What Causes OCD?

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By Dr. David Woo - May 15, 2023

Obsessive-compulsive disorder (OCD) is an anxiety disorder that often manifests with repeating, ritualistic behaviors that the patient feels compelled to perform in order to manage intrusive thoughts. Like many other mental health disorders, it is not easy to say precisely what OCD is caused by; there are a range of factors that affect someone’s risk of developing OCD and at what severity. Understanding the different causes and contributing factors and how they interact can be extremely helpful in recognizing, managing and treating OCD.

Different Causes of OCD

The causes of OCD are varied and not mutually exclusive. Symptoms of OCD can be caused by one or more of the following factors.

Biological Causes

The physical state of the brain affects our thoughts, feelings, and mental condition; as such, it plays a significant role in disorders such as OCD. Imaging studies conducted on the brains of OCD patients have shown abnormalities in certain regions.

For example, OCD patients sometimes have an underactive ventromedial prefrontal cortex, which is responsible for evaluating safety or danger(1). This can result in perceiving normal situations as threatening. Other brain abnormalities documented in OCD individuals include reduced blood flow, dysfunction in the basal ganglia(2), and impaired frontostriatal function(3). The biological state of the brain can also be disrupted by brain injury, after which some people develop symptoms of OCD.

Genetic Factors

Researchers have yet to identify a specific gene that causes OCD, although there are some that appear to contribute. However, current studies do indicate that OCD runs in families(4). OCD is more likely to occur in someone with a family history of it, although there are many OCD patients who do not.

Life Experiences

OCD could also be a learned behavior in response to certain life experiences. For example, patients could adopt rituals learned from parents or developed as coping mechanisms in response to trauma, which create a fear of certain objections or situations. Periods of intense stress may also be triggers for OCD.

Treatment for OCD

While it can be difficult for patients to break the cycle of obsessions and compulsions, it is very possible thanks to several different treatment options. One example is cognitive-behavioral therapy, which helps patients overcome negative thoughts and behaviors. Medication can also help regulate brain chemistry, although it is not effective for everyone.

One newer treatment for OCD that should be considered is transcranial magnetic stimulation (TMS), a non-invasive, drug-free treatment. Magnetic pulses delivered via a headpiece boost brain activity in regions associated with OCD symptoms, directly targeting its biological factors. TMS is FDA-approved for OCD and a variety of other mental health conditions, and can be the ideal option for patients seeking an alternative to mood-altering pharmaceuticals.

If you or a loved one is experiencing symptoms of OCD, then it’s important to seek professional help as soon as possible. Madison Avenue TMS & Psychiatry offers talk therapy and TMS for the treatment of OCD and other conditions. These treatments can help you find relief from your symptoms and live a fulfilling, satisfying life. To make an appointment for consultation or treatment, contact us online or call (212) 731-2033.

The Conversation. Brain scans reveal why it is so difficult to recover from OCD – and hint at ways forward. Updated March 7, 2017. Link. Accessed March 2, 2023.
Rapoport, J. Obsessive compulsive disorder and basal ganglia dysfunction. Psychological Medicine. 1990;20, 465-469. Link. Accessed March 2, 2023.
Vaghi M, Kitzbichler M., Kundu P., Bullmore P., Robbins T., et al. Specific Frontostriatal Circuits for Impaired Cognitive Flexibility and Goal-Directed Planning in Obsessive-Compulsive Disorder: Evidence From Resting-State Functional Connectivity. Biological Psychiatry Journal. 2017;81,8,708-717. Link. Accessed March 2, 2023.
Zai, Gwynetha, Barta, Csabad; Cath, Daniellee, Eapen, Valsammag; Geller, Danielh; Grünblatt, Ednai. New insights and perspectives on the genetics of obsessive-compulsive disorder. Psychiatric Genetics 2019;29(5):p 142-151. Link. Accessed March 2, 2023.

Dr. David Woo

Dr. David Woo is the owner and head clinical psychiatrist at Madison Avenue TMS and Therapy in New York City. Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.

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