Arithmomania: What it Is, Examples, & Treatment

What Is Arithmomania?

Arithmomania is a subtype of the mental health diagnosis Obsessive Compulsive Disorder (OCD), where a person is abnormally preoccupied with counting things. A person with arithmomania has intense preoccupations and beliefs about counting. The compulsions to count things or behave based on certain numbers can be incredibly time-consuming and disrupt their lives.

OCD is characterized by:

• Obsessions: Obsessions are recurrent and persistent intrusive thoughts or urges that cause a person a lot of stress and anxiety.
• Compulsions: When a person struggles to ignore their obsessions, they may engage in compulsions that they’re using to try to neutralize the obsessions or impact of the obsessions.¹

What Triggers Arithmomania Symptoms?

Arithmomania, or counting OCD, can sometimes differ in the root cause of what is motivating the counting behaviors. Unlike most types of OCD, arithmomania’s compulsion to count is not always triggered in response to an obsessive thought, but counting can sometimes be used as an attempt to block out intrusive thoughts.

However, much of the time, arithmomania’s counting compulsion can be in response to intrusive thoughts and obsessions that aren’t always directly related to the counting itself. For people with arithmomania, counting can lend a sense of “rightness” to the person’s experience or provide a sense of control and comfort because they believe doing things a specific number of times can prevent bad things from happening.

Common triggers for arithmomania include:

• Obsessions that something bad will happen to them or their loved ones
• Fears of what happens if something isn’t done “right”
• Worrying about breaking internal rigid “rules” if they do not count.
• Fear of not counting will leave them unprepared for something bad that will follow if they miss out on counting

Symptoms of Arithmomania

Symptoms of arithmomania align with the general symptoms of OCD, but compulsions will specifically revolve around something related to numbers. Specific numbers may induce anxiety for a person with arithmomania, while others can reduce anxiety; this largely depends on the meaning that the person places on each number, which often comes from past experiences or specific situations.

Common compulsions in arithmomania include:

• Performing a series of mathematical calculations over and over again
• Counting to a specific number
• Doing things to a certain number of times, or in sets of that number
• Adding to behavior sets in order to avoid “bad” numbers
• Only doing certain things at a certain time of the day (Numbers on the clock)
• Counting how many times they thought about things
• Counting things as they experience them, including floor tiles, road signs, words or letters in a word, steps taken
• Preferring certain numbers or evens/odds

Impacts of Arithmomania

Arithmomania can have a significant impact upon a person’s life, because the obsessions they are experiencing cause a significant amount of stress and the counting they are engaging in can be extremely time consuming and exhausting. The time taken up by a person’s counting can hinder or prevent a person from participating in work, relationships or everyday essential tasks, and it can ultimately consume their thoughts and life entirely.

What Is Arithmomania?

Arithmomania, and OCD in general, is diagnosed by doing a biopsychosocial evaluation of your symptoms and the history of these symptoms, as well as any family history or traumatic past life experiences for context:² A provider will need to be able to confirm that a person is experiencing obsessions/intrusive thoughts that cause distress and to understand the different ways that number significance and counting plays into compulsions.

There are several people who can give a diagnosis of OCD with an arithmomania subtype. A general medical doctor (MD) can often make this diagnosis, although they will often refer to a mental health professional for diagnostic confirmation and for treatment. Mental health professionals who are able to provide this diagnosis include mental health counselors, marriage and family counselors/therapists, licensed social workers, psychologists as well as psychiatrists. The difference in these lies in training programs, but all of these have education, training, and experience in the mental health field.

Questions to ask your provider or mental health specialist about arithmomania include:

• Where can I find specialized OCD treatment?
• What is expected of me during the course of treatment for OCD?
• What does a typical treatment plan look like for arithmomania?
• How will I know that treatment is working and when it is finished?

Treatment for OCD

There are several options available to a person who is considering OCD treatment for arithmomania. While exposure response prevention therapy (ERP) is generally considered the best choice, the psychotherapy treatment that will work best will depend on individual factors, such as symptoms and causes.

A comprehensive treatment plan will include a form of psychotherapy with the option to pursue a different modality if needed. Sometimes, medication is needed in addition to therapy. People can often begin to see improvements as early as 4-6 months after starting treatment, but often need a year or longer to complete treatment.

Treatment options for arithmomania include:

• Exposure response prevention therapy (ERP): Exposure and response prevention therapy is considered the first-line psychotherapy treatment for this disorder.³ It works by exposing a client to their fears gradually through real or imaginary situations, and then preventing the client from engaging in their compulsions; this helps the client to learn that things can be okay without having to engage in their compulsions.
• Example: A person experiences fear that they will die if they leave the house outside of the 8 a.m. hour because they believe 8 is a safe number. ERP therapy would help a client first to imagine leaving outside of the 8 a.m. hour and regulating themselves, and then later supporting them to leave briefly and see that they are okay, and then extending the periods to longer and longer to build belief and resilience.
• Medications: There are many medications for OCD, such as SSRIs, that can help with obsessive thinking, anxiety, and somatic anxiety responses.
• Cognitive behavioral therapy (CBT): Many of the treatments for OCD are actually subtypes of CBT (including ERP and ACT), but classic CBT for OCD has also been shown to be an effective treatment for OCD.⁴ CBT is based on the principle that. thoughts, feelings, and behaviors are interconnected and focus on altering the experience in one of the areas in order to change its impact on the other areas; this often focuses on changing a person’s thoughts in order to change their feelings and behaviors.
• Example: The person who believes they will die if they leave the house outside the 8 a.m. hour may be challenged to examine how this belief is a black-and-white cognitive distortion and to replace this belief with something less distressing and more helpful.
• Acceptance and Commitment Therapy (ACT): ACT is another subtype of cognitive behavioral therapy that has been shown to be an effective treatment for OCD.⁵ The foundation of ACT is that no thoughts or feelings are bad, but the struggle against thoughts and feelings that a person believes is bad can cause them to engage with behaviors that are disconnected from who they want to be as a person. ACT teaches a person to notice their thoughts and feelings and to detach from them in order to make intentional behavioral decisions that follow.
• Example: The person who believes they will die if they leave the house outside the 8 a.m. hour will work with a therapist to witness the belief and the fear that follows, to remember that this is not an accurate indicator of who they are and what they must do next, and to choose a behavior response that aligns with their values and who they want to be as a person.

5 Tips for Coping With Arithmomania

Arithmomania can be extremely time-consuming and exhausting, which makes it extremely important for a person to focus on maintaining good self care and developing healthy coping mechanisms for when their obsessions strike, and they feel the urge to engage with their counting and number-based compulsions. While general emotional and physical self-care is critically important, there are some things that a person can do to cope with arithmomania, obsessions, and compulsions specifically.

Here are 5 tips for coping with arithmomania:

1. Name it to Tame It: By labeling things such as “That’s an obsession” or “That is fear that is making me feel I need to do something,” a person is able to reduce some of the intensity and the disconnect that can happen between having a thought and responding with a behavior.
2. Practice urge surfing: This includes riding out an urge instead of giving into it, like riding a wave. A person focuses on regulating and keeping in mind that the urge will eventually pass and cannot last forever.
3. Change your ritual: By breaking the pattern of behavior that a person becomes so accustomed to that it feels automatic, the brain is forced to recalculate; in this recalculation time, sometimes a person can choose behaviors that align more with how they want to live. This could look like changing to counting backward, counting in different increments, or stopping halfway through.
4. Practice postponing: By postponing engaging with your counting when you feel the compulsion rising and telling yourself it’s okay to count later, you give yourself more control over the behavior and disrupt the automatic process that obsessions to compulsions can become.
5. Focus on Mindfulness: By becoming more aware of the thoughts, feelings, and urges, a person can better understand their patterns, detach from them, and notice where they have opportunities to choose something different.

When to Seek Professional Support

If you feel you may be struggling with arithmomania and notice that it is disrupting important aspects of your life – such as work, relationships, household tasks, and essential daily tasks – don’t wait to seek professional help. There are many ways to begin your search for a professional who can help you feel relief, including filtering through therapists using an online therapist directory. If you have financial limitations at this time, beginning your work on an online therapy platform can be helpful, although it is unlikely you will be able to connect with a therapist who specializes in OCD there. There are many therapists who work via telehealth and can provide OCD treatment if you are struggling to leave the house, as well as online psychiatrist options, if you feel adding medication, could be beneficial.