Existential Wellness
On a foggy morning I stood on the bluffs above Bodega Bay, on the California coast, watching waves break on the rocks below. Boats moved slowly offshore. The people around me were fiddling with their cameras. For a few seconds my to-do list went quiet, and a question arrived that I had not planned to ask: what does it mean to live a meaningful life?
I have asked it many times since. The answer keeps reshaping itself as my life changes.
What it covers
Existential wellness is your relationship with meaning, the story you believe you are living inside. It replaces the older term spiritual wellness, to be more inclusive. Faith can be part of it, and so can nature, art, or service. There is no tracker for it. It rests on four things.
Meaning
A sense of why your days matter, which can change from one season of life to the next.
Values
Living in line with what you say matters most.
Awe
Encountering something larger than yourself, in nature or in holding a newborn.
Mortality
Knowing your time is finite, and letting that shape how you spend it.
When the pager stops
For most of my years as an anesthesiologist I gave this dimension little thought. The work was meaningful, but the meaning was buried under urgency: keeping patients safe through surgery, managing crises, mentoring young physicians. In an operating room you watch vital signs, ventilators, and blood loss, and you do not pause for existential questions.
The questions came later, after losses, transitions, and mornings like the one at Bodega Bay. What gives my life coherence? What will matter when the pager stops buzzing and the job titles fade? Those questions pushed me toward integrative medicine and, eventually, toward building HealthHippieMD.
What the research measures
Researchers at the University of Michigan School of Public Health drew on the national Health and Retirement Study, in which 6,985 adults over 50 rated their sense of purpose on a seven-item scale in 2006. Over the next four years, people in the lowest purpose category had about 2.4 times the risk of death of those in the highest. Deaths from heart and circulatory conditions followed a similar pattern. The study appeared in JAMA Network Open in 2019. It was observational and cannot rule out that illness lowers a person's sense of purpose rather than the reverse.
Paul Piff, Dacher Keltner, and colleagues tested awe experimentally. In one of five studies they published in 2015, participants at UC Berkeley spent a minute looking up into a grove of towering eucalyptus trees or at a tall building. When an experimenter then dropped some pens, the people who had looked at the trees picked up more of them, and they reported feeling less entitled. In several of the studies, a sense of a smaller self partly explained why awe made people act more for others.
Listen and read
The Well-IQ assessment is free and takes about 15 minutes. It scores Existential alongside the other eight dimensions.
Educational content, not medical advice.