OCD and the Exhaustion of Constant Mental Monitoring
If you have ever ended a perfectly normal day feeling completely drained despite doing little more than thinking, you are not alone.
For many living with Obsessive-Compulsive Disorder (OCD), the fatigue is not from activity. It is from monitoring.
The Hidden Mental Marathon
OCD is not always about handwashing, checking locks, or arranging items just right.
For many, it happens entirely inside the mind. Internal compulsions, like reviewing conversations for mistakes, replaying decisions, or mentally checking moral “rightness”, can take up hours of the day.
It is like running antivirus software on your brain 24/7. You might look calm, but behind the scenes your mind is scanning every thought for potential danger or imperfection.
Common Mental Monitoring Loops
“Did I offend them?”
“Was that the right decision?”
“What if I am a bad person?”
“Did I lock the door or just imagine it?”
These repetitive thought patterns are not just worry. They are mental compulsions which are acts meant to neutralize anxiety, confirm safety, or restore certainty. Unfortunately, they rarely succeed for long, and the cycle starts again.
Why It Is So Exhausting
Cognitive scientists estimate that the brain can generate around 60,000 thoughts per day.
When OCD turns even a fraction of those into threats to analyze or “solve,” mental bandwidth burns out fast. The result: chronic fatigue, irritability, sleep issues, and burnout that mimic ADHD or generalized anxiety.
In fact, many clients who present with “decision fatigue,” “analysis paralysis,” or “overthinking” discover through evaluation that their symptoms align with internalized OCD, a form that thrives on invisible mental rituals rather than physical ones.
The Overlap with ADHD and Anxiety
The mental tug-of-war between focus and reassurance often shows up alongside ADHD.
Someone may hyperfocus on intrusive thoughts, get derailed mid-task by mental checking, or procrastinate because every decision feels risky. Anxiety further fuels the loop, convincing the mind that not checking is irresponsible.
This triad—OCD, ADHD, and anxiety—is common but treatable when properly identified.
How Therapy and Coaching Can Help
At Palm Atlantic Behavioral Health, we address both sides of the struggle:
Therapy (ERP, CBT, and Mindfulness-Based Work):
Helps you tolerate uncertainty, recognize thought traps, and break mental ritual cycles.
Coaching (ADHD and Executive-Function Focused):
Supports the real-world impact to help you rebuild routines, stay organized, and manage decision fatigue as mental space begins to free up.
Together, therapy and coaching create a full recovery framework: therapy rewires the thoughts, and coaching restores the habits.
This OCD Awareness Week: Give Your Mind Permission to Rest
If you are mentally tired all the time and can never “turn it off,” that fatigue is not a character flaw. It is a signal.
With the right support, the mind can finally shift from constant scanning to calm observation, and from self-doubt to self-trust.
You do not have to do the mental marathon alone.
Explore therapy or coaching for OCD, anxiety, or ADHD at Palm Atlantic Behavioral Health.
We are in-network with Aetna and Optum/UnitedHealthcare and provide out-of-network support for private-pay clients for therapy services.