Is OCD An Hereditary Condition?

Obsessive-compulsive disorder (OCD) is a chronic mental health condition. According to the American Psychiatric Association, up to 3%¹ of the US population has OCD.

With OCD, you may get particular thoughts and an urge to act a certain way.

Obsessions may be around hygiene, safety, or many other things. If you’re concerned about hygiene, you may repetitively wash your hands. If safety is your main obsession, you may check the locks several times before being confident that you’re safe from intruders. 

The common name for these behaviors is rituals. They’re compulsive, rather than choices you make, and they may limit, disrupt or complicate your life. Even if you know your thoughts are unlikely to happen, you may still act on them.

That’s because you believe your compulsions prevent specific fears from becoming a reality. They also reduce the stress caused by obsessive thoughts.

What are the symptoms of OCD?

There are two main symptoms of OCD: Obsessions and compulsions. You may experience obsessions, compulsions, or both.

Obsessions

You may experience a wide range of obsessive thoughts. Common obsessions include:

• Illness, germs, and dirt

• Fear of offending other people or saying obscene things

• Concern over “impure” or intrusive thoughts about sex or violence

• Organizing your personal belongings in a certain way, by color or symmetry

• Worrying about throwing things away

Compulsions

A compulsion is an urge to behave in a certain way. You may notice some of these symptoms:

• Washing yourself and items regularly

• Organizing objects in a specific way

• Repeating numbers or phrases

• Touching a particular object several times

• Constantly seeking reassurance

• Collecting certain items or buying several at once

You may perform rituals where you repeat particular actions several times to confirm everything is in order.

What causes OCD?

The exact cause of OCD is still unknown.² However, studies have explored these areas: 

Biological factors

Some mental health researchers have tested whether biological or genetic factors cause OCD by using brain scans. Typically, studies have focused on these causes:

• Brain circuitry

• Genetics

• Chemical imbalances

The scans often indicate differences between the brains of patients with OCD and those without. However, the cause of the differences is often unknown, but researchers³ have noted variances in aspects such as blood flow in the brain. Still, it’s difficult to separate the cause or effect of OCD.

PANDAS (Pediatric autoimmune neuropsychiatric disorders)

This theory focuses on the effects of streptococcus bacteria. Streptococcus infections cause several illnesses, from mild throat infections to pneumonia in severe cases. 

Research has shown that the basal ganglia (structures deep in your brain) may be related to the development of OCD. Strep infection may generate antibodies that can cross-react with the basal ganglia. This has subsequently resulted in OCD symptoms in children after a strep infection. 

However, studies have not proven a causal link between streptococcus infection and OCD. Strep infection may not directly cause but trigger OCD in children predisposed to the disorder through genetics or other pathways. 

Genetic factors

Like other mental health conditions, there is likely a genetic link. Studies⁴ have found that people with a family member with OCD are more likely to experience OCD than those without a family member with the condition. Despite this evidence, researchers are yet to identify a specific gene responsible for OCD. 

Chemical imbalance

Scientists have studied the impact of neurotransmitters on OCD. Neurotransmitters⁵ are chemical messengers that transfer information from one part of the brain to another. Serotonin regulates functions such as memory, anxiety, and sleep. It may contribute to OCD symptoms. 

Doctors use serotonin reuptake inhibitors (SSRIs) to treat the symptoms of OCD. These drugs also treat comorbidities (when you have more than one condition), such as generalized anxiety, which may reduce your OCD symptoms. 

Psychological theories

Other studies indicate that environmental, behavioral, and cognitive factors play a significant role in OCD. The premise has led to cognitive behavior therapy (CBT) being one of the main treatments for OCD. CBT aims to manage OCD’s psychological factors.

The main psychological theories in the diagnosis and management of OCD are:

Cognitive theory

Some experts claim that OCD can be due to strong beliefs, and the misinterpretation of the ideas causes OCD.

The cognitive model of OCD proposes that everyone experiences intrusive thoughts occasionally. For people with OCD, these can be persistent and highly uncomfortable. Amid the distress, you may engage in behaviors to neutralize the thoughts or prevent things from happening. 

The cognitive theory focuses on the meaning we attach to thoughts and events. It aims to help you understand where your thoughts originate from and why they result in specific behaviors. Once you’ve identified this pattern of thinking and behavior, you can develop strategies to reduce the cycle. 

Exposure and response prevention therapy (ERP)

Behavioral theory⁶ is the idea that obsessive thoughts arise due to high anxiety levels around a topic. You develop avoidance behaviors that exacerbate the anxiety associated with the original thought. 

In ERP therapy, your therapist exposes you to stimuli to prevent or reduce avoidance behaviors. In the longer run, your therapist will help you replace your obsessions and compulsions with healthier reactions.

Psychoanalytic theory

The psychoanalytic theory attributes OCD symptoms to your life experiences, especially in infancy and childhood. Fixation (obsessing over a particular event) is central to the approach.

In the past, scientists used this theory to explain OCD. However, psychoanalytic interventions have failed to manage OCD, so the idea doesn’t carry much weight. 

Stress

Some theories propose that OCD may have links to environmental factors such as parenting styles. However, no conclusive evidence validates these ideas.

Stress may trigger the onset of OCD, and untreated stress could worsen OCD symptoms, but it doesn’t appear to cause it.

Depression

Similar to stress, depression worsens OCD symptoms. There is no evidence that it causes OCD.

Risk factors in OCD

Particular factors correlate with a higher likelihood of developing OCD:

• Stress: Stress can trigger OCD or make symptoms worse.

• Personality: Your personality may involve aspects such as heightened worrying when you are nervous. The resultant stress could worsen OCD.

• Traumatic brain injury (TBI): Some studies⁷ indicate that OCD could result from a severe brain injury.

• Pediatric autoimmune neuropsychiatric disorders: OCD has links to PANDAS,⁸ an autoimmune reaction to strep infection during childhood.

How is OCD diagnosed?

While you may experience compulsions and obsessions, your therapist can confirm whether or not you have OCD.

Symptoms of OCD, such as anxiety (as a reaction to certain factors), may be apparent in childhood. However, OCD may be chronic and develop slowly over time. Therefore, a diagnosis may be delayed in some cases. 

When you speak to your doctor, they may ask the following questions to establish whether you have OCD symptoms and their extent:

• How much time do you spend per day on particular activities?

• The measures you take to suppress specific unwanted thoughts and actions.

• Whether you believe certain things (OCD-related).

• The effects your OCD actions and thoughts have on you.

Your therapist may ask if you are taking particular medications and ask about the side effects.

OCD has symptoms that overlap with other mental health issues. Some conditions that your doctor may misdiagnose as OCD include:

• Body dysmorphic disorder⁹ involves obsessing over your body image. The obsession may be confused with OCD.

• Trichotillomania¹⁰ involves a persistent urge to pull your hair out.

• Depression¹¹ may come along with obsessive thoughts that can trigger compulsive traits similar to those observed in OCD.

• Hoarding disorder¹² is where you collect items even when you don't need them. In OCD, you may save items to achieve order or protect yourself from perceived harm.

• Generalized anxiety disorder¹³ causes unnecessary worry about daily activities. It may be accompanied by compulsions as you try to minimize risks, making it easy to confuse with OCD.

How is OCD treated?

Your therapist may recommend medications, therapy, or a combination. Psychological therapy is the first-line treatment. 

Therapy

Your doctor may recommend therapy as a combined approach to managing OCD. Your therapist may help you:

• Develop tools for managing unhealthy behavioral patterns or unwanted thoughts

• Create strategies to reduce emotional distress and improve relaxation

They may suggest one of the following therapy options:

• Cognitive behavior therapy:¹⁴ CBT aims to reframe unwanted thoughts and actions.

• Exposure and response prevention (ERP):¹⁵ In ERP, your therapist may expose you to some of your fears rooted in your obsessions. ERP is a form of CBT.

• Mindfulness-based cognitive therapy:¹⁶ Mindfulness refers to being aware of your thoughts. Your therapist may enable you to identify factors (triggers) of OCD and how to manage them better.

Medication

Your doctor may recommend the following medication to manage OCD:

• Selective serotonin reuptake inhibitors (SSRIs): Specific medication may include fluoxetine (Prozac) or sertraline¹⁷ (Zoloft).

• Your doctor may use other medications if they are appropriate for you. 

Maintaining effective communication with your therapist allows you to report unwanted side effects. They may switch your medication if necessary.

The lowdown

OCD is a condition where obsessive thoughts cause anxiety. You may experience repetitive thoughts and be convinced to act upon them by compulsions. You may perform particular rituals to feel safer.

Some symptoms of OCD are either obsessions, compulsions, or both. You cannot ascertain if you have OCD unless you consult your doctor, as these symptoms can indicate another condition. Your doctor may ask you questions to establish whether you have OCD.

The treatment for OCD includes therapy, medication, or both. Therapy may involve identifying triggers of unwanted thoughts and developing strategies to manage them better.

FAQs

What can I do if my child has OCD?

Doctors treat OCD through therapy and medications. Your primary role when your child has OCD is to support them in the following ways:

If you have concerns that your child has OCD, ensure they see a doctor for a diagnosis.  

• Once diagnosed, take your child to appointments as needed. If your child’s doctor prescribes medications, administer them in the proper dosages and at the right time.

• Maintain good communication with your child to address issues such as the embarrassment that may come with the disorder.

• Create a suitable treatment plan with your doctor. Build an inclusive team that incorporates professionals such as teachers to maximize your child's safety and comfort.

• Reach out to other parents whose children have OCD. Learning from others can be invaluable.