Causes and Risk Factors

The exact cause of OCD is not fully understood, but several factors are believed to be involved: 

  • Genetics: OCD often runs in families.

  • Brain biology and chemistry: Differences in certain brain structures and the levels of the neurotransmitter serotonin may play a role.

  • Environment: A history of stress, trauma, or abuse may increase the risk. In some cases, a sudden onset of symptoms in children after a streptococcal infection (PANDAS) has been noted. 

If you or a loved one is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org. 

Obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by a cycle of uncontrollable, recurring thoughts and fears (obsessions) and repetitive behaviors or mental acts (compulsions) performed to reduce the distress caused by these thoughts. These symptoms are time-consuming, taking up at least one hour per day, and significantly interfere with daily life, work, or social functioning. 

Symptoms

People with OCD may have obsessions, compulsions, or both. They often recognize that their thoughts and behaviors are irrational but feel unable to stop them. 

Obsessions (unwanted, intrusive thoughts, urges, or images): 

  • Fear of contamination by germs, dirt, or bodily fluids.

  • Doubts about having done something correctly, such as locking a door or turning off a stove.

  • Need for order, symmetry, or perfection.

  • Aggressive or horrific thoughts about harming oneself or others.

  • Unwanted sexual or religious (blasphemous) thoughts. 

Compulsions (repetitive behaviors or mental acts performed in response to an obsession): 

  • Excessive washing or cleaning (e.g., hand-washing until skin is raw).

  • Repeated checking of locks, appliances, or switches.

  • Ordering or arranging items in a precise way.

  • Compulsive counting or repeating words or phrases silently.

  • Seeking constant reassurance from others. 

Diagnosis and Treatment

If symptoms are present, a healthcare professional or mental health specialist should be consulted for a comprehensive evaluation. Diagnosis involves assessing symptoms, medical history, and ensuring they are not caused by substance use or another medical condition. 

OCD is a chronic condition, but it is highly treatable, and symptoms can be effectively managed with proper care. Treatment options include: 

  • Psychotherapy: Exposure and Response Prevention (ERP), a specific type of cognitive-behavioral therapy (CBT), is considered the "gold standard" treatment. ERP involves gradually exposing yourself to the feared obsession (e.g., touching a doorknob) while resisting the urge to perform the compulsion (e.g., washing your hands).

  • Medications: Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, are commonly used to help reduce symptoms. These may take several weeks to work and often require higher doses for OCD than for depression.

  • Support: Joining a support group can provide mutual support and connect you with others facing similar challenges. You can find resources on the Anxiety and Depression Association of America (ADAA) or National Alliance on Mental Illness (NAMI) websites.