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Written by:Ashley Ertel, LCSW, BCD

Published On: August 1, 2022

Medically reviewed by: Bisma Anwar, MA, MSc, LMHC

Reviewed On: August 2, 2022

Updated On: July 17, 2023


What are the causes of OCD? Despite significant research and various theories, we don’t yet fully know a definitive cause for obsessive-compulsive disorder (OCD) — the mental health condition that causes unwanted, repetitive, and intrusive thoughts (obsessions) that often lead to involuntary, destructive acts (compulsions) to relieve those obsessive thoughts.

However, researchers do believe that one or more genetic, environmental, or biological factors contribute to the likelihood of someone developing this common condition that affects an estimated 1% of the population.

Read on to learn what we know about the probable causes of OCD and what you can do if you think you or a loved one is living with this tricky but treatable mental health condition.

What Research Says

The precise cause of any of the types of OCD is not fully known. However, what we do know is that it seems to be related to one or a combination of the following:

  • Comorbid mental health conditions like an anxiety disorder or depression
  • Imbalanced brain chemistry
  • A change in brain function
  • Environmental factors
  • Family history of obsessive-compulsive disorder
  • A specific type of streptococcal infection
  • Alcohol or drug abuse
  • Unmanaged stress — note that while stress doesn’t actually cause OCD, it seems that trauma may trigger symptoms in those predisposed to it


OCD is a disorder that tends to onset slowly, but it’s not uncommon to be able to trace when the related obsessions and compulsions begin.

Very early research found that OCD can be related to either life changes or an extremely stressful life event. This can be especially true when an event results in incredible responsibilities, for example, the birth of a baby, a new big promotion or job, or a divorce. For some people, even the onset of puberty can trigger OCD. The key findings of this research recognize that compulsive rituals help serve a specific purpose for people with OCD — an attempt to reduce their discomfort.

“The general public commonly misunderstands OCD, so if you’re struggling with clinical OCD, it can feel difficult to find answers to your questions amidst people who flippantly use the term. Be encouraged and keep reading for a deeper understanding of what may be going on and how you can find some relief.”

Licensed Clinical Social Worker (LCSW), BCD, C-DBT Ashley Ertel

Four Possible Causes of OCD

Everyone is affected uniquely by their upbringing, subjective experiences, life events, genetic makeup, self-image, self-esteem, learned behaviors, and unlimited other variables. It’s also worth noting that different subsets (types) of OCD can present with different symptoms and behaviors.

Understand that there may not be one single culprit to blame for causing OCD. Thus, it can help to look at some of the distinct factors we know about that might play a role in whether or not someone develops the condition.

1. Genetics

Possible OCD causes can, at least in part, include genetic makeup. Research has shown us that obsessive-compulsive disorder clusters in families, making it very likely that there’s a genetic component.

However, genes appear to be only partially responsible for causing OCD. Certain genes may be activated by excessive stress in life, illness, or other conditions, resulting in OCD symptoms.

Significant efforts have been made to discover the genetic basis of OCD. However, much remains unknown about how both genetic and environmental risk factors can interact when OCD is present. More research is needed.

2. Environmental

According to researchers at VU University Amsterdam, understanding what causes OCD means we should consider environmental factors. Things like experiencing major stress or a traumatic experience like the death of a loved one might contribute to the onset of symptoms.

That said, we still need to do much more research if we’re to link solid, specific scientific evidence between environmental factors and the onset of OCD.

3. Psychological

We believe obsessive-compulsive disorder involves psychological factors caused by a direct lack of communication between the frontal brain and deeper brain structures.

This inefficient communication may be due to an imbalance in levels of neurotransmitters, including serotonin, dopamine, glutamate, and others. It could also be caused by faulty brain circuitry, brain damage, or other chemical imbalances.

According to research, studies examining brain images consistently show a difference in blood flow patterns in those diagnosed with OCD. Compared with control subjects, it appears likely that cortico-striatal-thalamic-cortical (CSTC) circuitry abnormalities are at least somewhat at play.

4. Depression

According to researchers at Maastricht University, a third of OCD patients in their study were depressed. Further research confirms that depression occurring in those with OCD is common. That said, whether depression actually causes OCD, or is a result of it, remains to be determined.

“While knowing what has caused your diagnosis of OCD may feel comforting, it’s also okay if you’re not able to pinpoint a single source. Many mental health diagnoses are caused by multiple factors, and the cause is often less important than participation in your treatment plan.”

Licensed Clinical Social Worker (LCSW), BCD, C-DBT Ashley Ertel

Understanding More About OCD

What are the causes of OCD? The bottom line is that, at least for now, nobody knows for sure exactly what causes OCD. However, we do have an abundance of research that allows us to learn more about obsessive-compulsive disorder, and when you know more, you’ll be able to manage OCD symptoms better. The most important thing to remember is that you can find help if you need it.

When it comes to how to deal with OCD, many people with OCD are surprised at how fast they experience benefits from OCD treatment. It can allow them to regain control over their obsessions, minimize compulsive behaviors, and develop increased confidence and enjoyment in life.


Research from large trials supports that cognitive behavioral therapies are effective and should be used in treating OCD. Regardless of the cause of OCD, a subtype of cognitive behavioral therapy for OCD, called exposure and response prevention (ERP), is the most effective frontline treatment.

The International OCD Foundation (IOCDF) notes that “exposure” in ERP refers to being exposed to thoughts, sensations, mental pictures, situations, or objects that you find trigger your obsessions. The “response prevention” in ERP refers to identifying and putting coping strategies in place so you can learn to remain mindful of your actions, especially during your obsessions.

Exposure therapy for OCD is controlled and safe. They allow the individual to experience obsessions and control compulsive reactions with the help of a skilled therapist. Over time, repeated exposure to triggers and an ability to control reactions enable people with OCD to experience fewer and less intense OCD symptoms.


OCD medication can also be an effective OCD treatment option, especially when used in combination with therapy.

Self-help techniques

Learning to practice self-care is important in all areas of life. From mental health, to being productive at work or school, to maintaining healthy personal relationships, when we take care of ourselves first, we’re able to give and do more in every aspect.

Online therapy with Talkspace has helped countless people gain control over their OCD. It’s a convenient way to access the therapy you need to manage obsessive-compulsive disorder and any other mental health condition you’re trying to cope with.

Find out how online therapy can offer affordable, easy-to-access therapy that you can do right in the comfort of your own home. You deserve to get the effective help you need. Talkspace is there to ensure you can find it.

Ashley Ertel, LCSW, BCD

Ashley Ertel, LCSW, is a Nationally Board Certified Licensed Clinical Social Worker. She has over a decade of experience specializing in trauma and depression, working primarily with first responders, military personnel, and veterans, and sexual assault survivors.

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