Is OCD Genetic? Possible Causes & Risk Factors

What Is Obsessive Compulsive Disorder (OCD)?

Obsessive compulsive disorder (OCD) is characterized by obsessions, (unwanted intrusive thoughts) and compulsions (rigid and repetitive behaviors). Compulsions develop as someone attempts to rid themselves of or cope with the anxiety caused by obsessions, causing an OCD cycle.⁴ OCD is one of the most debilitating forms of mental illness, and often causes people extreme distress and impairment. The symptoms of OCD generally begin emerging in childhood or adolescence.^1,2,5

A person’s specific obsessive thoughts and compulsive behaviors can vary depending on the type of OCD they experience. For example, someone with contamination OCD may struggle with intrusive thoughts about germs and bacteria, resulting in compulsive hand-washing, disinfecting, or cleaning. Someone else might have relationship OCD and perform mental rituals to try to calm their obsessions about being in the wrong partnership. Without treatment, OCD symptoms can worsen to the point where the condition consumes the majority of a person’s time and energy.^4,6

How Does OCD Develop?

Experts theorize that OCD develops as a complex interaction between a person’s genes and their environment. Family and twin studies document biological and genetic components of OCD, although research is ongoing around which specific genes and brain areas are involved. One study documented a breakdown of 65% heritability of OCD, leaving 35% to develop from environmental factors.⁷ When OCD runs in someone’s family and environmental factors, such as having trauma or severe stress occur, a person is more likely to develop OCD.

Is OCD Hereditary?

OCD has a hereditary component. Studies indicate that having a close family member with OCD, such as a parent or sibling, more than doubles a person’s likelihood of developing the disorder.¹ Further results suggest this possibility may actually be much higher, showing that there can be a genetic component to developing OCD.^2,3

Additionally, research into molecular genetics has identified specific genes that may be involved in OCD. Still, this does not guarantee that a person will develop the condition just because another close family member has it.^5,8,9

Are You Born With OCD?

Some experts theorize that you can be born with a genetic predisposition to develop OCD. Family and twin studies have confirmed that OCD has some genetic components.¹⁰ Rather than being born with the disorder itself, you may be more likely to develop OCD if a family member has it.

Having a family member who has OCD puts you at a genetic risk and may also affect your environment, leading to the development of the disorder. For example, if a parent has OCD and you also grow up in a home watching someone engage in compulsions, you are more likely to develop OCD.

What Are the Chances of Inheriting OCD From a Parent?

If you are diagnosed with OCD, it does not mean that your child will develop it themselves, even if they’re genetically predisposed. In some cases, it is possible to offset genetic risks with protective factors.^5,8 It’s important to remember that if your child does experience OCD, there are many effective treatments available. OCD symptoms can often be managed or even overcome with early treatment.^11,12

Environmental Causes of OCD

It is theorized that genetic and biological predispositions for OCD can be “activated” by certain stressful events or circumstances. Some of these risk factors are common to many mental illnesses, while others are unique to OCD.

Environmental risk factors of OCD may include:^5,8,13

• Experiencing trauma in childhood
• Having an overprotective parent
• Heavy substance use in adolescence
• Experiencing many major life events and changes at once
• Being the victim of rape or sexual assault
• Separation anxiety in children and teens
• High levels of toxic stress
• Having another co-occurring condition along with OCD

Risk Factors for OCD

There are several other biological factors that increase the risk of developing OCD. There is some research suggesting edema, excessive weight gain, and complicated, prolonged labor during pregnancy may increase the risk of OCD in offspring. However, this thesis needs to be proven in future studies.⁸ Additionally, shifting hormones and stressors from giving birth may trigger postpartum OCD.⁵

Some people may develop OCD after contracting certain illnesses, such as strep infection (a phenomenon known as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections [PANDAS]). Studies indicate that, while infection doesn’t necessarily cause OCD, it can trigger the onset of OCD in children who are genetically predisposed.¹³

Certain personality traits may increase a person’s risk as well, such as high levels of perfectionism, conscientiousness, and neuroticism.¹³

Can OCD Be Learned?

Learned behavior can be partially responsible for causing OCD. Learned behavior comes from observing someone else engaged in behaviors, such as compulsions, and then copying those behaviors yourself. For someone with OCD, they may sometimes pick up on obsessional thinking and compulsive behaviors from family members. For example, watching your parent obsess over contamination-related fears and then engage in compulsive cleaning behaviors could encourage you to utilize these behaviors to deal with your own distress.

Is OCD a Chemical Imbalance?

OCD can be influenced by a chemical imbalance of certain neurotransmitters, and experts are looking into which ones are involved. Some research indicates a dysregulation of the neurotransmitter glutamate in individuals who have OCD.¹⁵ Glutamate is involved in learning, plasticity, and memory. This imbalance leads to dysfunction in the goal-directed areas of the brain and habit learning areas of the brain.¹⁵

Is There a Link Between OCD & Serotonin Deficiency?

Similar to other mental health disorders like depression and anxiety, some research supports OCD as having links to low levels of serotonin. All that is known for sure is that OCD symptoms commonly improve with SSRI treatment, which has led researchers to theorize that low levels of serotonin may cause OCD symptoms.¹⁶ This is simply one theory of how OCD develops, and it is important to recognize that even though serotonin levels may be low in individuals with OCD, this does not mean it is the one and only cause of symptoms.

Treatment for OCD

While OCD is usually a chronic condition, there are several effective treatments for OCD. Therapy is considered the frontline approach, but may sometimes be combined with medication. In therapy, people learn how to cope with obsessive thoughts without relying on compulsive behaviors. Breaking compulsive habits slows or halts the progression of OCD symptoms for many, and is an important aspect of managing the condition.¹¹

Therapy for OCD

Certain types of therapy have proven  effective for individuals with OCD, including:^11,12

• Exposure and response prevention (ERP)
• Cognitive behavioral therapy (CBT) for OCD
• Acceptance and commitment therapy (ACT) for OCD

OCD is commonly misdiagnosed, so it’s important to find the right therapist who specializes in treating the condition to obtain an accurate diagnosis.¹⁷ Many people begin their search by using an online therapist directory that allows them to filter results based on location, insurance, and specific treatment needs. There are also specific online OCD treatment programs, like NOCD, that offer knowledgeable specialists.

Medication for OCD

In addition to therapy, some individuals with OCD also benefit from psychiatric medication. Antidepressants like SSRIs are generally the most common type of medication for OCD prescribed. However, benzodiazepines, antipsychotic medications, or anticonvulsant medications are sometimes recommended if antidepressants aren’t alleviating symptoms.¹¹

Medications may help people with OCD reduce obsessive thoughts, anxiety, and urges to engage in compulsive behaviors. Because OCD often co-occurs with depression, anxiety, or other mental health conditions, prescriptions may be needed to help reduce symptoms of accompanying disorders as well.¹¹

Can OCD Be Cured?

OCD cannot be cured. It is a common desire of people with OCD to make their obsessions disappear through treatment, but it is important to understand OCD is a lifelong condition, and no level of treatment can make obsessions and compulsions stop altogether. Rather, through therapy and medication, a person can learn to make lifestyle changes and learn to respond more adaptively to OCD obsessions without using compulsions.