What is Hit-and Run OCD?

Hit-and-Run OCD is a subtype of obsessive-compulsive disorder (OCD) characterized by a persistent fear of accidentally hitting or killing someone with a vehicle while driving. Individuals with this condition experience intrusive thoughts or mental images of having harmed a pedestrian, despite having no evidence that an accident occurred.

These distressing thoughts can make driving—especially in crowded environments such as city streets, parking lots, or construction zones—particularly anxiety-provoking. Even normal occurrences, like driving over a bump or pothole, may trigger intense fear that someone was run over.

In response, individuals often engage in compulsive behaviors to reduce their anxiety. These may include repeatedly checking mirrors, retracing their driving route, or scanning news reports for car accidents. Many also seek reassurance from others or mentally replay their drive to search for signs that they might have caused harm.

These compulsions can make driving a time-consuming and emotionally exhausting task, often leading to tardiness or missed responsibilities. In more severe cases, individuals may avoid driving altogether. Although these behaviors are intended to prevent a feared outcome, they ultimately reinforce the OCD cycle—making driving increasingly difficult over time.