OCD subtypes
Harm OCD

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

3 min read
Keara Valentine
By Keara Valentine
All types of OCD include obsessions and compulsions. Obsessions are unwanted and intrusive thoughts, feelings, urges and doubts, while compulsions are repetitive physical or mental actions performed in an attempt to relieve distress and anxiety

Obsessive-compulsive disorder (OCD) is a common disorder in which a person experiences intrusive thoughts (obsessions) and engages in ritualistic behaviors (compulsions) to alleviate the distress caused by the intrusive thoughts.

Hit-and-run OCD is a subtype of OCD in which someone experiences obsessions centering on hitting a pedestrian or animal while driving, or feeling as if they already hit a pedestrian or animal and can’t remember the accident. Sometimes, the intrusive thoughts may happen subconsciously, and it’s not until the person is done driving that they realize they were afraid they were going to hit something the entire time. 

This can be a less common subtype of OCD, and it may fall under the umbrella of harm OCD, with specific manifestations related to driving. No matter the roots of hit-and-run OCD, it can be an extremely overwhelming disorder to live with. If you feel you may have this form of OCD, read on to learn more about its symptoms and available treatment options.

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

Do you fear driving because you worry you’ll hit a cyclist? Do you avoid more congested streets for fear of harming someone with your vehicle? Have you spent time wondering “Did I hit someone while driving?” or, “Are those sirens going by for a person I accidentally hit?” Do you often feel the need to drive back to intersections or other areas to check if you might’ve injured or killed someone with your vehicle?

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 you zoned out for a moment while driving

Once you have been triggered, a cycle of obsessions will begin that may make you feel convinced you will 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:

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  • Listening to police radio scans
  • Going back to where you had been driving to check if there’s an accident/harmed person
  • 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

Oftentimes, your compulsions will only offer temporary relief, and you will find yourself repeating the same obsessive-compulsive cycle with no end in sight. 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 the seemingly endless cycle of obsessions and compulsions.

How is hit-and-run OCD treated?

Although this manifestation of OCD may be less common, it can still be treated just as effectively as many other subtypes. The recommended treatment option for all types of OCD is a form of cognitive behavioral therapy called exposure and response prevention (ERP) therapy.

ERP works by exposing you to the things that trigger your obsessive-compulsive cycles. 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. By experiencing your intrusive thoughts with guidance from your therapist, you can practice resisting your compulsions. Your therapist will work with you to become more tolerant of the distress your obsessions cause by sitting with the uncertainty. 

Over time, you will feel more capable of enduring the uncertainty without the need to engage in your compulsions.

How can I begin treatment of hit-and-run OCD?

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, and you can get started today with a free call to our clinical team.

Once we match you with a therapist, you can start sessions quickly and from the comfort of your home. We offer teletherapy options where you can complete ERP sessions virtually over a video or phone call. Over time, you can learn how to resist your compulsions and feel more at peace while driving.

Keara Valentine

Keara E. Valentine, Psy.D., is a postdoctoral fellow at Stanford University School of Medicine in the OCD and Related Disorders Track, where she specializes in the assessment and treatment of OCD and related disorders. Dr. Valentine utilizes behavioral-based therapies including Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) with children, adolescents, and adults experiencing anxiety-related disorders.

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NOCD Therapists specialize in treating Harm OCD

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Adriana Delgado

Adriana Delgado

Licensed Therapist, LMHC

My journey as a therapist has brought me in front of more and more cases of OCD, which has led to specialization in OCD treatment. My experience working at intensive in-home services for children & families, and intensive outpatient programs, has prepared me for even the biggest challenges. During sessions, I use Exposure and Response Prevention (ERP) therapy because it’s one of the most effective treatments for OCD, and works for any OCD subtype.

Alyse Eldred

Alyse Eldred

Licensed Therapist, LMFT

I’ve been a licensed therapist since 2017, and as an OCD specialist, I only use Exposure and Response Prevention (ERP) therapy. Research shows that ERP is the most effective OCD treatment available. I truly enjoy helping people understand themselves through ERP and I’m grateful to be part of a process that helps people gain control of their lives.

Andrew Moeller

Andrew Moeller

Licensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

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