What Causes OCD? | Orlando OCD Specalist Shares Information 

At GroundWork in Orlando, we work with children, teens, and adults struggling with various forms of OCD.

Often, individuals and their families seek information as to “what caused OCD?”

Obsessive Compulsive Disorder (OCD) is a chronic mental health condition that consists of obsessive, unwanted, distressing thoughts and compulsive mental and physical rituals. OCD tends to have a considerable negative impact on an individual’s levels of functioning socially, academically and professionally. According to the World Health Organization, OCD is among the ten most disabling medical conditions in the world.

OCD is common in children and adults and it is equally prevalent in males and females. The first onset of OCD often occurs in childhood or during the teenage years, with 19 being the average age of onset. OCD that begins during the childhood years is more common in boys than girls and childhood-onset OCD appears to run in families more than OCD that begins as an adult. Several large studies have found that the most common obsession is contamination and the most common compulsion is checking. However, most people who suffer from OCD have multiple obsessions and compulsions over time.

So, What Causes OCD?

In spite of a great deal of research, the exact cause of OCD is not known. Research does indicate that OCD is a neurobiological disorder, which means it is a disorder of the nervous system. OCD is likely caused by a complex interaction of genetic, psychological and environmental factors.

Clinicians have long suspected that genetics play an important role in the development of OCD. One of the first studies of OCD was conducted in 1932 at the Maudsley Hospital in London. Researchers found that in 50 cases of OCD, 37% of parents had “pronounced obsessional traits” and 21% of siblings had “mild or severe obsessional traits”. Since these early reports, there have been many rigorous family studies and most support the hereditary transmission of OCD. A large study conducted at Johns Hopkins University in 2000 had results that were remarkably similar to the early Maudsley Hospital report.

The genetic explanation of OCD suggests the biochemical factors that may play a part in OCD are lower levels of serotonin as well as abnormally high levels of dopamine, which suggest that other neurotransmitters are also involved in OCD. Medications that increase serotonin levels (SSRIs) have been shown to reduce the symptoms of OCD, however, in some instances, symptoms have worsened and in most cases, medications seem to only give partial improvement of symptoms. The individuals with OCD that find medication successful tend to experience a 40-60% reduction in OCD symptoms. Basal-ganglia abnormalities in the prefrontal cortex, where decision making and judgment take place, have also been found in OCD sufferers. The orbitofrontal cortex, another region of the prefrontal cortex that sends “worry signals” also appears to be implicated as the caudate nucleus that normally suppresses these worry signals has been found to be abnormally small in those with OCD.

What We Do Know:

OCD is not caused by parenting. Although Sigmund Freud posited that OCD was caused by strict and rigid parenting and punitive toilet-training, there is absolutely no evidence that a certain parenting style or the way a child is disciplined causes OCD and parents should never be blamed when a child has OCD. Although parenting absolutely does not cause OCD, parents may unintentionally help to maintain OCD symptoms by making accommodations for OCD behaviors.

OCD is not caused by stress or trauma. Although stress and trauma cannot “cause” OCD, stressful situations or traumatic events can precipitate or exacerbate symptoms in those who have a genetic predisposition for OCD. Stress triggers can include divorce, death of a loved one, birth of a child or sibling or life transitions such as marriage, moving to a new home, attending a new school, and so on. Psychoanalysis and talk therapies that explore childhood trauma, self-esteem issues or focus on family dynamics are not effective treatments for OCD.

OCD is not caused by demons. Some religious websites and religious leaders believe that OCD is caused by a demon or spirit – this is one of the most damaging misconceptions. It is absolutely not demonic torment that is brought on by a person’s fear and shame. OCD does not stem from a sin the person may have committed. OCD is, without a doubt, a mental disorder. Any religious leader who discourages an individual from receiving effective treatment such as Exposure and Response Prevention (ERP) and/or medication is making a major error and is doing a great deal of harm to his/her constituents. All members of the clergy must recognize that they are in an important position to provide correct information about OCD to the individuals they counsel.

Effective OCD treatment is not focused on trying to find the “cause” of OCD, rather, efforts are used to provide evidence-based ERP treatment to decrease symptoms. Unfortunately misinformation about OCD can lead to misdiagnosis and ineffective or possibly even harmful treatment for many OCD suffers.

However, finding a therapist who can correctly diagnose and effectively treat OCD can be very challenging. Effective treatment from therapists who have received specialized training in Exposure and Response Prevention (ERP) is available at GroundWork Counseling in Orlando. With proper treatment, most people with OCD can achieve significant relief from their OCD symptoms.

Questions for OCD providers & therapists

Learn More: International OCD Foundation