Death & Dying Archives - Sergio Integral

When life looks fine, but something deeper feels unsettled

Picture someone with what looks like a good life: a promising career, people who love them, a full calendar, and a life that checks every box from the outside. Yet they may still wake up with a quiet, unsettling question: Is this really my life? Is this as good as it gets?

That question points toward what is often called existential anxiety in psychology. It is not necessarily a sign that something is wrong with you. It is a deeply human response to becoming aware of uncertainty, freedom, death, meaning, and the burden of taking ownership. We are all called to be fully alive, but often we do not know how.

Existential anxiety can be painful, even baffling, especially in a culture that rewards productivity, certainty, and the appearance of having “made it.” But some questions are not solved by better planning, another achievement, or the newest app. They ask us to pause and consider how we are living, what we value, and whether the life we have built still feels connected to something true inside us. Are the goals we are chasing really ours? Are they still worth it?

Key takeaways

Existential anxiety often arises when we confront meaning, freedom, mortality, isolation, or the responsibility of choosing a life.
It is not pathological, but it can become painful, persistent, overwhelming, and even paralyzing.
Therapy can help by listening to these questions and helping you find, or update, your own answers.

The questions beneath the anxiety

Existential anxiety is often hard to spot. It may first appear as restlessness, dread, boredom, indecision, irritability, or a sense that life has become strangely flat. It can surface as disappointment after finally achieving something we worked hard for, or unsettle us after a divorce, illness, birthday, career change, spiritual experience, accident, or the death of someone close.

On the surface, the questions may be practical: Should I stay in this job? Leave this relationship? Move? Change my life? But underneath, deeper undercurrents are at play. What really matters to me? What am I avoiding? What part of me have I ignored? Is this how I want to live the rest of my life?

Not all anxiety is existential. It can be shaped by trauma, stress, biology, social pressure, health concerns, family history, and the nervous system doing its best to protect us in a chaotic world. An integral approach does not romanticize anxiety. It asks what is happening at all the relevant levels: body, relationship, history, culture, circumstance, meaning, and soul.

Freedom and responsibility

Although it may sound paradoxical, one source of existential anxiety is freedom. We often imagine freedom as carefree, but real freedom bears responsibility. To choose one path is to let other paths go, at least for now. To stay in a relationship, leave one, become a parent or not, change careers, or admit that a former identity no longer fits, is to feel the weight of authorship. Sartre somewhat poignantly said that we are “condemned to be free.”

Many of us wish someone could tell us the right answer: “Just tell me what to do.” But while advice can be useful and guidance necessary, no one can live our life for us. We are responsible for our choices and their consequences, which is both nerve-wracking and the source of agency. The question shifts from “How do I avoid choosing wrong?” to “How can I take charge of this life that is actually mine?”

Meaning and the feeling that something is missing

This feeling usually does not arrive as a dramatic flare. It creeps into awareness while answering emails, sitting in traffic, preparing dinner, or scrolling through other people’s carefully edited lives. The question may not be “What is the meaning of life?” in some grand philosophical sense. It may be more personal: What do I really want to do? What matters enough to my limited time and attention?

Meaning can be found in relationship, work, service, creativity, devotion, family, community, play, spirituality, and care for the world. But it is different to each of us, and it changes over time. What was significant at twenty-five may not be enough at forty-five. What once felt like healthy ambition may later feel like a burden. What felt exciting may feel uninspiring.

There is no single purpose hidden somewhere that, once found, will solve the rest of life. Meaning is discovered, created, revised, lost, and found again.

Isolation, belonging, and being known

Even in close relationships, each of us carries an inner world that cannot be fully accessed by another: memories, sensations, longings, fears, and private meanings that remain ours alone. This recognition sometimes hurts, but it also makes intimacy more precious.

To know someone, and to be known, is a never-ending enterprise. It means risking being seen in our beauty, quirkiness, and uniqueness, while accepting that the seeing will never be complete. This is not an argument against relationship. It is an invitation toward deeper, more honest forms of it.

Mortality and loss

Sometimes existential anxiety emerges after a loss, a medical scare, becoming a parent, aging, or simply noticing time passing. Suddenly we face the fact that we are vulnerable and finite, something we work hard to keep below awareness. It can bring fear, sadness, urgency, or a sharper appreciation for life. These waking-up moments are often uncomfortable, but with proper support they can become opportunities to remember who we really are and what matters to us.

Since time is limited, what conversation has been postponed? What apology, creation, repair, project, or act of love matters now? The clock is always ticking. What you waiting for?

How therapy can help

Existentially informed psychotherapy offers a space for the mundane and the profound. We may talk about work stress, grief, heartbreak, family expectations, cultural identity, spiritual questions, or fear about the future.

Being seen and understood by someone can reduce the sense of isolation and create a holding space where these questions can be explored openly. There are no ready-made answers. But together, you can find your own.

Facing existential anxiety does not mean you have failed or that you made the wrong decisions. It may mean that life is knocking at your door, asking for better or updated answers. Do not ignore the call.

Sometimes existential anxiety feels never-ending or unbearable. You do not have to go through it alone. With support, things can get better. If it turns into thoughts of harming yourself, or you feel unable to stay safe, reach out immediately: call 988, contact emergency services, or seek urgent local support. There is help.

If this sounds familiar, existentially informed therapy can help you stay with the questions long enough to discover what they are asking of you. Let’s explore together meaning, relationships, grief, freedom, mortality, and the choices that shape your life. Become who you really are.

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How therapy can help us face uncertainty, grief, and meaninglessness.

In Before IT Hits the Fan… I wrote about how, as a therapist, I hear a version of the question that gives this article its title at least once a week; depending on what is going on, often many times per day.

Things Look Disheartening

We are living through what has been called a polycrisis: multiple crises that interact with and amplify one another. But you don’t need me to tell you that. Almost every conversation, if long enough, turns to politics, money, isolation, or the environment. Let’s face it: things look disheartening.

It is easy to lose hope when everything around us reminds us how bad things are. Crises breed helplessness, numbness, panic, and fatalism. It is tempting to disconnect through mindless scrolling, or to convince ourselves we must keep watching the news to stay informed. Cynicism and despair can feel almost rational when it seems there is nothing we can do.

Yet here we are. Do I wish things were different? Absolutely. I worry about my young daughters. I feel sad thinking they may inherit a worse world than the one I grew up in. So when clients, quietly or explicitly, ask me whether humanity will make it, my honest answer is that I don’t know.

This is not the first time things have looked grim. I find it hard to imagine how our predecessors endured wars, invasions, and upheavals throughout the ages. As a Mexican, I have tried to grasp how Native Americans must have felt when settlers and conquistadores shattered their cultures, or how European Jews must have felt during the Second World War. This is no consolation, but things have been worse¹.

The Question Beneath the Question

And still, it is hard to make existential sense of any of it. When a client looks me square in the eye and asks, “What is the point?” I understand why Camus thought life was absurd. Is there a plan? Is this some god’s test? Karma? An illusion? Does humanity deserve it? Are we doomed to follow the dinosaurs as just another curiosity in the history of this planet? Again, I don’t know.

Fortunately, as a therapist, my job is not to reassure clients or provide neat answers, but to witness and accompany them on their life path. Therapy does not solve the polycrisis, but I deeply believe it serves a purpose. This is not me justifying my profession, but trying to understand how I, and all of us in the helping professions, can help from our trench.

How can therapy help?

How can meeting privately with another person possibly help? For one, nobody should suffer alone. Crises heighten isolation and powerlessness. We may ask: Am I the only one seeing this? What can one person possibly do? It is easier to fall prey to doomsday news and despair in isolation.

Therapy offers a place to grieve together. A place to regain dignity, lucidity, and perspective; to figure out what matters and how to proceed. It offers a potential space to stay present in the face of doubt and to wonder what life is asking of us now. It also offers the possibility of reclaiming agency and deciding how to act, how to relate, and what not to become. Despair deepens when we become spectators instead of agents.

A Different Kind of Hope

It is also a place to rekindle hope. Not the naïve hope that everything will be okay. History provides no guarantees. Mature hope is a choice (Macy). The decision to keep going without surrendering is already a victory. As Václav Havel suggested, hope is not the conviction that things will turn out well; it is the conviction that something makes sense, regardless of how it turns out.

Not Becoming Cynical

When, in therapy, we face anxiety, adversity, despair, and meaninglessness together, we claim the “courage to be” (Tillich). In the presence of another person, the client confronts fear and desolation. This can revitalize us and keep us from becoming insensitive. We may not be able to save the world, but we can prevent our souls from becoming cynical, cruel, or inert.

Furthermore, as Jung suggested, evil flourishes when humans repress their shadow. The unconscious person is easy prey to fear, hatred, and mass ideology. In therapy, we stay present instead of avoiding reality; we metabolize grief, rage, and fear. Only then can we move from protection or paralysis into action.

It is in relationship that we remember we hurt because we belong. With that clarity, we can decide how to proceed, how we choose to show up in times of crisis, and how to uphold our values and the dignity of life.

When therapist and client courageously affirm life in the face of suffering and uncertainty, we connect with a deeper dimension of identity within us that is more spacious than fear. We remember that we are more than a frightened, skin-encapsulated ego.

Facing Uncertainty Together

So, are we gonna make it? I still don’t know. I hope we will. In the meantime, let’s walk together, meet our pain, find meaning amid the meaningless, and trust, not in a Pollyannaish way, but, as Tolkien suggested, with the clarity that we have the opportunity, and perhaps the obligation, to decide who we choose to be in the time given us.

Facing uncertainty with support

If you are moving through some version of this yourself, you are welcome to reach out. Therapy can help you stay grounded and make meaning. We don’t have to face it alone.

Book a Free 15-Min Call or Contact Sergio

Related reading: Why the Relationship Heals

We must remember that how we experience crises is relative to our level of privilege. Even if we are all going through this polycrisis, there are significant differences between how each group is being affected by it. Those differences matter. ↩︎

Things don’t look good. It’s getting harder to be an optimist. It doesn’t matter if you are liberal, conservative, man, woman, old, young, even wealthy or poor — there is a sense that we’re moving through dark times. Worse, it seems to be hitting us from every direction: health, safety, economy, relationships, ecology…

Of course, not everyone agrees. Pinker (Our Better Angels and Enlightenment Now), Rosling (Factfulness), and Norberg (Progress) argue that — contrary to what our brains (and the media) want us to believe — we are living in the safest, healthiest, most educated, and most prosperous times in human history. Then again, plenty argue the opposite. Graeber & Wengrow (The Dawn of Everything), Hickel (The Divide), and Mann & Wainwright (Climate Leviathan) claim that inequality, ecological collapse, autocratization, war, and mental health crises put humanity at risk.

I am not a global trends analyst but a psychotherapist. In my sessions, I don’t deal with the reality of the world, but with my clients’ perceptions of it. This makes my work both easier and harder. Easier, since we don’t need to figure out what is “real” (although at times reality-testing is useful). Harder, since facts don’t matter as much as how clients feel about them. (Nietzsche wrote, “There are no facts, only interpretations.”) In any case, I keep hearing concerns about the state of the world. It’s been a while since a client said, “I have a good feeling about where things are going,” quite the opposite, anxiety and depression have surged worldwide—up about 25–30% since 2020—with U.S. rates of depression rising over 60% in the past decade, reaching historic highs.¹

How can we face this reality? Faced with distress, our brain seems to have a limited number of preprogrammed responses: fight, flight, freeze, or appease. Depending on circumstances, we select the most viable. We can despair, give up, curl into a little ball and wait for impact, pray for divine intervention, etc. With my clients, we’ve explored many of these alternatives. None of them (with the exception, perhaps, of some forms of prayer) feels truly satisfying.

Fortunately, there are other options. Some existentialists, who also faced extreme circumstances (WWII, Nazi occupation, concentration camps), urge us to accept the absurdity of existence (not an easy thing to do) and remember that even in the worst situations (e.g., Frankl in Auschwitz), we still have the possibility — even the responsibility — to choose how to respond. We have agency. Our actions matter. We get to choose; we must choose. Regardless of the outcome, it is we who define the meaning of our lives. Some take it even further. Leaders such as Gandhi, MLK, or Thích Nhất Hạnh urge us not only to avoid running from suffering but also to face violence without succumbing to it, to transform hatred through love, and to act decisively with compassion.

There is yet another possible (and perhaps puzzling) approach. As a transpersonal psychotherapist and psychedelic facilitator, I am familiar with the teachings of sacred plants and mystics throughout the ages. Paralleling Buddhism and Hinduism, plant medicine consistently reminds us that life is illusory, a cosmic game or līlā. Many times, I’ve witnessed clients cracking up (what I like to call the Cosmic Laughter) when they realize how silly and pointless our toils are — echoing Julian of Norwich saying, “All shall be well” amid Europe’s plague, or Ramakrishna’s supposed answer to why suffering exists: “to thicken the plot.”

How are you facing our current situation? How is the barrage of negative news affecting you? What resources do you have to move forward? Please remember: if you are struggling, if you feel despair (perhaps the healthiest reaction to our profoundly sick society), reach out. You are not alone. We are not made for suffering in isolation. There is help.

Since my clients are not mystics (yet), and many would not even consider themselves activists, my job is not to philosophize or tell them what to do. I am there (and here) to explore alternatives, to empower them (and you) to make their own decisions. How to face suffering, and what to do about it, is a deeply personal choice. Yet, perhaps influenced by those same mystics and plant-teachers, I — most of the time — remain optimistic. Mostly because every day I witness in my practice the strength, beauty, and dignity of our shared human struggles.

Perhaps, until each of us finds our own answers, the best we can do — as Vonnegut suggests — is to remember that “we are all here to help each other get through this thing, whatever it is.”

Sources: https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2025/20250416.htm?utm_source=chatgpt.com
https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide?utm_source=chatgpt.com ↩︎