I Can’t Count Beyond 12. What Can I Do?

Reader’s Question

I have a strange question/problem. Recently, I’ve been having a problem whenever I count. Whenever I get to the number twelve, instead of going on to thirteen, fourteen, fifteen, etc., I start over at one. It screws me all up, because I then have to recount, or add whatever number I get to, to twelve. This wouldn’t be such a problem if it happened only once or twice, but this has been going on for about two to three weeks now. I am a manager at a really busy video store, and am constantly having to count money, and this issue I have with counting is affecting my work. It’s embarrassing having to recount 3 to 4 times, even when I’m only supposed to be counting to 20. It can’t be “old age”, I’m only 22 years old. What can I do?

Psychologist’s Reply

You’re correct — this isn’t old age. You are describing a symptom often associated with Obsessive-Compulsive Disorder (OCD). OCD symptoms have been found to cluster in four areas:

• aggressive/sexual obsessions/compulsions,
• ordering and counting,
• contamination and cleaning, and
• hoarding.

A counting obsession and related compulsive behavior is fairly common. Some clues to the situation are found in your recent onset (2-3 weeks), need to add the numbers, the anxiety connection, and your age. Is this the only OCD or related symptom — probably not.

OCD symptoms — like clinical depression, eating disorders, body dysmorphic disorders, and several other clinical conditions — are all associated with low levels of the brain neurotransmitter Serotonin. The theory goes something like this:

• A high level of stress (job, family, friends, romance, college, health, lifestyle, etc.) over a long period of time, gradually decreases our Serotonin levels.
• As Serotonin decreases, depressive symptoms appear such as sleep/appetite problems, poor concentration, fatigue, worry, anxiety, etc. Very low levels of Serotonin produce crying spells, preoccupation with your past, suicide thoughts, and other serious symptoms.
• For a percentage of depressed individuals, their low level of Serotonin activates obsessive thoughts such as counting rituals (yours), fears of contamination (hand washing), and even earworms (music stuck in our head). It’s common for individuals with no history of OCD to suddenly develop OCD symptoms when they become depressed. I recently worked with an auto mechanic who couldn’t work on an automobile unless all the numbers in the serial number added to an even number.
• Once the OCD symptoms begin, as Serotonin continues to decrease, the symptoms become disabling and overpowering.

I suspect that you’ve been gradually slipping into a depression due to factors not mentioned in your question. About three weeks ago you hit a level of depression that activated OCD symptoms and for you, making change each day, it was a counting obsession and ritual. Patients working in hospitals suddenly feel they’ve been contaminated. If you put your counting symptom aside, you’ll see a number of symptoms related to depression such as emotional fatigue, low energy, rapid mind speed, worry, social sensitivity, poor appetite, etc.

The good news: this is fairly easy to fix. As both depression and OCD are associated with low levels of Serotonin, the use of an antidepressant medication can improve both at the same time. We have several medications that are research-proven to be used in both situations. I’d start by consulting your family physician for his/her help or a referral. I’d also read questions linked in the sidebar menu with the tag “OCD”. As treatment continues, you may be referred for counseling which would also be helpful.

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As a side note, in my experience each person has a specific low-Serotonin indicator. Most people don’t know their indicator until they experience a depression. Counting rituals may be yours. In the future, if counting rituals surface again, it will be a sign that you are becoming stressed and depressed again and a return to the physician will be needed. With counseling and stress-reduction methods, our goal is to keep our stress level far away from activating that warning signal.