Existential Distress

Distress within spiritual, psychological and social domains. Usually linked with physical disease burden.

Feelings of loss of control, loss of role, hopelessness, meaningless, feeling a burden to others, depression, anxiety, loss of will to live, wish to die.  Screening scale

Strong relationship between hopelessness and suicidality, often lack family/friend and social supports.

Ensure all physical and psychological symptoms are assessed thoroughly and managed optimally

Clinicians need to provide “intensive caring”:

  • Nonabandonment, taking interest in patient as person, holding/containing hope, dignity-affirming tone of care, therapeutic humility.
  • Target achievable goals, focused on ways of affirming that patient matters.
  • Elements of caring encompass presence, compassion, and hope.

Validated methods for addressing existential distress:

Consult Palliative Care for consideration of further therapy. Psylocibin for severe death anxiety requires training in administration of psylocibin, and have trained psychotherapist.