Obsessive-compulsive disorder (OCD) is identified by obsessive and intrusive thoughts, stress, anxiety, and engagement in repetitive behaviors to reduce these symptoms. “Checking” is both a common symptom of OCD and its own subtype. Checking OCD is observed in checking-based repetitive behaviors; these behaviors occur to prevent the possibility of something bad occurring. Treatment exists to help with these thoughts and behaviors.
What Is Checking OCD?
OCD is explained in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) by the presence of obsessions (recurrent and persistent thoughts, urges, or images that are intrusive and unwanted) and compulsions.1 OCD checking is observed in checking compulsions and rituals that are completed repetitively to reduce the fear of or chance of something bad happening to the individual or others.2,3,4
Checking OCD compulsions can look different for each individual. Some checking rituals look like continuous double-checking that doors and windows are locked (even to the point of leaving work to ensure), ensuring appliances are off to reduce the chances of a fire, and repetitively looking for accidents or stopping to see if they hit someone as they’re driving to work.2,4
Rituals and compulsions are meant to reduce anxiety, but they only reinforce it. It’s common for those with checking OCD to distrust their memory as a result of these experiences, even to the point of questioning their memories. Studies have found that engaging in these compulsions only makes individuals experience more memory distrust.3
Other common subtypes of OCD include:
- Homosexual or sexual orientation OCD (H-OCD/SO-OCD)5
- Pure obsessional OCD (Pure O-OCD)5,6
- Scrupulosity OCD
- Contamination OCD6
- Harm OC 5,6
- Existential OCD
- Just right OCD
- Symmetry OCD6
- Postpartum OCD
- Somatic OCD5
Checking OCD Symptoms
OCD symptoms tend to focus around obsessions and compulsions. These symptoms play a role in the creation and maintenance of anxiety and fear. People with checking OCD may struggle with intrusive thoughts regarding fears and safety. This applies to checking compulsions, as well as the behaviors that are created to reduce the related anxiety and fears or decrease risk to themselves or others. This can play a distinctive role in sexually intrusive thoughts in OCD.
Checking OCD obsessions can include:
- Fear of something bad happening to yourself or other 2,4,5
- Intrusive thoughts of not doing something that could lead to or prevent harm (like turn the stove off or lock your door)2,4,5
- Fear that you lost a meaningful item
- Fear that you will make an error or say something hurtful2
- Fear that you may contract a serious illness2
Checking OCD compulsions can include:
- Repeatedly (and sometimes ritualistically) checking that appliances are off
- Repeatedly ensuring that doors or windows are locked5
- Inspecting things closely, potentially even taking photos to confirm suspicions2
- Seeking reassurance regarding concerns or assurance to see if they did something2,5
- Mentally engaging in rituals to review that they did or didn’t do, and generally spending a significant amount of time thinking about what they did or said that day 2
- Avoiding certain tasks, behaviors, interactions, etc. to attempt to avoid anxiety and checking2
- Repeating certain phrases or words4
Effects of Checking OCD
Individuals who live with OCD often experience significant impairments in several areas of their lives. The World Health Organization (WHO) identified OCD as one of the top ten debilitating disorders in the world.4 For those who experience checking, this can be even more pronounced. Checking causes memory distrust and impair one’s ability to attend school, work, and socialize.3,4
Those who experience checking OCD may struggle to maintain healthy relationships without significant stress on both parties. They may even experience physical health issues as a result of their rituals, checking, and compulsive behaviors.4 Suicidal thoughts, attempts, and self-harm behaviors have also been observed in those experiencing OCD.4
Examples of Checking OCD
It may be hard to recognize or distinguish checking OCD symptoms. It may look different for each person, dependent on their symptoms. These individuals may spend a lot of time involved in obsessions and compulsions, even if it is not physically obvious. However, even when not obvious, these behaviors are negative for the person who feels stuck repeating them.
Examples of checking OCD include:
- Leaving work to check if the lights and applications are off at home, even though they can verify that they or their partner did5
- Rushing away from dinner with friends to see if their car and house doors are locked5
- Constantly fearing they haven’t done something and bringing it up repeatedly to get reassurance that they have5
- OCD checking and re-checking personal items to ensure they have them, even if they haven’t moved5
- Taking significantly longer to complete tasks, especially if they involve fears of harming others or themselves2
How to Get Help for OCD Checking
OCD checking can impact people’s lives significantly to the point of isolation and suicidal thoughts. If you or a loved one experiences suicidal thoughts, seek professional help immediately. In general, it can be helpful to reach out early to challenge and work on what is happening to you. Once you notice issues with a small to moderate impact on your ability to function, this is generally a sign that it’s time to reach out.
It may be difficult and stressful to find a therapist, especially if you have never sought out help before. Therapy can occur with a counselor, social worker, psychologist, or psychiatrist. If you’re ready to find a therapist, one simple way to start is by using an online therapist directory, where you can filter by specialty and insurance coverage.
Treatments for Checking OCD
There is a significant amount of research backing current treatments for OCD and checking OCD. Treatment often includes cognitive and exposure-based therapies as well as medication.7
Therapy
Although everyone responds differently to therapy, there is potential for progress. Exposure and response prevention (ERP) is considered the “gold treatment” by a number of researchers.2 ERP works through exposure to triggers (e.g., thoughts about fears of causing harm) and reinforcing that they don’t need to engage in compulsions, checking, or rituals to reduce the chances of harm.
Further, this approach encourages the client to challenge the cycle of obsessive thoughts that influence these behaviors.2,5,7,8,9 While ERP can be helpful, researchers note that drop out rates are high due to the difficulty and triggering nature of engaging in ERP.
Cognitive-behavioral therapy (CBT), sometimes with a mindfulness-based focus, has also been researched significantly in treating checking OCD. Through these styles, an individual can learn to reduce the power of obsessions and learn to acknowledge but not engage with these feelings and thoughts. It can also increase insight into the cycle as they challenge the related thoughts.5
Medication
Medication can help reduce symptoms of OCD checking. Serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) tend to be more common in treating these symptoms.7 While SRIs and SSRIs are also given to treat depression, they’re often effective in lowering symptoms of OCD checking, including rumination, worrying, and irritability.7
The only people who can prescribe medications are doctors (MDs,), psychiatrists (MDs with mental health specialty), and nurse practitioners (NP/ANP). The best way to explore if medications may be effective for you is to reach out to your primary care doctor or a psychiatrist and discuss your concerns with them.
Final Thoughts
Although it may not be easy to acknowledge, symptoms of checking OCD can affect you or a loved one in several ways. Recognizing these symptoms and experiences is important to explore what is happening and to start seeking treatment.
For Further Reading
Checking OCD Infographics
