Understanding checking OCD: Symptoms and treatments

Have you ever left your house, arrived at your destination, and suddenly wondered if you accidentally left the stove on? Most people can relate to the fear that creeps in the moment you start to question whether you forgot to do something that could have serious consequences. This stress response is the brain’s way of making sure that we keep ourselves and our environment safe.

But people living with a form of obsessive-compulsive disorder (OCD) called checking OCD experience these worries excessively. Unlike the nagging forgetfulness we all experience sometimes, they experience obsessive thoughts that don’t let up and lead to compulsive checking behavior.

Left untreated, this cycle can impact their mental health, relationships, and ability to function in daily life in significant ways. But fortunately, like other presentations of OCD, it can be managed with the right support.

What is checking OCD?

While not a recognized diagnosis, checking OCD is a term for a specific category of OCD symptoms. Like other types of OCD, it involves a combination of intrusive, upsetting thoughts called obsessions. In response, people with OCD engage in repeated, ritualistic behaviors called compulsions to reduce the discomfort brought on by their obsessions.

In the case of checking OCD, a person’s obsessions revolve around a desire to ensure that things are done completely or the “right” way. People living with checking OCD, like people living with other forms of OCD, often have an irrational belief in their ability to control their environment. They also tend to feel an outsized sense of responsibility for themselves and others.

This doesn’t mean they have a desire to control or manipulate anyone. Instead, they’re driven by unrelenting fears that if they don’t do something the “right” way and repeatedly “check” to ensure correctness, something bad will happen to themselves or others.

Symptoms of checking OCD

Checking OCD can take a variety of forms. But there are a few signs and symptoms to be aware of, including:

• Excessive checking of locks, appliances, and windows

• Overwhelming fears of making mistakes or causing harm

• Feeling that you could be to blame for things like a home break-in, fire, or other property damage

• Excessive worries about getting sick or making others sick due to some sort of oversight

• Unfounded fears of engaging in inappropriate behavior (like saying a racial slur, saying something insulting or hurtful, or assaulting someone)

• Being frequently late due to excessive checking

Of course, most of us want to avoid these kinds of thoughts, feelings, and behaviors. So we take reasonable steps to ensure that we don’t harm or offend anyone or do anything that could compromise safety.

For example, imagine getting to work and thinking you forgot to lock the front door. You know your partner is still at home, so you call them to make sure the lock is secure. Taking this action is enough to quell your anxiety, and you’re able to go about your day without distress.

But a person with checking OCD may respond to this situation differently. A repeated worry about the front door being left unlocked could cause significant panic that cannot be resolved with a simple phone call. The person might face uncontrollable worry that their home could be robbed or their partner could be hurt by an intruder. In turn, they may engage in ritualistic, compulsive checking behaviors in an attempt to alleviate their discomfort.

This might include things like:

• Checking the lock repeatedly each day and night, even when they logically know the door is locked

• Avoiding leaving the house because they’re afraid they’ll leave the door unlocked

• Spending hours picturing themselves locking the door

• Constantly calling their partner throughout the day to make sure the lock is secure

Living within a cycle of obsessions and compulsions can make it difficult for a person to function in daily life. In this example, the person’s obsessive fears and subsequent obsessive checking could make them late for work, negatively impact their relationships, and compromise their health and well-being.

What causes checking OCD?

We don’t have a clear understanding of what causes compulsive checking. But there are a few known factors that may increase your risk of developing OCD, including:

• Brain structure: Some research indicates that OCD may be the result of problems with how certain parts of the brain communicate with one another.

• Genetic predisposition: Having a first-degree relative, like a parent or sibling, who has OCD could increase your risk.

• Trauma exposure: Experiencing chronic or acute stress or trauma can lead to the onset of OCD and other mental health concerns.

Most effective treatment options for checking OCD

Left untreated, OCD can be incredibly difficult to live with. But fortunately, there are several treatment options that can help you manage your symptoms. These include:

• Cognitive behavioral therapy (CBT): This form of treatment helps interrupt irrational, unhelpful, or distressing thoughts. Learning to manage your thoughts with CBT can help you respond to stressful situations in a more healthy way.

• Exposure and response prevention (ERP): This is a subtype of CBT that can help reduce the distress you experience in the face of triggers. It involves a slow, gradual exposure to stressors under the supervision of a trained therapist.

• Acceptance and commitment therapy (ACT): Another form of CBT, this therapy encourages people to see their behavior as changeable. ACT can help you see your obsessions and compulsions differently by increasing your mental flexibility.

• Medications: Certain medications may help alleviate OCD symptoms. You can talk to your provider about whether this option is right for you.