Obsessive-compulsive disorder (OCD) is an often disabling condition consisting of recurrent, bothersome, and intrusive thoughts, urges, or images that cause feelings of discomfort. To reduce the anxiety and distress associated with these thoughts, the patient may employ certain compulsions or rituals. The DSM-5 defines compulsions by the following points:

• Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession.
• Behaviors or mental acts that are intended to reduce anxiety or prevent some feared situation. However, these behaviors or mental actions don’t really connect with what it is they’re meant to prevent.

The cause of OCD is still unknown, but it’s likely to be multifactorial. It’s believed that there’s a genetic predisposition since 45 to 65 percent of its variations are attributable to genetic factors. In fact, research has shown that the heritability of this disorder is as high as 45 to 65 percent in children and 27 to 45 percent in adults.

It’s also been observed that an inability to cope with uncertainty, a heightened sense of responsibility, and magical thinking seem to predispose to obsessive-compulsive habits.

Now that we have a global overview of OCD, let’s take a look at one of its most interesting variations: arithmomania.

Arithmomania

Arithmomania is a type of OCD characterized by the compulsion to count objects or actions and do mathematical calculations. The sufferer may be overwhelmed by an irresistible urge to keep track of things around them. Those who suffer from arithmomania can’t avoid counting numbers, objects, or words, or even stop repeating actions a certain number of times.

This kind of OCD operates like any other. Uncomfortable thoughts (obsessions) invade the individual, their anguish is triggered, and actions or rituals emerge (compulsions) as a mechanism to neutralize it.

Appealing to compulsive rituals is the main strategy that the obsessive person uses to deal with their anguish. However, while this may help in the immediate moment, it’s extremely damaging in the long run. In fact, it produces more distress than not carrying out the compulsive behavior.

The most common manifestations of arithmomania

• Counting words. The sufferer might count the words in a conversation, written texts, etc.
• Counting objects. Some count steps as they go up them, the license plates of cars, the number of things in a room, etc.
• Performing mathematical calculations. Sufferers are constantly doing arithmetic calculations. For example, addition, subtraction, and multiplication.
• Counting to a number before doing something. For instance, before leaving home, the person has to count to 50.
• Repeating something a number of times. The sufferer might have to look in the mirror three times, stir their coffee five times before drinking it, or lather their hands three times.
• Avoiding a certain number. The sufferer avoids a number (this has nothing to do with superstition). For example, you have to wash your hands three times because doing it once would make you too anxious.

Other examples of arithmomania are the following:

• Counting things in a box.
• Pressing the switch to turn on the light a certain number of times.
• Doing things a certain number of times with the compulsion to make the number even or odd.
• Checking that the house door is closed a certain number of times, etc.

Arithmomania negatively affects the sufferer’s quality of life

Like all kinds of OCD, arithmomania can significantly affect the lives of those who suffer from it. In fact, it can hinder a person’s growth and social development.

One study found marked impairment in all specific domains of OCD patients’ quality of life. This included the ability to work and perform household tasks, their subjective sense of well-being, their social relationships, and their ability to enjoy leisure activities, as suggested by community norms.

As you can imagine, arithmomania is limiting. That’s because it requires constantly paying close attention to the environment. The most frequent consequences are the following:

• Not being able to keep a job. Constantly counting makes it impossible to perform sufficiently in assigned tasks. In many cases, it leads to dismissal for poor performance.
• Social isolation. Because the mind is often busy counting, the person is often inattentive to their social interactions.
• Anxiety. We mentioned earlier that compulsion, in the short term, can reduce anxiety. However, in the long run, it only generates more.
• Depression. Feelings of sadness are often recurrent in this type of disorder.

Interventions to deal with arithmomania

Early identification and immediate intervention in OCD are important. Furthermore, intervention may be more effective when the disorder is diagnosed early. Often, those who suffer from this disorder experience a significant improvement in symptoms with adequate and timely therapeutic work. Some even achieve remission (Fenske & Schwenk, 2009).

• Exposure therapy with response prevention. This is a type of cognitive therapy used to treat OCD. Exposure with response prevention is intended to help the patient break the cycle of obsession and compulsion and improve their overall quality of life. It encourages the person to face their fears without engaging in compulsive behaviors.
• Cognitive behavioral therapy. This type of therapy focuses, among other things, on the cognitive distortions, irrational thoughts, emotions, and problem behaviors that are part of OCD.
• Motivational interviews. The use of motivational interviewing has been shown in some studies to increase participation in therapy and improve outcomes for people with OCD.
• Psychopharmaceuticals. There are several types of medications that can be prescribed to treat OCD. Selective serotonin reuptake inhibitors (SSRIs) are the preferred initial drug therapy for this disorder. SSRIs work by blocking the reuptake of the neurotransmitter, serotonin so that it’s not reabsorbed back into the presynaptic neuron that released it.

To conclude, arithmomania is a type of OCD related to counting or doing mathematical calculations. It’s a fairly limiting condition that affects sufferers’ quality of life.

Dealing with OCD can be a challenge, both for the patient and for their family members. For this reason, it’s necessary for sufferers to receive the support of mental health professionals.

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