Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Fear of Hit and Run

By Justin Trout, LPC, QMHP

Aug 30, 20226 minute read

Reviewed byTaylor Newendorp

What is Hit and Run OCD?

Hit and Run OCD is characterized by unwanted thoughts or doubts about hitting a person or animal with your car and not remembering. It can also involve obsessive fears about causing an accident but not being fully aware of it. Driving and hitting speed bumps, potholes, or running into a curb can trigger these unwanted thoughts. Sometimes, these thoughts can be triggered when you are done driving or have finished riding with somebody else driving.

People who experience this subtype of OCD do not want to hit people or animals with their vehicles, and they are no more likely to get in a hit-and-run than anyone else. If anything, they are likely to be more careful and cautious when driving than most others, so their intrusive thoughts and doubts can cause great distress and anxiety. 

When somebody experiences fear of hit and run OCD, they experience unwanted intrusive thoughts, images, doubts, or urges that cause distress and anxiety, called obsessions. To relieve this distress, people with OCD resort to compulsions, such as turning around and checking where they thought the accident might have happened, constantly looking in their rear-view mirror, driving excessively slowly, or driving the same route over and over again to make sure they didn’t miss something. Sometimes, the compulsions happen when people arrive home. This can involve watching the news to see if something has happened, looking up news stories related to recent hit-and-run stories online, or even calling the police on themselves in case they committed a hit-and-run episode and didn’t realize.

Fear of Hit and Run – Common Obsessions

  • Fear of causing an accident and not realizing it
  • Fear of losing control and hitting a pedestrian on accident or on purpose
  • Fear of hitting animals
  • Fear that hitting a pothole or a speed bump might have been a person or animal
  • Fear of losing control and driving off the road

Common Triggers

Just as there are many different types of obsessions, there are plenty of common triggers that can cause intrusive thinking. Hit-and-Run OCD doesn’t only occur when someone is driving, but can also be triggered when they are a passenger. For example: the passenger may worry that they are being too distracting and could cause an accident. People with OCD tend to often avoid situations where they could potentially have an accident or be partially responsible for one.

Consider these possible scenarios that could trigger obsessive episodes in Hit and Run OCD:

  • You are driving down a busy street and notice a woman pushing a baby stroller. You look off the road for a moment and hit a pothole. You keep driving, but fear sets in that you might have caused an accident and you continuously check in the rearview mirror. About a mile down the road, you turn around and drive slowly over the same roads, checking for any bodies or evidence of an accident.
  • You are watching the news and hear about an incident on a street where you often drive. You review in your mind over and over about your driving patterns and memories. You remember that it has been a few days since you drove on that street, but you are convinced that it must have been you who hit somebody. You call the police because you don’t know for sure or not if you hit somebody earlier that day, despite not having any evidence that you were driving on that street at the time. 
  • You are driving with a friend and a good song comes on the radio. You go to turn it up. You notice the driver observes you while you mess with the radio. The two of you start to sing, and the driver hits a speed bump. You are convinced that the driver hit somebody, but they aren’t concerned. A minute or so down the road, you hear sirens and see an ambulance. You are convinced that you distracted the driver, and start telling them that they need to turn back.

How can I tell if I’m experiencing Hit and Run OCD and not just anxiety or cautiousness?

This is a good question. Many people will spend a lot of their time looking for one simple answer, but the truth is, you have to learn to recognize the cycle of OCD.

OCD is composed of three basic stages: 1) intrusive thoughts, feelings, or urges; 2) anxiety that comes as a result; 3) compulsions done to relieve anxiety. Understanding this cycle can help you distinguish OCD from other conditions or issues. Another good rule of thumb is this: a person who has hit-and-run OCD does not have a desire to hit anybody with their vehicle, and will likely be particularly cautious, rather than reckless or careless, when driving.

Intrusive thoughts can happen to everybody, with or without OCD, on any given day. OCD, on the other hand, causes people to give these thoughts special significance, often making them question their identity, values, intentions, and character. 

Another sign is that thoughts or urges from OCD are often especially aggressive and completely out of character. This is because intrusive thoughts are ego-dystonic, which means that they do not align with someone’s values, beliefs, or identity.

Common compulsions

When people with Fear of Hit and Run experience these intrusive thoughts, they may start to engage in compulsions. Compulsions only offer temporary relief and encourage the cycle of OCD to continue. Repeating the same action only brings the same result, and often causes people to feel hopeless. 

Because of the vicious cycle of OCD, people with Hit-and-Run OCD may think they will never be healed or can never drive again without extreme anxiety. In some instances, people with OCD Hit and Run fears will practice extreme compulsive avoidance, only leaving the home if somebody else is willing to drive them. 

Compulsions for people with fear of hit and run, both physical and mental:

  • Listening to police radio scans
  • Going back over your driving route to check
  • 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 especially slowly or cautiously

How to treat fear of hit and run

Hit and run OCD may make it seem like there is no end in sight, but that is not true. While many people struggle with it, many people do overcome it. It is highly treatable by doing Exposure and Response Prevention (ERP) therapy with an OCD specialist. At NOCD everybody is highly trained to treat OCD using ERP.

ERP is the gold standard treatment for OCD and many other anxiety disorders. It is 80% effective and shows promising results within 12-25 sessions. With ERP, you will be able to teach your brain that your intrusive thoughts don’t have any real meaning; they’re just thoughts. 

In ERP, you’re gradually, safely exposed to thoughts or environments that are likely to trigger intrusive thoughts and anxiety. Then your therapist guides you in resisting the urge to respond to the distress with compulsions. By doing this over time, you learn that you are able to tolerate anxiety and as a result, your thoughts become less and less distressful.

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