Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Hit-and-Run OCD: Overview, Symptoms and Treatment Options

By Dr. Keara Valentine

Mar 21, 20245 minute read

Reviewed byApril Kilduff, MA, LCPC

hit and run ocd

Obsessive-compulsive disorder (OCD) is a common condition where you experience intrusive thoughts, images, urges, or feelings (called obsessions), and engage in ritualistic physical or mental behaviors (compulsions) to try to alleviate the distress caused by your intrusive thoughts.

Hit-and-run OCD is a subtype of OCD that centers around obsessions about hitting a pedestrian or animal while driving, or feeling like you have already something or someone and can’t remember the accident. It can fall under the umbrella of harm OCD. Sometimes the intrusive thoughts may happen subconsciously, and it’s not until you’re done driving that you realize that you were afraid that you were going to have an accident the entire time. 

As a licensed therapist, I can tell you that any type of OCD can be extremely overwhelming to live with. But if you feel like you may have hit-and-run OCD, read on to learn more about its symptoms and available treatment options.

What are the symptoms of hit-and-run OCD?

Are you scared to drive because you worry you’ll hit a cyclist? Do you avoid congested streets for fear of harming someone with your vehicle? Have you spent a lot of time wondering “Did I hit someone while driving?” or, “Are those sirens about a person that I accidentally hit?” Or perhaps you feel the need to drive back to intersections or other areas to check and make sure that you didn’t injure or kill someone with your car?

These are just some of the symptoms you may experience with hit-and-run OCD. 

Your intrusive thoughts may be prompted simply by driving at all, or they may be brought on by certain situations, such as:

  • Looking down at your radio for a moment
  • Running over litter in the road
  • Hitting a pothole
  • Hearing sirens or brake screeches nearby 
  • Driving on a busy road or past a cyclist or jogger
  • Noticing that you zoned out for a moment while driving

Once you’ve been triggered, a cycle of obsessions will begin that may make you feel convinced you’ll actually hit someone, or an animal, or that you already have and can’t remember it. The uncertainty may lead you to engage in compulsions to seek out a sense of clarity or to simply comfort yourself. 

Compulsions associated with hit-and-run OCD may include:

  • Listening to police radio scans
  • Going back to where you had been driving to check if you caused an accident or whether someone is hurt
  • Avoiding driving at night or in crowded areas
  • Avoiding driving altogether
  • Asking nearby people if they saw someone get hit
  • Looking for accident reports in news media
  • Driving extra slowly

Often, your compulsions only offer temporary relief, and you’ll find yourself repeating the same obsessive-compulsive cycle again and again. This can be extremely frustrating and may feel as if you’ll never be able to drive peacefully again. Luckily, with treatment, you can gain control over your symptoms and find freedom from this seemingly endless cycle of obsessions and compulsions.

How is hit-and-run OCD treated?

This manifestation of OCD is not as common as some other subtypes, but it can still be treated just as effectively. The gold-standard treatment option for all types of OCD is a form of behavioral therapy called exposure and response prevention (ERP). Unlike traditional talk therapy, which can backfire and make OCD worse, ERP—which was developed specifically to treat OCD—is clinically proven to be highly effective in the majority of people.

Here’s how it works: A trained therapist who specializes in OCD will take the time to understand your symptoms and create a custom ERP therapy plan for you. Then, you’ll work together to rank your fears or triggers based on how stressful they seem. To begin with, your therapist will typically have you face a fear that brings on only a mild amount of distress. Your therapist may have you practice driving in situations you tend to avoid, or write exposure “scripts” exploring the uncertainty you’ve felt in previous driving situations. 

The fear thoughts will likely come up, but instead of responding with a compulsion, you’ll learn to tolerate the discomfort. By making this conscious choice and seeing that nothing bad happens, or realizing that you handled the discomfort better than you thought you could, your brain gets the message that there was nothing to fear in the first place.

As your therapy progresses, you’ll tackle triggers that elicit a bit more distress, to conquer bigger fears. With an ERP therapist guiding you, you’ll practice confronting your fears in your everyday life, too, instead of just the controlled setting of therapy. 

The result is that you won’t be riddled with distress from intrusive thoughts, images, or urges. Your need to engage in compulsions goes away. You get to live a life that’s free from the grip of OCD.

Working with an OCD specialist to address the thoughts and situations that cause you distress is more accessible than ever thanks to virtual ERP therapy. In fact, peer reviewed research shows live teletherapy sessions of ERP can be more effective, delivering results in less time than traditional outpatient ERP therapy, often in as little as 12 weeks. 

Finding the right therapist for you has been made easier than ever thanks to NOCD’s virtual treatment options. Available nationwide, our therapists specialize in the treatment of OCD using ERP therapy. As an OCD specialist, I’ve used ERP to help many people regain their lives from OCD. I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment.

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