable questions that remain constant and may not be ignored. For example, an individual feeling directionless or without life purpose and may reason they have nothing to lose. In such desperation for numbness or stimulation, this can lead to substance abuse.13

The addictive nature of substances can quickly take hold, momentarily relieving suffering, only to increase it in the long-term. Addiction is a paradoxical circumstance, a result of attempts to avoid the parts of life beyond human capacity to control and manipulate, produced by chemicals too powerful to resist.

How Can Drugs Create Existential Meaning?

Drugs can produce experiences that allow for reality to feel different from normal perception. Drugs can ‘fill the void’ and chemically drive a person to seek out more of the drug, thus giving a purpose, direction, and meaning to act.14

Existential Concerns of Young People and Club Drug Abuse

Young people are as vulnerable to existential concerns as any adult. Adolescence is the transitional period from childhood to adulthood. Many adolescents raise questions about themselves, such as “Who am I? Who have I been? Who am I becoming?”. In other words, the major causes of youth substance abuse are existential concerns: (lack of) personal identity, intimate relationships, and life purpose.

Taking drugs may temporarily relieve young people’s stresses accompanying an existential crisis. Drugs may be a means to momentarily step away from life struggles including identity confusion, loneliness and isolation, the emptiness of life, and dilemma over freedom and responsibilities. It’s not enough to teach factual knowledge of the health hazards of substance abuse because the potential to relieve existential concerns through drug use may outweigh the risks.

Addiction Treatment Using an Existential Focus

Existentialism in 12-Step Recovery

Generally, 12-step recovery programs address issues of fear, abandonment, and shame and teach tools that support spiritual change. This spiritual change is necessary because the unaddressed issues that were ‘frozen’ during addiction will come back and need to be dealt with.15 There’s always the possibility for relapse and co-occurring issues (e.g. depression, anxiety, loneliness) to arise again.

Treating Addiction by Focusing on Spirituality and Existentialism

Successful addiction treatment establishes long-term tools to help resist returning to substance abuse, rather than short-term tools (e.g. anti-drug advertisements, government-conducted campaigns).16 Such tools involve developing the capacity of awareness and self-directed changes in attitudes and behavior.

Therapists using an existential approach help clients focus on free will, self-determination, and the search for meaning, allowing clients the opportunity to center on themselves, rather than on addiction. Young people in particular may benefit from having a relationship with someone who approaches from an internal perspective, is empathetic to their struggles, and is supportive of their efforts to reflect on their way of existing.

Symptoms of an Existential Crisis

The following symptoms may indicate an existential crisis.17

Panicked About Death

Death is inevitable, and life is finite and brief. Given this fact, it’s normal to have some fear or discomfort about the idea of death (depending on the cultural beliefs one partakes in). However, panic about death may be a mark of an existential crisis. For instance, an individual who is unable to function normally because they are overwhelmed by their ‘death anxiety’ may be spending too much time attempting to confront or contemplate death.

Upset About Things Beyond Control

Recall that the Serenity Prayer of Alcoholics Anonymous asks for the ‘serenity of mind to accept that which cannot be changed, the courage to change that which can be changed’, and the wisdom to know the difference. Even if they are not able to accept that there are things beyond their control, most people are not debilitatingly upset over that fact. Furthermore, while powerlessness is a discouraging feeling, but the inability to discern what is and isn’t under one’s control may be a sign of an existential crisis. For instance, a person may feel they have no autonomy over their actions and may become despondent and cease putting in effort into living.

Worrying Much More Than Normal

Defining the ‘normal’ amount of worrying is less important than recognizing whether worrying is affecting the ability to live life normally (e.g. fulfill obligations of childcare, keep a job, etc.). In essence, a person is worrying much more than normal if this worry interferes with their day-to-day functions.

Common Life Events Leading to Existential Crisis

Significant life events, as follows, can contribute to the onset of an existential crisis.18

Beginning a New Phase of Life

New phases of life, as follow, may trigger an existential crisis as an individual realizes their mortality.

Age milestones, such as the 40s or 50s, or retirement age (typically 65)

Becoming a parent

Getting married or divorced 

Approaching end-of-life (knowledge of death becomes real, proximal) 

Losing Family or Relationships

Death of family, diagnosis of terminal or serious illness, or deterioration of a relationship may instigate an existential crisis. After experiencing the death of someone close to them, and/or feeling the “nearness” and “reality” of death, a person may question the point of living if death is inevitable.

Having trouble in maintaining or forming relationships may lead a person to give up trying to cultivate interpersonal relationships, which may lead to increased feelings of isolation. Other events, such as a child’s entry into adulthood and subsequent move-out, or retirement, may also increase a person’s sense of ‘aloneness’.

Dissatisfaction with Career Path

It’s possible that feelings of having not accomplished what they set out to do at the beginning of their career or feel that they have chosen a career path that will not bring them happiness or satisfaction they once expected can cause a crisis. Also, you may feel trapped in your occupation (because of an educational specialty, or are supporting dependents, or do not have savings) and are unable to seek work elsewhere. Alternatively, it’s possible to have chased ambitions to the exclusion of other life experiences—such as pursuing financial success over developing meaningful relationships.

Living in an Uncomfortable Location

Moving to a new place can be a stressful process for anyone. The new location may be completely different from the previous location, or perhaps there’s no familiar face in the new location that can make the transition easier. However, living in an uncomfortable location may lead to feelings of existential isolation, especially if other people do not share the same discomfort.

Feeling Stuck in Life

It is not uncommon for people to feel that they are stuck in life. However, this feeling becomes existential upon realizing that there is no external blueprint given for living and that the world isn’t inherently structured. Each person must create a structure to live by, and this can feel overwhelming. There’s no true meaningful framework for life, and there is a myriad of choices from which to build this framework. This can lead to paralysis and a fear of making the wrong move.

Apathetic About Life

Apathy—a lack of interest, enthusiasm, or concern—towards life goes against survival instincts and may indicate an existential crisis. They may be thinking, “humans are so insignificant, nothing we do matters, so why not give up on everything?” They may feel that what they do makes no lasting difference and that they will have no legacy after death. This attitude can lead to self-destructive behavior and choices that are not in the interest of self-preservation.

Mental Health Disorders and Crisis

Existential Psychology

While the field of existential psychology is relatively new, it has been observed that certain mental health conditions may increase the risk of an existential crisis.19

Existential Depression

Existential depression is characterized by a unique sense of hopelessness in understanding the possibility that life may be meaningless. A marked difference between clinical depression and existential depression is that the latter is not usually treated with prescribed medication. Instead, psychotherapy helps explore the ideas about the meaning of life. Existential depression has similar symptoms as typical clinical depression, including:

Suicidal thoughts and feelings

Low motivation and energy levels to complete normal activities 

Cutting ties with social groups

Existential Anxiety

Existential anxiety is the experience of angst, including feelings of panic, agitation, and dread about the nature of existence. For instance, if it’s given that life is merely a series of unavoidable choices with an immutable time limit, then the individual is solely responsible for their actions. A great deal of existential anxiety may result from this struggle to choose how to act for building a successful or enjoyable life, for fear that making a wrong choice will result in a terrible future.

Existential Obsessive-Compulsive Disorder (OCD)

There are many forms of OCD besides those that drive you to endlessly worry about contamination and organization. The defining symptom of existential OCD is having intrusive, persistent, and repetitive thoughts about questions that are unanswerable and may be philosophical or frightening that produces anxiety.

Such questions typically involve the meaning, purpose, or reality of life or the existence of the universe or oneself. The difference between existential OCD and existential depression is that those afflicted with existential OCD spend significant chunks of time (hours) thinking about these questions and ideas. In addition, existential OCD-type thoughts have some element of uncertainty. A person affected by existential OCD is consumed by these thoughts and is inhibited from living a normal because these obsessions cannot be argued with, reasoned out, analyzed, or questioned.

Existential Crisis Bipolar Disorder 

BPD (previously known as manic depression) is characterized by intermittent periods of depression and abnormally elevated moods. The periods of existential crisis BPD are simply motivated by existential concerns.

Existential Substance Use Disorder

Substance use disorder (SUD) is defined as the persistent use of drugs or alcohol without regard to significant harm and adverse consequence that may be suffered as a result. SUD may be marked by mental, emotional, physical, and behavioral issues, including the inability to stop or reduce substance use despite repeated attempts and physiological withdrawal symptoms.

Existential SUD is shaped by a perceived lack of meaning in life, fear of death or failure, alienation from others, and spiritual emptiness. The existential anxiety generated by confrontation with the existential concerns of freedom and responsibility, death, isolation, and meaninglessness of life is magnified by the threat of death from substance overdose and the powerlessness over the substance and behavior.

How to Deal with an Existential Crisis

Recognize that existential issues cannot be dealt with in one fell swoop. Rather, existential crises typically require repeated revisiting and reconsideration to manage the symptoms leading to the initial crisis.20

Existential-Humanistic Therapy

Under this type of therapy, psychological problems (including substance use disorders) are viewed as the result of the inhibited ability to make authentic, meaningful, and self-directed choices about how to live. Interventions are aimed at increasing self-awareness and -understanding. Existential humanistic therapy places an emphasis on lived experience, authentic relationships, and recognition of the subjective nature of human experience.

Humanistic therapy also aims to teach how to overcome reactionary behavior and replace it with self-aware and thoughtful actions by developing self-confidence and mindfulness. People have the capacity to exercise willpower to make constructive changes in their lives. This includes the ability to address behavioral and emotional concerns during stressful external events and to suspend or change primary emotional responses to situations that may be creating problems.

Take Control of Your Thoughts

While changing one’s train of thought may be challenging, doing so can have a significant effect on how you respond to life experiences. For example, developing ‘anxiety buffers’ such as self-esteem and faith in a cultural worldview may help keep existential dread in check—that is, to manage the distressing feelings associated with cognizing the inevitability of death, the meaninglessness of life, etc. Another example: face death with some sense of peace and equanimity by learning to accept the life one has lived or is living. Additionally, consider that anxiety experienced during substance abuse recovery is normal and a sign of vitality.

Gratitude Journal

A gratitude journal is simply a journal of anything and everything for which one is grateful. There is some evidence that keeping a gratitude journal improves psychological and physical functioning by serving as a reminder about things to be thankful for and that add meaning to life. Creating a gratitude journal involves thinking about and recognizing the cause of gratitude. A relatively easy and enjoyable way to improve one’s outlook on life, keeping a journal can add routine to the day or week. A journal can also aid in determining what to change to address the existential crisis.

Changing Thought Patterns

Ultimately changing thought patterns is the key to emerging from an existential crisis. There are certain unavoidable truths to this perilous life, and the best anyone can do is to keep from giving up. Keeping a gratitude journal will provide a means to remember why life has meaning. It may also be helpful to simply look for smaller answers. Humans are fragile, imperfect, and vulnerable- forgive yourself for being so.

Meditation

Deep personal reflection in the form of meditation can aid in understanding existential concerns, such as that:

At times, life is unfair and unjust 

Ultimately, there is no escape from some of life’s pain, or from death

No matter how close one gets to other people, one must still face life alone

Life may be lived more honestly and with less involvement in trivialities by facing basic issues of life and death 

One must take ultimate responsibility for the way one lives life, no matter the amount of guidance and support others provide 

Don’t Expect All the Answers

No one knows the meaning of life, or purpose, or has any certainty of right or wrong or good or bad. In fact, it’s been hypothesized that “culture” originally resulted from the need to reduce ‘death anxiety’. Many types of “culture” explain the origins of the universe and provide a belief system that can be used to guide choices and actions through life.

Consider exploring the insights of notable existential therapists, including James Bugental, Rollo May, Kirk Schneider, and Irvin Yalom. Also consider reading works from key philosophers of existentialism, including Martin Buber, Albert Camus, Martin Heidegger, Karl Jaspers, Soren Kierkegaard, Gabriel Marcel, Friedrich Nietzsche, Maurice Merleau-Ponty, and Jean-Paul Sartre.

Finding Holistic Addiction Treatment to Address Existential Problems

Many drug and alcohol addiction recovery centers offer a variety of long-term inpatient programs exclusively for people that turned to drugs during an existential crisis. The recovery centers provide specifically tailored support to provide the authenticity that is essential to recoveries, such as honesty, vulnerability, and openness. Having these authentic experiences also lends participants accountability for their recovery progress.

A rehab center’s array of treatment programs may include a 12-step program (modeled off of Alcoholics Anonymous’), relapse prevention program, trauma program, family workshop, and addiction treatments for such substances as alcohol, benzodiazepines, cocaine, crack, ecstasy, fentanyl, heroin, marijuana, meth, opiates, prescription drugs, and stimulants. Many treatment plans consist of a 3-phase approach. During residential treatment, participants live on-site and, with staff input, create incentives for sobriety and realize the potential life changes recovery can make. Other therapies provided by quality addiction treatment centers may include humanistic, group, and individual therapies, and therapies that focus on anger management, motivational interviewing, and dialectical behavior.

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