While the exact cause of OCD is unknown, research suggests it arises from a combination of genetic, biological, and environmental factors.
Obsessive-compulsive disorder (OCD) is a complex chronic (or long-term) condition characterized by a cycle of obsessions and compulsions. Obsessions are intrusive thoughts, images, urges, feelings, or sensations that cause significant distress. In response to obsessions, people with OCD perform compulsions, which are repetitive physical or mental behaviors done to relieve distress or prevent something bad from happening. If OCD is left untreated, symptoms can become worse over time, impacting your relationships, work, school, and daily responsibilities.
If you have (or think you have) OCD, you might wonder how and why the condition developed. Many OCD experts believe the underlying causes of OCD include a combination of genetic, biological, and environmental factors. Note that regardless of the specific cause of your OCD, the condition is highly treatable. While it can be interesting to explore the potential underlying factors behind the condition, you don’t need to know what’s caused your symptoms in order to manage them with more ease.
Keep reading to learn more about what causes OCD, when it often appears, and how treatment can help you escape the cycle of symptoms.
What causes OCD?
The exact cause of OCD is unknown. However, researchers have identified a few factors that seem to be more common among people with OCD. Let’s explore some of the questions they’ve investigated:
Is OCD genetic?
Research suggests that a family history of OCD increases the likelihood of developing the condition. Some studies estimate that 10% to 20% of people diagnosed with OCD have an immediate family member with OCD. Studies looking at OCD in twins have also found that when one twin has OCD, it significantly increases the odds that the other will develop the condition. This finding seems to be especially true among identical twins.
That being said, please note that while a family history of OCD may play a part in developing the condition, there is no specific gene responsible for the condition.
Is OCD a result of brain differences?
Some theories suggest that OCD may be due to differences in the brain. In some people with OCD, certain regions of the brain appear to be overactive or differ in size. Some evidence also points to chemical messengers or neurotransmitters in certain brain regions being responsible for OCD, but more research is necessary to confirm this.
Studies suggest that serotonin, a type of neurotransmitter, might be associated with OCD. Serotonin sends signals between nerve cells and plays a role in mood, sleep, anxiety, appetite, digestion, and more. Additionally, research suggests that certain levels of glutamate, another neurotransmitter, may contribute to OCD. Glutamate is responsible for brain functions such as learning and memory.
While these biological factors may play a role in OCD, warn that pinning OCD on brain differences may be an oversimplification. “OCD is much more complex than a simple chemical imbalance,” says Jamie Feusner, MD, Chief Medical Officer at NOCD.
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Can trauma cause OCD?
It’s possible that experiencing traumatic events could increase your chances of developing OCD. One study found that people with OCD were much more likely to report a stressful life event in the six months before the onset of their symptoms. Another showed that people who experienced traumatic events during childhood were five to nine times more likely to be diagnosed with OCD in adulthood than those without a history of trauma. Many people with post-traumatic stress disorder (PTSD) also experience OCD.
While there’s evidence to support trauma as a potential factor for OCD, this doesn’t guarantee that you’ll develop OCD simply because you’ve experienced a traumatic event.
Can substances cause OCD?
No evidence suggests that using drugs or other substances causes OCD. However, it’s common for OCD and a substance use disorder (SUD) to co-occur. Many substances can worsen OCD symptoms, but OCD can also worsen substance use issues. People with OCD sometimes find temporary relief through alcohol or drugs—and can become dangerously dependent on these substances.
What makes OCD worse?
OCD is a condition that ebbs and flows, as there are periods when your symptoms may intensify or spike, which some refer to as “flare-ups.” Here are some common triggers that can make OCD worse:
- Engaging in compulsions: The main reason for OCD flare-ups is compulsions. The more compulsions you do, the more you reinforce the idea that your fears are dangerous and you need compulsions to cope—deepening the symptom cycle.
- Trauma: In addition to being a possible cause for the onset of OCD, traumatic experiences can also worsen your symptoms. The distress from a traumatic experience can trigger obsessions, which may, in turn, cause you to engage in compulsions.
- Stress and change: Life changes—whether positive or negative—may heighten OCD symptoms. Starting a new job, having a child, facing financial difficulties, or caring for an aging parent are just a few stressors that could cause your OCD to flare up.
- Other mental health conditions: It’s common for OCD to co-occur with other mental health conditions, such as generalized anxiety disorder (GAD) and major depressive disorder (MDD). The symptoms from co-occurring conditions can make your OCD more intense.
When does OCD develop?
OCD can appear at any point in your life, but it typically develops during childhood or early adulthood. In rare instances, OCD symptoms may develop after the age of 35, which is known as late-onset OCD. There’s also acute-onset OCD, which refers to the rapid onset of symptoms, usually in children between the ages of 3 and 12 diagnosed with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS) or Pediatric Acute Neuropsychiatric Syndrome (PANS). PANDAS/PANS develops after a streptococcal (strep) infection and can include OCD symptoms, a tic disorder, or both.
How can I get help for OCD?
If you believe you have OCD, the first step is to get diagnosed. It’s best to seek a diagnosis from an OCD specialist who will be most familiar with the condition and can create a personalized treatment plan that sets you on the path to recovery.
Can OCD be cured?
While there’s no cure for OCD, the condition can become very manageable through exposure and response prevention (ERP) therapy.
Exposure and response prevention (ERP) therapy
ERP therapy is a specialized form of cognitive behavioral therapy (CBT) designed to treat all forms of OCD. ERP is proven to be highly effective, with 80% of people seeing a significant reduction in their OCD symptoms.
With the help of an ERP therapist, you’ll work through exposures and response prevention techniques that teach you how to address your fears head-on without engaging in compulsions. This process helps you learn how to sit with the discomfort and anxiety from obsessions rather than resort to compulsions that perpetuate the OCD cycle and make it worse over time.
OCD’s core message is that uncertainty is bad, and bad things will happen if you are uncertain. Doubt is something that we live with on a daily basis. It doesn’t have to stifle us and stop us from living our lives. ERP’s role is to help prove that to you.
Patrick McGrath, PhD
ERP can be challenging, but with patience, consistency, and determination, you’ll notice changes in your symptoms.
Bottom line
OCD is a complex mental health condition that experts are still trying to understand. Research thus far indicates that the condition may develop from a mix of genetic, biological, and environmental factors. If you suspect that you have OCD, it’s important to seek treatment from a mental health professional—preferably an ERP therapist. These individuals are specially trained to identify your triggers, obsessions, and compulsions and create a customized treatment plan that can help you get your life back from OCD.
Key takeaways
- Genetics may play a role in OCD, with family history increasing the likelihood of developing the condition.
- Differences in brain structures and neurotransmitter activity, particularly serotonin, may contribute to OCD symptoms.
- Trauma and stress can trigger or worsen OCD, but they do not guarantee its onset.
- While there’s no cure for OCD, exposure and response prevention (ERP) is highly effective in reducing symptoms and improving quality of life.
