hit and run ocd - man retracing route

What is Hit and run OCD?

Written by Dr Elaine Ryan

Dr Elaine Ryan PsychD is a highly experienced Chartered Psychologist with 20+ years of experience. She specialises in Obsessive-Compulsive Disorder (OCD) and Anxiety Disorders.

Hit-and-run OCD is a type of obsessive-compulsive disorder. It includes an irrational fear or obsession with accidentally causing a car accident. This could be because someone has been in an accident before or is afraid of being responsible for someone else’s death.

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10 Important Points about Hit & Run OCD:

  1. Intrusive and distressing: Unwanted, disturbing thoughts about causing hit-and-run accidents are the hallmarks of this OCD subtype.
  2. Not reality: These thoughts are intrusive and do not reflect your true self or intentions. Remember, OCD often latches onto worst-case scenarios.
  3. Compulsions offer temporary relief: Rituals like checking news, driving routes repeatedly, or seeking reassurance can temporarily quell anxiety but ultimately strengthen the OCD cycle.
  4. Resistance is key: Breaking the compulsion cycle is crucial for recovery. Avoiding reassurance-seeking, mental rituals, and excessive checking can be challenging, but it’s the path to progress.
  5. Professional help is vital: OCD is a treatable condition. Seeking help from a therapist specializing in OCD treatment and CBT (Cognitive Behavioral Therapy) can equip you with practical tools and strategies.
  6. Self-care matters: Prioritize practices that promote overall well-being, like regular sleep, healthy eating,exercise, and relaxation techniques. These can build resilience against anxiety.
  7. You’re not alone: Connecting with others who understand Hit & Run OCD can be powerful. Support groups and online communities offer validation, encouragement, and practical tips.
  8. Acceptance is a friend: Accepting the presence of intrusive thoughts without judgment is part of the healing process. Remember, thoughts are just that – thoughts – and they don’t define you.
  9. Progress, not perfection: Recovery takes time and effort. Celebrate small victories and recognize that even tiny steps forward are significant.
  10. Hope is here: With the right support and tools, you can manage Hit & Run OCD and live a fulfilling life free from its grip. Focus on building your emotional resilience and remember, you are not defined by your intrusive thoughts.

Hit-and-run OCD

Hit and Run OCD is a type of OCD that causes people to fear hitting, injuring, or killing a pedestrian while driving. They may check their vehicle for damage and avoid driving or driving in certain places and conditions. They often go to great lengths to do so. This point is explained well in a case study by the International OCD Foundation.

Like many forms of OCD, people with hit-and-run OCD experience the need to check and recheck their actions. The checking follows anxiety, producing obsessive thoughts such as did I run someone over? This need to check is a compulsive behaviour to ease their anxiety about the thought that they could have run someone or something over and not be aware of it.

The cornerstone of OCD is to have both obsessions and compulsions, and with hit-and-run OCD, the obsessions are the thoughts about a car accident, and the compulsions are the checking.

Obsessions in hit-and-run OCD

  • Did I run someone over and not notice?
  • Did I cause an accident and didn’t know?
  • Will the police come to my door as I failed to stop at an accident, as I did not see it?
  • Will I go to jail?
  • Could I have hit a car in the car park and not known it?


False memory OCD

A false memory is where you remember something that did not happen

Compulsions in Hit-and-Run OCD

  • Retracing their driving route to make sure there were no accidents.
  • Checking their mirrors too often while driving to make sure they did not cause any accidents.
  • Asking people travelling in the car with them did they hit anything, needing reassurance, as they cannot trust their senses.
  • Avoid driving in places they consider high risk and are more likely to cause accidents, such as busy roads, motorways, the fast lane and busy car parks.
  • Not being able to drive alone as they need someone with them to corroborate there were no accidents.
  • Avoiding driving at night or in the rain.
  • Driving below the speed limit. This helps reduce anxiety, giving drivers more time to react if they see an obstacle in their path.
  • Avoiding Tv or news coverage of accidents out of fear of being triggered.

Difference between being anxious about driving and having hit-and-run OCD

It’s difficult to tell the difference between being anxious about driving and having hit-and-run OCD. Here are some things you should know:

People with Hit & Run OCD will have thoughts they have caused an accident or injury when there are no signs of an accident or injury. People who are anxious while driving are more focused on the present moment. Their anxiety is related to their driving, as opposed to the fear that they could have hurt someone without knowing it.

People who experience panic attacks or have anxiety may feel more stress than usual while driving, but do not obsess that they could have caused an accident without realising it.

Treatment for Hit and Run OCD

CBT is an effective treatment for Hit and Run OCD. Exposure Response Prevention therapy can teach you how to avoid actions that worsen the disorder while exposing you to situations that worsen it.