Understanding Existential Distress: What It Is and Why It Matters
- David Maginley
- Aug 23, 2025
- 3 min read
Updated: Aug 30, 2025
When someone faces a serious illness, a major life transition, or the end of life, the suffering they experience is often described as physical or emotional. But what is far less discussed, and yet far more profound, is existential distress. This is the type of suffering that arises when we confront the deepest questions: “Why am I here?” “What does my life mean?” “Who am I beyond my roles, my body, my accomplishments?”
Existential distress is not about pain that can be medicated, nor is it about depression in the clinical sense. It is spiritual suffering - a reaction to the threat that life, and ultimately death, poses to our identity, to the story we tell ourselves about who we are. In my work as a psychospiritual therapist, I’ve seen it over and over: people in otherwise stable circumstances can experience profound suffering simply because their sense of meaning or purpose feels fractured.
This distress often manifests in ways we can see: anxiety, agitation, anger, withdrawal, or despair. But it is also subtle: a restless mind, sleepless nights, a gnawing sense that life has lost its cohesion or colour. What makes it particularly difficult is that it arises not from something “wrong” in the body or the world, but from the self’s encounter with the impermanence and mystery of life.
Recognizing existential distress is the first step in helping someone navigate it. It requires understanding that this suffering is not a failure, not a flaw, but a natural human response to the challenge of living fully in awareness of life’s limits. It is often triggered by illness, grief, and most acutly, one's own impending death.
And in this final farewell lies the ultimate secret: existential distress is, in a profound sense, the ego’s last stand; the personal self pushing back against its own dissolution. It is natural to resist the unknown, to cling to identity, to fear what is beyond comprehension. Yet within this struggle lies a hidden gift: the resistance itself becomes a guide, a signal that the ego is being calibrated for its final stage: transcendence. This is exhibited in nearing-death awareness, mystical and expansive states of consiousness, and a deep peace (made all the more possible when physical pain is well controlled!). As we gradually release the need to control and surrender to the flow of life and to the mystery of dying, we begin to touch upon states of grace that were always available, yet hidden behind the walls of self-attachment. In this, the very suffering we fear can become the doorway to peace, presence, and profound spiritual awakening. As Fr. Richard Rohr states, there are only two ways to spiritual growth: great love, or great suffering.
Addressing existential distress is different from addressing physical pain. It involves creating space for reflection, meaning-making, and connection - sometimes to loved ones, sometimes to the deeper reality that underpins existence. It invites us to explore questions like: What is truly important in my life? How can I find peace amid uncertainty? How can I reconcile myself with my own mortality? Spiritual Care providers are experts in this, and do so respecting your beliefs and personal story.
The profound insight here is that existential distress is not only a challenge, it is also an opportunity for transformation. When approached with compassion and guidance, it can catalyze deep reflection, spiritual growth, and a realignment with what matters most. People often emerge from this suffering with a renewed sense of purpose, connection, and peace.
For those who care for people in this space - family members, friends, healthcare providers - awareness of existential distress is essential. Listening without judgment, bearing witness to suffering, and helping someone connect to meaning can be as important as any medical intervention.
In short, existential distress reminds us that life is more than survival. It is about the quality of consciousness, the depth of meaning, and the integrity of the human spirit. And while it can feel overwhelming, it is also a doorway: a doorway into understanding ourselves, our lives, and the mystery that sustains us.
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