Existential Anxiety: 5 Questions to Assess It

In brief: Assess your existential anxiety with a validated psychological test. Understand its causes and find meaning in your life again.

Marie, 34, often wakes up in the middle of the night with a feeling of tightness in her chest. She asks herself nagging questions: "What is the meaning of my life? What will happen after death? Do my choices really matter in the immensity of the universe?" These questions, far from being philosophical and detached, generate in her a deep anxiety that interferes with her sleep, her concentration at work and her personal relationships. This particular form of anxiety, which we call existential anxiety, affects about 15 to 20% of the general population according to recent epidemiological studies. It is characterized by anguish linked to the fundamental questions of existence: death, the meaning of life, freedom, isolation and the responsibility of our choices. Unlike generalized anxiety, which concerns concrete everyday worries, existential anxiety confronts us with the deepest and most inevitable aspects of the human condition. So how do we identify, assess and understand it? Which psychological tools allow us to measure this very particular dimension of our emotional experience?

Understanding existential anxiety: definition and manifestations

Theoretical foundations

Existential anxiety has its roots in the existentialist philosophy of the 20th century, with thinkers such as Kierkegaard, Sartre and Camus. In clinical psychology, it was formalized through the work of Irvin Yalom, an American psychiatrist and psychotherapist, who identified four fundamental existential concerns:

• Death: the anguish in the face of our finitude

• Freedom: the vertigo of our choices and our responsibility

• Isolation: the fundamental solitude of the human being

• Lack of meaning: the search for significance in a universe sometimes perceived as absurd

Symptoms and clinical manifestations

Existential anxiety manifests differently depending on the individual, but certain symptoms recur frequently: Cognitive manifestations:

• Rumination about death and the afterlife

• Obsessive questioning about the meaning of existence

• Feeling of emptiness or absurdity

• Concentration difficulties linked to existential concerns

Emotional manifestations:

• Deep anguish in the face of uncertainty

• Feeling of isolation and solitude

• Sadness linked to identity questioning

• Intense fear of the unknown

Physical manifestations:

• Sleep disorders (insomnia, nighttime awakenings)

• Muscle tension

• Chest tightness

• Neurovegetative symptoms (palpitations, sweating)

Existential anxiety is not a mental disorder in itself, but rather a normal reaction of the human being to the fundamental questions of existence. It becomes problematic when it significantly interferes with daily functioning.

Tools for assessing existential anxiety

The Existential Anxiety Scale (EAS)

Developed by Weems and colleagues in 2004, the Existential Anxiety Scale is one of the first tools specifically designed to measure this dimension. It comprises 16 items divided into four subscales corresponding to Yalom's existential concerns. Examples of items:

• "I worry about what happens after death"

• "I feel anxious when I think about the fact that I am alone in the universe"

• "The idea that life has no meaning distresses me"

The Existential Concerns Questionnaire (ECQ)

More recent, this questionnaire developed by van Bruggen and colleagues in 2006 evaluates five dimensions:

Mortality: concerns linked to death

Solitude: feeling of existential isolation

Freedom: anguish in the face of choices and responsibility

Meaning: questioning about the significance of existence

Identity: questioning about who we really are

Complementary assessment tools

For a complete assessment, it is often relevant to use complementary scales: The Beck Anxiety Inventory (BAI) allows existential anxiety to be distinguished from other forms of anxiety. With its 21 items, it measures the intensity of general anxiety symptoms. The Hamilton Depression Scale helps identify a possible depressive component often associated with deep existential questioning. The Purpose in Life Test (PIL) by Crumbaugh and Maholick evaluates the feeling of having a purpose in life, a central dimension for understanding existential anxiety.

Self-assessment: practical questionnaire

Simplified self-assessment grid

Here is a self-assessment questionnaire you can use to take stock of your own existential concerns. For each statement, indicate your level of agreement on a scale from 1 (strongly disagree) to 5 (strongly agree): Mortality dimension:

• I often think about my own death with anguish

• The idea of the finitude of existence preoccupies me

• I feel anxiety when I mention the death of a loved one

Freedom dimension:

• I feel overwhelmed by the weight of my choices

• The responsibility of creating my own life distresses me

• I am afraid of making bad important decisions

Solitude dimension:

• I feel fundamentally alone, even when surrounded by others

• I feel that no one can truly understand me

• The feeling of isolation generates anxiety in me

Meaning dimension:

• I regularly wonder what the purpose of my life is

• The apparent absence of meaning in existence worries me

• I feel an existential emptiness that is difficult to fill

Interpreting the results

A high score (above 15 out of 20 in a dimension) may indicate a significant existential concern in this area. However, it is important to contextualize these results:

• Moderate scores (10-15): normal existential questioning

• High scores (15-20): concerns that may benefit from support

• Functional impact: the key is to determine whether these concerns interfere with your daily life

Do not hesitate to consult the Psychologie et Sérénité practice if you wish to deepen this self-assessment with a professional.

Distinguishing existential anxiety from other disorders

Existential anxiety vs generalized anxiety

The distinction is crucial for appropriate management: Generalized anxiety (according to the DSM-5):

• Excessive worries about concrete events

• Difficulty controlling everyday concerns

• Prominent physical symptoms

• Avoidance of specific situations

Existential anxiety:

• Questioning about the fundamental aspects of existence

• Search for meaning and significance

• Direct confrontation with the "ultimate givens" of life

• No avoidance but rather a quest for answers

Link with existential depression

About 30% of people presenting existential anxiety also develop depressive symptoms. The difference lies in:

• Existential anxiety: tension toward the search for answers

• Existential depression: feeling of powerlessness in the face of perceived absurdity

Special case of life transitions

Existential anxiety often emerges during important transitions:

• Adolescence: identity construction

• Mid-life: assessment and questioning

• Grief: direct confrontation with mortality

• Retirement: questioning about legacy and accomplished meaning

These moments can reveal or intensify latent existential concerns, hence the importance of an appropriate assessment.

Risk factors and vulnerable populations

Socio-demographic profile

Research conducted by Steger and colleagues shows that certain populations are more vulnerable: Individual risk factors:

• High level of education (paradoxically)

• Intellectual or artistic profession

• Introspective and sensitive personality

• History of trauma or loss

Environmental factors:

• Important life transitions

• Exposure to mortality (medical profession, etc.)

• Social isolation

• Absence of a structuring spiritual or philosophical framework

Impact of life events

A 2018 longitudinal study followed 1,200 participants over 10 years and identified the most frequent triggers:

• Death of a loved one (45% of cases)

• Serious personal illness (32% of cases)

• Couple or family crisis (28% of cases)

• Professional questioning (25% of cases)

Moreover, relationship difficulties can particularly exacerbate existential questioning. If you are going through a difficult period in your relationship, you could benefit from an analysis of your couple conversations to better understand these dynamics.

Specific populations

Young adults (18-25 years): A period of identity construction where existential questions are naturally prominent. 22% present high levels of existential anxiety according to Arnett's study (2014). Healthcare professionals: Confronted daily with suffering and mortality, they more frequently develop this type of anxiety (prevalence of 28% vs 15% in the general population). Creative people: Artists, writers and intellectuals present higher scores on existential anxiety scales, possibly linked to their sensitivity and capacity for introspection.

Management and therapeutic support

Specialized psychotherapeutic approaches

Existential therapy: Developed by Yalom, it supports patients in exploring their existential concerns without seeking to eliminate them, but rather to integrate them in a constructive way. Adapted CBT: Cognitive-behavioral therapies can be modified to treat existential anxiety by:

• Identifying catastrophic thoughts linked to existential questions

• Developing appropriate coping strategies

• Working on the acceptance of fundamental uncertainty

ACT (Acceptance and Commitment Therapy): Particularly relevant because it helps to:

• Accept existential questioning as normal

• Identify one's deep values

• Engage in actions aligned with these values

Self-help strategies

Immediate management techniques:

• Mindful breathing during anxiety peaks

• Existential journal to explore one's questioning

• Meditation practice to tame uncertainty

• Engagement in meaningful activities

Building meaning:

• Identifying one's fundamental values

• Engaging in causes that transcend us

• Cultivating authentic and deep relationships

• Creating or contributing to something lasting

When to consult?

It is recommended to seek professional help when:

• Existential anxiety significantly interferes with daily functioning

• The questioning becomes obsessive and invasive

• Depressive symptoms become associated with existential concerns

• Social isolation sets in through avoidance of others

• Risky behaviors appear as an attempt at escape

Conclusion and perspectives

Existential anxiety, far from being a simple passing discomfort, represents a fundamental dimension of the human experience that deserves to be understood and supported with kindness. The assessment tools we have explored — from the Existential Anxiety Scale to self-assessment questionnaires — constitute valuable resources for better understanding this complex reality. Testing and self-assessing regularly not only allows us to know ourselves better, but also to identify the moments when professional support could prove beneficial. For while this existential questioning is an integral part of our humanity, it should not paralyze or isolate us. Existential anxiety can even become, with appropriate support, a source of personal growth and renewed meaning. It invites us to an authentic exploration of what makes the richness and depth of our existence. If this article resonated with your experience, do not hesitate to continue your reflection by consulting a qualified professional.

FAQ

How does the existential anxiety test work?

Assess your existential anxiety with a validated psychological test. The test is designed to provide you with a fast and reliable assessment, based on validated clinical criteria.

Is this test reliable for diagnosing existential anxiety?

This questionnaire is based on clinical scales used in CBT and clinical psychology. It does not replace a professional diagnosis, but constitutes a valuable first indicator to guide a consultation.

What should I do if the test result indicates a high score?

A high score suggests that a consultation with a practitioner or psychologist may be beneficial. CBT offers effective protocols to work on these dimensions in 8 to 16 sessions.