Existential Crisis among University Students in Bangladesh

Bio-psycho-social factors can cause various psychological problems which are existential in nature. For instances, psychological problems derived from death of a friend or family member, suicidal ideation, and relationship difficulties are considered as existential crisis. These existential crises exacerbates when a student enters university life, she/he faces different challenges such as adaptation to university life, lack of effective study skills, exam anxiety, adverse life events, relationship problem with family and peers, and couple relationship problems. Therefore, existential crises need to address for betterment of their academic performance. This paper discusses previous studies on existential crisis among university students in relation to 1) academic performance, 2) suicidal behaviour among university students, 3) existential crisis among students during the Covid-19 pandemic, and 4) existential therapy for university students. In conclusion, we propose that existential crisis should be exclusively addressed in education settings for improving academic performance of the students as well as their mental health.


Introduction
Bio-psycho-social factors cause different kinds of psychological problems. Day-by-day, students are facing more psychological problems in comparison to earlier generations (Eisenberg et al., 2013). Students experience psychological problems that affect their academic performance. For example, depression affects academic performance (American College Health Association, 2015). University students' self-rating depression scores directly correlate with suicidal ideation (He & Yang, 2015;Y.-H. Wang et al., 2017). Again, there is a clear association between lower GPA and subsequent suicide attempt (Wallin et al., 2018). Many research findings indicate that students have non suicidal self-injury. Non suicidal self-

Philosophical Foundations
Not all psychological problems are existential crises. Existential crises have certain characteristics that make it distinguished. Hence, at first, we explain existentialism briefly; then how existential crisis can be related and differentiated from psychological problems will be illustrated in the following sections. The existential philosophy is some set of ideas that "challenge our very assumptions about how things are" (Cooper, 2017) though it has diverse thoughts including much confusion and misinterpretation. For example, many people considered existentialism as meaninglessness, nihilism, death, angst, and atheism (Cooper, 2017). Now-a-days, existential philosophy term is used in broad sense where it is considered that existential issues are important in human life as it is crucial in establishing meaning, freedom, and authenticity in life (Cooper, 2017). Jean-Paul Sartre and Martin Heidegger believed that existence comes first and then essence (van Deurzen & Adams, 2016). The existence of human is the first principle of existential philosophy. Søren Kierkegaard is called 'the father of existential thinking' ( van Deurzen & Adams, 2016) who believed human's struggle as the core of existence where human beings face the challenges ( van Deurzen, 2010). He emphasized on subjective experience rather than objective truth. Friedrich Nietzsche also focused on subjective experience where human beings re-evaluate right and wrong by asking questions persistently to acquire the sense of autonomous human being ( van Deurzen & Adams, 2016). Edmund Husserl opined that objective science could not depict subjectivity and acts of consciousness. He founded phenomenology, a new science of psychology, to describe and understand the process of consciousness, subjectivity, and intentionality ( van Deurzen, 2010; van Deurzen & Adams, 2016). Existential philosophy focuses on human subjectivity and individuality where human beings can understand their experience of life through a meaningful way (MacMillan & Yue, 2017). This understanding of meaning and experience of life is not confined in long-term future perspectives. It includes both macro and micro view of life where macro view means life's long-term picture and micro view refers to daily view of life (Belliotti, 2001). Understanding and exploration of macro and micro view of life is a continual process (as cited in MacMillan & Yue, 2017). Existential angst and despair are very common in this continual process of understanding and exploration of macro and micro view of life. The university students experience angst and despair due to transition period from adolescent to adulthood and different adverse challenges.
Relationship between psychological problems and existential crisis It will be wise to clarify the relationship and differentiation between psychological problems and existential crisis. Firstly, this section will discuss what is existential crisis and psychological problems. Then, it will explain how existential crisis can relate with psychological problems. Finally, how existential crisis can be differentiated from psychological problems will be discussed. The definition of existential crisis in literature is not conveyed the same meanings. For this article "existential crisis can be defined as a confrontation and an experienced relationship of the existential realities, therefore, a crisis becomes an existential crisis" (Butėnaitė et al., 2016, p. 24). In other hand, psychological problems, mental illness, mental disorder, or psychological disorder are synonymous in the field of psychology. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is one of the diagnostic tools to diagnose mental disorders. According to DSM-5, a mental disorder is defined "as a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning" (American Psychiatric Association, 2013, p. 20).

Relationship between existential crisis and psychological problems
Psychological disorders hamper functioning of major domain of life. For example, it affects individual's cognition, emotion regulation, or behaviour (combination of two or more). Existential crisis also hampers major functioning of life. Yalom (1980) explained that existential realities caused psychological problems. The relationship between existential crisis and psychological problems can be stronger when individual confronts and experiences existential realities. If we discuss the association between depression, anxiety, and existential anxiety; it will be clearer to understand the relationship between existential crisis and psychological problems. Based on the cognitive models, depression and anxiety originate from negative ways of thinking (Beck, 1976;Ellis, 1962). Existential anxiety is also derived from same way as depression and anxiety originate. It can stem from maladaptive thinking about the future, world, and the self (Beck, 1976). The world concern is related to meaninglessness and emptiness where concern of future and self are related to death/fate and guilt/condemnation respectively. Here, death and fate, guilt and condemnation, meaninglessness and emptiness are domains of existential anxiety (Tillich, 1952). Therefore, it can be stated that existential crisis and psychological problems are interrelated with distinctive characteristics that differentiate one from another. Now the question is how we can differentiate existential crisis from psychological disorders. The answer will be found within the definition of existential crisis. Existential crisis is defined as a confrontation and an experienced relationship of the existential realities (Butėnaitė et al., 2016). When psychological problems will be linked with existential realties, it will become existential crisis. For instance, we can take anxiety to illustrate the difference between existential crisis and psychological problems. Anxiety is a psychological problem. American Psychological Association defines anxiety as an emotion characterized by worried thoughts, feelings of tension, and physical changes (American Psychological Association, 2021). Any individual can experience anxiety in their lifetime or daily life. If individual experiences this anxiety that is confronted with existential realties, it will become existential crisis. Existential anxiety can include anxiety about ultimate meaning of life, death, freedom, responsibility, and other existential related concerns.

Problem Statement
According to fifth stage of Erikson's (1950) theory of psychosocial development, individuals search for their identity. In this process they want to be an independent from their parents and elders (Maxwell & Gayle, 2013). When they separate themselves from their parents and elders, they develop a sense of isolation. This sense of isolation continues, and sixth stage of Erikson's (1950) theory appears in their life. Isolation is one of the fundamental aspects of existential angst (Maxwell & Gayle, 2013) and isolation of sixth stage of psychosocial development theory of Erikson's (1950) plays an important role in developing existential crisis. Existential crisis also emerges with the transition from adolescence to adulthood. When a student enters university life, she/he faces different challenges such as adaptation to university life, lack of effective study skills, exam anxiety, adverse life events, relationship problem with family and peers, and couple relationship problems (Dogan, 2018). These adverse challenges make them more prone to existential crisis. Therefore, it is essential to unpack the specific existential crises facing by university students as well as the coping mechanisms against these existential crises. How these crises affect academic performance of university students also needs to reveal.

Domains of Existential Crisis
Eminent existential philosophers and existential psychologists established distinct theories and concept to explain existentialism. Among them, Tillich (1952) theory of existential anxiety and Yalom (1980) concept of ultimate concerns can be used to address discussed problems of this article. Tillich's work on existential anxiety is expressed ( van Deurzen, 2010, p. 99) in his book titled by 'The Courage to be' 1952. Existential anxiety is the anxiety of the death and utmost meaning of life. Existential anxiety can be conceptualized by the three domains of existential anxiety where each domain is explained by following ultimate and relative concerns. The first domain of existential anxiety is termed as fate and death. Here, absolute concern for human being is fear of death where anxiety about fate is a relative concern for human being. The second domain of existential anxiety is termed as emptiness and meaninglessness. Here, anxiety about meaninglessness is the absolute concern for human being that life of human being is without purpose and value. Anxiety about emptiness is the relative concern for human being. Anxiety of emptiness is related to loss of meaning in a specific belief. For Tillich (1952) the anxiety of emptiness and meaninglessness is like that human being must experience the likelihood of meaninglessness of their life, where experiencing of emptiness of their life that endangers their spiritual self-affirmation. The third and final domain of existential anxiety is termed as guilt and condemnation. Here, anxiety about guilt is considered as relative concern where anxiety about condemnation is considered as the absolute concern. The third domain of existential anxiety is derived from a threat to moral self-affirmation (Tillich, 1952). Yalom (1980) identified four basic threats and challenges of human life. He called them ultimate concerns of human life. They are death anxiety, freedom, existential isolation, and meaninglessness. The ultimate concerns are essential to human existence and every individual encounters these ultimate concerns (Yalom, 1980). Yalom (1980) views death as an early source of anxiety and it is the core origin of psychopathology. There is an existential conflict exist that is people know that death is unavoidable, but they desire to continue their life. Generally, freedom is a positive concept. In existential sense, freedom is the lack of peripheral structure. According to Yalom (1980), "freedom in this sense, has a terrifying implication: it means that beneath us there is no ground-nothing, a void, an abyss" (p. 9). "Existential isolation refers to an unbridgeable gulf between oneself and any other being. It refers, too, to an isolation even more fundamental-a separation between the individual and the world" (Yalom, 1980, p. 355). Meaninglessness is the fourth ultimate concern of existence which is derived from the dilemma where human being is seeking meaning of their life, but their universe has no meaning. This dilemma has two propositions. First proposition is that it seems that human being needs meaning to live. Without meaning and purpose in life seems to elicit substantial suffering. Second proposition is that human being creates their own world, and own life design in this universe. For Yalom (1980) there is no meaning or principles for living in this universe except the principles formulated by individuals. This section demands to illuminate related studies that is allied to existential crisis among students. There are five major aspects are derived from combing Tillich (1952) theory of existential anxiety and Yalom (1980) concept of ultimate concerns. This section describes the five merging aspects based on the recent studies that studied existential crisis among students.

Death Anxiety
Death anxiety is an important aspect for both Tillich (1952) theory of existential anxiety and Yalom (1980) concept of ultimate concerns. Besharat et al (2020) found a direct and significant correlation between death anxiety and symptoms of depression and anxiety. Death anxiety is not a concern for only general students but also a concern for medical and nursing students. Students experienced death anxiety in medical emergency (Sadeghi et al., 2018) as well as nursing students also suffered from death anxiety (Çetintaş et al., 2021). Nurses who were experienced death anxiety could face stress, anxiety, helplessness, depression, and extreme tiredness that affected their job responsibilities (Ferguson & Cosby, 2017). For example, death anxiety affected nursing students to provide efficient and complete care to their patients. Students also reported that death of a friend or family member affected their academic performance (American College Health Association, 2015).

Meaninglessness and Emptiness
Meaninglessness and emptiness are important aspects of existential crisis. Besharat et al (2020) found an inverse relationship between meaningfulness of life and perceived stress. Meaninglessness was one of the prevalent themes for being burnout among the medical students (Song, 2020a). Meaninglessness was also a sub-dimension of estrangement from school, and it was significantly positively associated with the tendency to violence in school (Cimen, 2022). Besides, existential meaningless predicted depressive symptoms and suicidal ideation (Li et al., 2022). Suicidal behavior is associated with poor academic performance (Sörberg Wallin et al., 2018) and depression is directly linked with suicidal behavior (Wang et al., 2017). Emptiness was considered as a risk factor for involvement in addictive behaviors (Casale et al., 2022). Addiction such as substance addiction makes students more prone to existential crisis (Butėnaitė et al., 2016). Casale et al (2022) found that emptiness was related with internet gaming disorder. Emptiness not only involved individuals with gaming disorder but also it could diminish family support (Zarzycka et al., 2022). Weakening family support offers university students to be isolated from their families. Thus, they experienced existential crisis.

Guilt and self-condemnation
Guilt and self-condemnation are present in some mental illnesses such as depression, suicidal behavior, and post traumatic disorder (American Psychiatric Association, 2013). Guilt can be existential in rooted. For example, social work students experienced existential guilt (Weerman & Abma, 2019). Students of generation Z (individual born between 1995 to 2010) experienced existential guilt firmer in comparison to non-generation Z (Conlin & Bauer, 2022).

Isolation
Isolation is one of the key aspects of Yalom (1980) concept of ultimate concerns as well as it plays an important in students' life when they enter in sixth stage of psychosocial development theory of Erikson's (1950) in developing existential crisis. Helm et al (2018) conducted a study using a large undergraduate survey to explain the sex differences in existential isolation research. They found that men experienced higher existential isolation in comparison to female students because male did not ratify social values as like as female did. The sex difference finding of research was supported for students' population by finding of study conducted by (Zhu et al., 2022). Zhu et al (2022) also found that students from rural areas with a poor economic status also experienced higher level of existential isolation. Helm et al (2019) conducted three studies to examine how existential isolation related to death-thought accessibility. First and second study supported their hypothesis that existential isolation was associated with greater death-thought accessibility where third study was failed to support the hypothesis. Existential isolation could predict suicidal ideation directly and indirectly through creating a meaninglessness in life (Zhu et al., 2022). Helm et al (2020) found that existential isolation was positively related with insecure attachments where existential isolation with loneliness was firmly associated with anxious attachment among young adults. Research findings indicated that nonnormative group of people (e.g., minority, stigmatized, or underrepresented people) had higher trail levels of existential isolation in comparison to normative group of people (Pinel et al., 2022). Students from these nonnormative groups are more vulnerable to existential crisis. Hence, we cannot ignore existential isolation in terms of student population.

Freedom
Freedom is an important aspect in educational systems. It describes the teacher-student relationship in different educational regimes (Brady, 2019) as well as students' choices in their every stage of academic life. For example, student needs to choose their career, to craft their identity and values, and to select courses. Students face challenges such as selection of crucial courses, careers, and overall life path (Reynolds, 2021). Here, freedom entails positive aspect to select their choices. Individuals are responsible for their inner and outside world (Mazaheri & Alizamani, 2017). Reynolds (2021) suggested that students are inspired to make genuine choices in their every stage of academic life through establishing a relationship between freedom and responsibility.

Existential Crisis Among University Students
University students are experiencing different existential crisis like existential anxiety, death anxiety, and perceived stress that may affect their academic performance. Existential concerns are also common in career anxiety (Pisarik et al., 2017). Existential crisis does not only decline academic performance but also it helps to make them burnout. Song (2020b) conducted a study with medical students to explore the cause of burnout among medical students. Existential isolation, freedom (groundlessness), and meaninglessness rather than witnessing patients' death and suffering were the main themes for the burnout of medical students. Besharat et al (2020) conducted a study with university students and found that perceived stress deteriorated the responsibility and meaningfulness in life significantly. They recommended to give priority to the management of perceived stress to reduce anxiety disorders. Perceived stress also generated symptoms of anxiety to deal with ultimate concerns (e.g., death, freedom, loneliness, and meaningfulness). Existential crisis like existential anxiety is very common in people who experience death anxiety. Evram & Eş (2020) performed a study with university students to examine a theoretical model related to existential anxiety. They formulated a hypothesis that death anxiety, life satisfaction, meaning of life, and depression might be associated to existential anxiety. The results of the study showed that existential anxiety forecasted death anxiety. Perceived stress is also generated death anxiety among university students (Besharat et al., 2020). Hence, existential anxiety and perceived stress are closely interconnected regarding ultimate concerns.

Existential Crisis and Academic Performance
Existential facets (e.g., meaningfulness and crisis of meaning) of health is getting interest in academic settings (as cited in Vötter, 2020). The state of crisis of meaning is unbearable and it is different from depression. Crisis of meaning is an influential risk factor of committing suicide (Schnell et al., 2018) where suicidal behaviour like suicidal attempt has a negative impact on academic performance (Wallin et al., 2018). On the other hand, depression is positively correlated with suicidal ideation among university students (He & Yang, 2015;Wang et al., 2017). Depression can be developed because of unsettled existential crisis (Commons et al., 2019). The root cause or the path of poor academic performance is not explored yet.
For example, existential crisis (i.e., crisis of meaning) is a risk factor for suicidal behaviour and unsettled existential crisis can cause depression. Suicidal behaviour affects academic performance of the students where severity level of depression increases the tendency of suicidal behaviour. It means depression has also an impact on poor academic performance. Vötter (2020) conducted a study with two gifted groups named 'academically high-achieving adults' and 'intellectually gifted adults' to explore their crisis of meaning and subjective wellbeing. Intellectually gifted adult refers to an individual whose intelligent quotient (IQ) score is equal or higher than 130 where academically high-achieving adult refers to individual who has exceptional performance such as academic achievement (Pollet & Schnell, 2017). Results indicated that intellectually gifted adults experienced higher crisis of meaning than the academically high-achieving adults. Intellectually gifted adults had lower self-control in comparison to academically high-achieving adults. Intellectually gifted adults demonstrated lower meaningfulness and subjective well-being than academically high-achieving adult (Pollet & Schnell, 2017). From the earlier paragraph it is found that students who experience(d) existential crisis, their academic performance is poor. From the findings of Vötter (2020); Pollet & Schnell (2017) it maybe stated that students who have higher IQ level can also experience existential crisis. Spiritual well-being is one of the aspects of existentialism. Tillich (1952) points out that existential anxiety includes spiritual concerns in which individuals have the fear that they do not have a morality to live. Existential anxiety is considered as existential crisis. Hence, improvement of spiritual well-being means the overcoming or reducing the existential crisis. Pong (2017) conducted a study with university students in Hong Kong to explore the relationship between spiritual well-being and academic performance. Result indicated that a moderately positive relationship existed between academic performance and spiritual wellbeing of the university students. Based on this discussion, it can be stated that existential crisis can play an important role in poor academic performance that needs to address.

Suicidal Behaviour among University Students
This section focuses on the suicidal behaviour related data for Bangladesh context. There is paucity in suicidal behaviour related data especially in educational institutions. There may be research conducted to explore suicidal behavioural aspects among students, but very few researchers published their work in indexed journal. Considering this limitation, this section uses data from different sources such as daily newspaper, website of different organizations, and peer reviewed online journals. Suicidal behaviour such as suicidal ideation is very prominent among university students in Bangladesh. Rasheduzzaman et al (2022) conducted a cross sectional study with university students in Bangladesh. They found that female had higher tendency to commit suicidal behaviour in comparison to male students. The prevalence of suicidal behaviour includes suicidal ideation (13.4%), lifetime suicide plans (6%), and suicide attempts (4.4%). In another study, it was found that the prevalence of suicidal ideation among university students was 14.5% where the prevalence for male students was 12.4% and female students was 17.3% (Bala et al., 2020). This study also supported the data of earlier mentioned study that female students have higher suicidal behaviour than male students. In another case, researchers found very high prevalence of suicide ideation among university students that was 61.1% (Mamun et al., 2020). Aachol Foundation conducted a survey to explore suicidal death among students in Bangladesh (The Financial Express, 2022). Newspapers and online portals were the source of data for their study. They found that 101 university students committed suicide where 62 students were from public universities. It was also found that percentage of committing suicide among male students was 64.36% where 35.64% female students committed suicide. According to the above-mentioned prevalence, it can be stated that both female and male university students are vulnerable for committing suicidal behaviour.
Students' crisis during the covid-19 pandemic COVID-19 aggravated the risk of experiencing existential crisis (Tomaszek & Muchacka-Cymerman, 2020). People including students also exhibit existential crisis such as meaning of life, death anxiety, and other mental health disorders that are rooted in existential crisis. For example, Tomaszek et al (2020) found that existential anxiety was a mediation factor for developing posttraumatic growth (PTG) as an effect of posttraumatic stress disorder (PTSD) symptoms. Wang et al (2020) conducted a cross-sectional survey study to investigate mental health of college students during the COVID-19 pandemic. They found that 18.04% (n=366) students reported suicidal thoughts where 71.26% students (n=1443) informed that their level of stress or anxiety had intensified because of COVID-19 pandemic. COVID-19 pandemic has also an impact on ultimate concerns. For example, during the COVID-19 pandemic people had worries of being exposed to the virus. People experienced existential isolation during the pandemic (Gultom et al., 2022). Anxiety of death, worries of being isolation, and meaninglessness were present among majority of the college students during the COVID-19 pandemic situation (Gupta, 2020) where higher severity of level depression decreased meaning of life among students (Parra, 2020). Özgüç et al (2021) conducted a systematic review and meta-analysis and found that death anxiety was comparatively high during the COVID-19 pandemic. With elevation of anxiety, death anxiety was also acted as a contributory role for many mental illnesses (Menzies & Menzies, 2020). Cho et al (2021) conducted a quasi-experimental design and found that logoautobiography for college students (LAC) reduced severity level of depression and stress and increased meaning of life. LAC is psychological intervention based on existentialism. Existential based psychotherapy improved mental health conditions among students as well as general population. Therefore, the present study demands an exploration of the existential crises facing by the university students in Bangladesh.
Existential therapy for university students According to American College Health Association (2015) depression, anxiety, and stress are essential psychological problems that reduce academic performance of the students. Fereydouni & Forstmeier (2022) performed a study with university students in Iran to examine the effectiveness of spiritually sensitive logotherapy on anxiety, depression, and stress. They found that spiritually sensitive logotherapy reduced severity level of anxiety, depression, and stress significantly. In another case it was found that medical students experience immense psychosocial and existential stress during their training. Their academic performance is affected due to deterioration in their cognitive function (Saoji et al., 2017). Saoji et al (2017) conducted a randomized crossover trial where they applied a yogic meditation technique named 'mind sound resonance technique (MSRT)' to improve cognitive functionality of medical students. They found that MSRT had a positive impact on cognitive functionality of medical students. Yoga practice has a relationship with several aspects of spirituality (Csala et al., 2021). In the systematic literature review Csala et al (2021) explored several aspects of yoga practices such as consolidative worldview, quest for wisdom, meaning, and harmony, faith, and hope. Improvement of students' spiritual well-being means the improvement of their academic performance (Pong, 2017). Based on these studies, it may state that academic performance of university students maybe improved with the improvement of existential aspects like search for meaning and peace, faith, and hope.

Conclusion
Existential anxiety is associated with identity development and considered as a common concern that is experienced by adolescents (Berman et al., 2006). Individual develops identity distress or crisis if she/he is failed to acquire a coherent and integrated sense of identity. When university students start their university life, some of them maybe live without their parents. Students want to be in independent and self-reliance individual, that process of growth makes them separate from their previous established boundaries. This separation and growth process is existential isolation. University students think about their responsibility and freedom in their university life. They also think about the death, determination of meaning and meaninglessness in their life. Therefore, university students' life transition from adolescent to adulthood and evolving existential crisis need to address for improving their mental health, thereby, their academic performance. There is no single psychological problem that affect academic performance. Different psychological problems affect academic performance, and a complex association exists between these psychological problems. Existential crisis plays a crucial role to decline academic performance. The students who have higher level of IQ also experience crisis. Hence, we cannot ignore existential crisis in academic settings. We suggest conducting research to explore existential crises that university students are experiencing and how these existential crises are affecting their academic performance. This exploration will provide a concrete background to the mental health professionals in addressing specific existential crisis in academic settings. For instance, determination of future goal (i.e., career choice) is one of the prime concerns for university students. If they are in a loop of existential crisis (e.g., purpose of life or future), they cannot choose their career as a future goal. In addition, researchers and practitioner psychologists like student counsellors can be benefitted by the research findings. For instance, psychologists can address the existential crises in their interventions for university students to improve their academic performance as well mental health. They can incorporate the findings such as themes of existential crisis into workshops, seminars, or psychoeducational programs for university students especially for newly arrived students to enhance their adjustment to new environment. The present paper has contributed to literature by introducing complex existential approaches with academic achievement and psychosocial development theory. For example, psychological problems are a very generic term to describe the mental health status of university students. This study juxtaposed existential crises from other psychological problems. University students encompass a life transition that starts from their entrance to university where existential crisis plays an important role. Hence, exploration of existential crises facing by university students provides a significant contribution to the literature. Explained theories under domains of existential crisis section can be used to develop a theoretical framework of the study regarding existential crisis and academic performance has also provided an insight to the researchers and it has added an extra value to the body of knowledge.