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Home Exclusive Mental Health Depression

Existential anxiety might be an important underlying mechanism in depressive disorder

by Eric W. Dolan
August 2, 2023
in Depression
(Photo credit: Adobe Stock)

(Photo credit: Adobe Stock)

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New research suggests that a feeling of existential anxiety (a sense of fear or uncertainty about our existence itself) acts as a “middleman” or mediator between the sense of meaning in life and how severe someone’s depression is. In other words, when people felt like their life had less meaning, it made them more anxious about the uncertainty of life’s purpose, and this anxiety, in turn, was connected to more severe symptoms of depression.

The findings have been published in the Journal of Humanistic Psychology.

Despite its significant impact on individuals’ lives, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not include difficulties in the experience of meaning as a feature of depression, despite growing research suggesting that problems with meaning play a crucial role in the condition. Previous studies have shown a negative association between the experience of meaning in life and the severity of depression, particularly in clinical and non-clinical populations of adults and the elderly.

The primary aim of the study was to replicate previous findings concerning the association between the experience of meaning in life and depression in a sample of psychotherapists and counselors from Belgium and the Netherlands. These professionals are at higher risk for mental health problems, including depression. The researchers hypothesized that the experience of meaning would be negatively associated with the severity of depression, similar to previous findings.

The researchers also aimed to explore the role of existential anxiety and the ability to attend to bodily felt experiences (referred to as “focusing manner”) in the relationship between meaning in life and depression. They expected that existential anxiety and focusing manner would mediate the association between the experience of meaning and the severity of depression. Gaining a deeper understanding of these pathways could help improve the psychotherapeutic treatment of depression.

To conduct the study, the researchers recruited participants from an online postgraduate course on Existential Well-being offered by KU Leuven. They collected data using an online questionnaire from 77 psychotherapists and counselors. The participants’ ages ranged from 23 to 73 years, with the majority being female.

The study used various measures, including the Patient Health Questionnaire (PHQ-9) to assess the severity of depression symptoms, the Meaning in Life Measure (MiLM) to evaluate the experience of meaning in life, the Existential Concerns Questionnaire (ECQ) to measure existential anxiety, and the Focusing Manner Scale (FMS) to assess the degree to which participants attended to their bodily experiences.

Contrary to previous studies, the researchers found no significant association between meaning in life and depression severity in this specific sample. Additionally, focusing manner did not mediate the association between meaning in life and the depression severity.

However, the study found that existential anxiety played a significant mediating role in the relationship between the experience of meaning and depressive symptoms. In other words, less experience of meaning in life was associated with more existential anxiety, which, in turn, was linked to more severe symptoms of depression.

Those with a high level of existential anxiety agreed with statements such as “The question whether life has meaning frightens me,” “It frightens me that at some point I will be dead,” and “I try to push away the thought that life will end.”

These findings suggest that addressing existential anxiety and specific themes in a patient’s life story associated with this anxiety might be helpful in treating depression. The study highlights the importance of attending to the existential dimension of patients’ problems in therapeutic approaches, as this could have important clinical implications for the treatment of depression. However, further research is needed to fully understand the relationship between the experience of meaning, existential anxiety, and depressive symptoms.

“The results of this study point to existential anxiety as a potential underlying emotional mechanism in the relation between difficulty in meaning experience and severity of depression. These results suggest that addressing the existential anxiety that appears to be inherent to depression might be an interesting approach in the psychotherapeutic treatment of this mental disorder. Longitudinal research is needed to further investigate the relationship between existential anxiety, difficulty in meaning experience and severity of depression, and the effectiveness of psychotherapies with a focus on the existential anxiety in the treatment of depressive disorder.”

The study, “To be Scared or Scared to be: Existential Anxiety as a Mediator between Meaning Experience and Depression“, was authored by Heidi Pellens, Jessie Dezutter, Patrick Luyten, and Siebrecht Vanhooren.

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