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Constant Counting Disorder

Question:

My wife is constantly counting all day long. she looks at me and counts the features on my face. she counts every letter that she sees in every word. when she is reading, watching tv, driving, no matter what she is doing she is always counting. It is really starting to affect her daily living and she’s starting to get real bad headaches and be depressed. any help would be grateful Thank you

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Answer:

This counting behavior may be nothing to speak of (clinical-wise), or possibly it could be an outward manifestation of an anxiety disorder, such as Obsessive-Compulsive Disorder (OCD), or possibly a neurological problem.  There is no way to tell without a face to face interview, detailed history and a physical/neurological exam. OCD is characterized by obsessions which are repetative thoughts and worries, repetatively themed in nature, and typically concerned with what seem like dangerous situations to the person having them. Examples of common obsessions are "did I leave the door unlocked?", "am I contaminated with germs?", "are my hands dirty?", etc. Counting things is a common behavioral theme, a sort of compulsion for some with OCD. A compulsion is a behavior that is acted out in an attempt to quiet down the obessive thoughts. As such, it is typically an anxiety reducing behavior and that is why it is repeated so frequently. I’m not sure what obsession a counting compulsion might be compensating for – it may not be linked to a particular thought – but the general pattern is that by acting out the behavior, people feel safer/better.

Given that there are compulsive behaviors present, and, particularly becuase there are headaches present, it would be wise to recommend to your wife that she be examined by a psychiatrist (or at least a regular medical doctor who can screen for organic brain/neurological damage).  Some headaches are signs of larger problems that require treatment, and the impact of benign headaches can be lessened by medical treatment in many cases. 

If OCD is diagnosed (by a psychiatrist), there are medications that can help the condition, but you should also know that behavioral and cognitive-behavioral psychotherapy can be of assistance as well.   

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