Does OCD Affect Memory?

Understanding the Link Between Memory and OCD

1. Memory Distrust

The phenomenon of memory distrust is one of the most widely recognized effects of Obsessive-Compulsive Disorder (OCD). Interestingly, people with OCD do not necessarily have worse memory than those without OCD, they just have an uncomfortable amount of doubt about their memory. For example, someone locks the door, then begins to question if they really locked the door and must go back to check whether or not they locked it. 

Another example, if someone washes their hands, they may begin to question whether they washed thoroughly enough, and wash their hands again. The problem is not with memory itself, but rather the intrinsic doubt that arises from OCD and the resulting need for certainty. Essentially, compulsive checkers do not forget things more often than others, they just lose faith in their own memory over time because of repeated checking.   

2. Overload of Attention & Anxiety

People with OCD tend to focus intently on specific details, but that intense focus can also hinder memory. For example, if you are preoccupied with anxiety about burning down a house, then you may have difficulty remembering if you turned off the stove. In this case, the obsessively intense focus on “not making a mistake” distracts from the act of turning the stove off in the first place and your brain is not retrieving memories when there is anxiety and high stakes. 

Moreover, when you are feeling anxious, your brain is hijacked, pulling your attention away from the current moment thereby limiting cognitive resources and processing deeply about the memory. In turn, when the processing is limited to shallow memories or surface-level thinking, memory becomes increasingly difficult to retrieve later or hindering performance of memory. Thus, anxiety levels, which are heightened in OCD, can significantly destabilize memory performance when there are higher stakes for memory (i.e. locking doors, turning off appliances, taking medications).

3. The Role of Repetitive Behaviors

Over time, compulsive behavior, even just repeated checking, can have a negative effect on memory. Research has demonstrated that repeated checking diminishes the clarity and vividness of memory and causes an individual to have great difficulty recalling the differentiation of instances of the same action. An individual may become confused about whether they “just checked the door” or, in fact, “did this for the fifth time.” This fuzziness of memory crosses over several acts, decreases confidence in memory, and irrationally, over time, the repeated behaviors that are supposed to provide safety, exacerbate a person’s distrust in their memory. 

In other words, the obsession induces a need to act compulsively, making the individual doubt not only their memory, but now reality as well, and ultimately act even more compulsively.

4. Prospective Memory Deficits

Individuals with OCD frequently struggle with prospective memory, which is the ability to remember to do things in the future. Simple daily tasks (e.g., remembering to send an email, taking medication at a particular time, or bringing a gift to a friend’s party) assumes a level of faith in our own memory. OCD amplifies the fear of forgetting, frequently leading us to think “What if I forget and something bad happens…?.” As a consequence, people with OCD will tend to self-monitor excessively, set too many reminders, and experience heightened distress or anxiety even if they miss something minor. 

Most interestingly, research has suggested that while the actual prospective memory performance may be very similar to individuals who do not have OCD, the perceived threat of forgetting is over-exaggerated, leading to anxiety and hyper-vigilance that are not warranted given the actual circumstances.