Is Existential Distress Truly Different from Existential Anxiety?

 

In recent years, existential researchers have introduced an increasing number of concepts. Among these is "existential distress." Although this concept dates back to 2000 and has been discussed by existential psychologists, it was not until 2017 that Lo et al. began developing a scale to measure it. Existential distress is broadly used to describe various psychological disorders. More specifically, it occurs when an individual finds the meaning and value of life unclear, leading to feelings of loneliness and low self-worth.

Accordingly, the scale developed by Lo et al. (2017) consists of three subscales—feeling lonely, worthless, and finding life meaningless—which collectively measure existential distress through 10 items. This scale has been widely applied to individuals with terminal illnesses, and the concept of "existential distress" has been frequently discussed in relation to these patients. However, some studies have also used this scale to measure existential distress in the general population (Nikpour Rahmat Abadi, Rajaei, and Abdollahi Chirani, 2023).

The concept of existential distress may initially seem similar to "existential anxiety." Anxiety inherently involves "discomfort" and "distress." Similarly, existential distress evokes the term "stress," which also implies discomfort and distress. However, the key difference is that anxiety stems from an unknown internal issue, while stress arises from a clear, external cause.

The difference between stress and distress is outlined by the National Research Council of the United States (2008) as follows: "Stress responses are normal reactions to environmental or internal disturbances and can be adaptive. Distress, however, occurs when stress is severe, long-term, or involves both conditions." Thus, distress can be seen as a manifestation of severe and/or prolonged stress that is not considered a normal reaction or is an excessive response. This raises the question: what constitutes severe and/or long-term stress, and how does it develop?

As previously mentioned, stress is a natural and adaptive response to a stimulus. However, when this response is abnormal or unusual—such as experiencing stress at the sight of a cat at the end of the street, a certain type of music, or recalling a memory—psychologists identify it as an anxiety response, distinguishing it from stress. In cases of anxiety, the primary cause is unknown, and the responses are typically very intense and long-lasting, often affecting the individual throughout their life.

Therefore, the concept of "distress" may essentially be equivalent to "anxiety" and might not offer anything additional. Consequently, using the term "existential anxiety" could be considered redundant. However, upon closer examination, we see that the subscales of existential distress differ from those of existential anxiety, justifying the use of a distinct term and scale. Another important point to consider is whether the concept of existential distress and its measurement scale are truly relevant to existential philosophy and existential psychology.

Examining the concepts presented by May (1958), Tillich (1952), Frankel (1953), Yalom (1980), and existential researchers such as Pyszczynski, Greenberg, Solomon, and their colleagues, we see that the concept of meaninglessness is thoroughly discussed, while the concept of loneliness is addressed to a lesser extent. However, the concept of value or worthlessness appears to be absent from the ideas put forth by existential philosophers and psychologists. Nevertheless, one could explore the link between self-worth and existentialism within the concept of "existential isolation," which arises from having unshared beliefs and behaviors in one's society.

In fact, a sense of worth can arise from sharing and understanding shared ideas and behaviors. This means that when a person does not feel alone in their thoughts and actions—distinct from the physiological state of loneliness—they gain a sense of worth. Therefore, what is defined as the feeling of worthlessness within the concept of "existential distress" can result from existential isolation, rather than being a separate causal structure. Accordingly, the feeling of loneliness—especially as measured by the scale for existential distress—is a concept outside the traditional ideas presented in philosophy and existential psychology, and only slightly resembles the concept of "existential isolation."

Based on this, although the concept of "existential distress" has been discussed and utilized by psychologists and existential researchers, it contradicts the literature of existential philosophy and existential psychology. The similarity between "distress" and "anxiety" raises questions about the need for a change in terminology. Furthermore, the inconsistency between the original concepts of existential philosophy and psychology and those presented in the definition of existential distress and its measurement scale casts doubt on the validity of this concept. Consequently, "existential distress" does not seem to be a distinct concept from existential anxiety, nor can it be clearly defined as another manifestation of existential anxiety.