What Causes OCD? Everything You Need to Know.

Disclaimer: This article is for educational purposes only and does not replace expert medical or mental health advice. OCD requires a comprehensive psychiatric evaluation by a qualified clinician. So, always refer to a licensed mental health specialist for diagnosis and treatment.

OCD, or obsessive-compulsive disorder, is a complex mental health condition that has no definitive known cause. In fact, the International OCD Foundation says that we do not yet fully know what causes OCD. Experts suggest a combination of several factors that can play a role. Psychologists have also suggested different theories. We will explore all these and more in this article.

Genetic predisposition plays a role in the development of OCD. OCD has moderate heritability - up to 40% to 50%.

Some studies have suggested that if a close relative of yours has OCD, your chances of developing it may be higher - up to four times more likely, to be very precise.

While this indicates that there is a role of genetics, it is not set in stone. In fact, some identical twin studies have shown that there are cases where one twin has OCD, and the other does not.

Brain functioning and chemistry play a role in the development of OCD.

Brain imaging studies show increased activity in the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), and caudate nucleus in those with obsessive-compulsive disorder (OCD). These are regions involved with habit-forming, decision-making, and goal-directed behaviors. This remains debated, however, as increased brain activity can be either a reason for OCD symptoms or a consequence of them.

In fact, chemical imbalances in the brain, such as imbalances in the dopamine, serotonin, and glutamate levels, can contribute to OCD as well.

Yes, the environment needs to be factored in when we are considering the causes of OCD. But it can be a bit tricky.

While shared environments, like your home, do not have a significant effect on the development of OCD, non-shared environments do. Obsessions and compulsions can differ based on different sexual orientations, ethnicities, cultures, and religions. A recent example is how the COVID pandemic led to an increase in COVID-related obsessions, just like how HIV/AIDS-related obsessions peaked during the 1980s, when a similar panic was taking over the world.

In fact, environments where there is a greater emphasis on common OCD themes like religion or cleanliness can contribute to corresponding OCD subtypes. For instance, societies where there is a greater emphasis on religion can contribute to religious OCD. CNN reports that 5% to 33% of those with OCD report religious thoughts and behaviors, with this number going as high as 50% to 60% in some countries where there is a greater emphasis on religion.

Similarly, stressors like traumatic life events can also play a role in the development of OCD. A recent systematic review of etiology and symptom severity estimated that 70% of those with OCD have traced back the onset of their symptoms to trauma, while 30% linked trauma with worsening OCD symptoms.

PANDAS and PANS remain areas of ongoing research and debate within the medical community.

In 1998, it was found that when children contracted streptococcal infections, it gave rise to an immune response that generated a set of antibodies. These antibodies then react with a region in the brain known as the basal ganglia and give rise to OCD symptoms among some children.

This led to a theory that certain antibodies linked with infections can impact the brain in some way. So, Paediatric Autoimmune Neuropsychiatric Disorders linked with Streptococcal Infection (PANDAS) or PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) were considered to be certain childhood disorders related to OCD.

While a few (not all) recent studies have not found such a link, the interpretation can also be that since OCD symptoms only developed among some children, these children were already predisposed to this mental health condition. Nevertheless, the link between streptococcal infections and OCD cannot be overlooked entirely either.

Three psychological theories have been proposed by three different schools of psychology to understand what causes OCD:

PSYCHOANALYTIC THEORY

This theory suggests OCD stems from early childhood attachment or conflict patterns, typically the discomfort or conflicts one experiences with their parents that become embedded in the unconscious mind. While once widely accepted, it has little to no bearing on today’s clinical understanding of what causes OCD.

BEHAVIORAL THEORY

One of the more popular explanations for OCD is based on learning and behavior rooted in behaviorism. Behavioral theory explains OCD as a learned response to uncertainty or fear. For instance, if praying eases anxiety, repeating that behavior may turn into a compulsion. This theory helped develop exposure and response prevention (ERP) therapy, a leading OCD treatment.

Whether or not this theory entirely explains OCD, it can still be understood in the broader context of genetics, biology, and environment.

COGNITIVE THEORY

This theory suggests that the origin of OCD is related to how you think. While most of us have intrusive thoughts from time to time, those with OCD assign more meaning to thoughts, triggering anxiety and compulsions. Compulsions then become their way of coping with the anxiety, whether or not they make any logical sense.

As the cognitive theory has evidence and empirical support, cognitive behavioral therapy (CBT) is often combined with ERP as a more comprehensive treatment for OCD.

While there is no definitive cause for OCD, the struggle is real. If you or a loved one has received a diagnosis of OCD, we understand how challenging it can feel. At the NuView Treatment Center, we offer a full continuum of personalized outpatient care for OCD - from partial hospitalization programs ,to step-down intensive outpatient programs and telehealth services.

Please do not hesitate to reach out to us at (323) 307-7997 to connect with our expert team now!

Is OCD linked to personality traits like perfectionism?

Certain traits, such as perfectionism, may increase susceptibility but do not directly cause OCD.

Can stress alone cause OCD?

No, stress does not generally cause OCD by itself, but it can trigger the onset or worsen symptoms in someone who is vulnerable.

Can trauma lead to OCD?

Yes, studies have indicated that trauma can lead to OCD or worsening of OCD symptoms.

Does parenting style cause OCD?

Parenting styles do not directly cause OCD; however, overly rigid or high-control environments may impact how symptoms present themselves.

Can OCD develop later in adulthood?

Yes, OCD can begin in adulthood, especially during hormonal changes, major life transitions, or periods of prolonged stress.