You may have said it or heard others say, “I’m so OCD.” But do you know what you’re saying? For some, those words carry more weight than you can think. It’s one thing to be neat and need your life to be in order, but it’s another for it to be an obsession. Obsessive-compulsive disorder (OCD) can be severe enough that some individuals believe if they don’t complete their ritual, bad things will occur. The messy truth about obsessive-compulsive disorder revealed by author Ethan Smith takes a look into the severity of the ailment.

“I barely made it through my twenties. In my early thirties, I hit rock bottom. I was bedridden in my parent’s guest bedroom, paralyzed by OCD.” Ethan’s accounting of OCD paints a picture of someone who is diagnosed. His story goes onto mention his stint in three separate psychiatric hospitals, intensive outpatient therapy, and two months at an OCD institute in his hometown Boston. He ended up kicked out of his treatment and forced to live on the street in the middle of a frigid winter.

OCD is not what we see on TV. Most people won’t wash their hands, organize, or clean. Most people won’t be afraid of germs, but many fear they will lose control of their lives. OCD preys on your unique fears that do not exist in reality. For some, it may be germs, but for others, it can be taboo topics, such as self-harm. While the fears many seem irrational and easy to brush aside for some, it can be debilitating for others.

Many of us may wonder where OCD comes from – is it genetic? Is it learned? It is a challenging question that has been studied for the past 100 years. There is good evidence of a genetic contribution to the disorder, but studies have also shown environmental risk factors are likely to be involved. There is an intricate pattern of inheritance, and molecular studies have found several relevant genes. Even with 100 years of research, much more is needed to establish a definitive cause of the condition.

What Is OCD?


The Mayo Clinic describes obsessive-compulsive disorder (OCD) as a pattern of unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). For some, the condition may be debilitating. As we touched on with Ethan’s story above, it took rock bottom for him to reclaim his life. For some, however, it can be a losing battle.

Those with the disorder may attempt to ignore the obsessions, but it will gradually increase your anxiety and distress. Eventually, you will feel driven to perform compulsive acts to try and ease the stress. Despite your best effort to get rid of or ignore these intrusive thoughts or urges, they will keep coming back. It will lead to more ritualistic behavior, which is known as the vicious cycle of OCD.

Symptoms of OCD

OCD typically includes both compulsions and obsessions. It’s likely that you may only have obsessive symptoms or only compulsive symptoms. You may not be aware that your obsessions or compulsions are excessive and unreasonable, but they can take up a great deal of your life and interfere with your daily routine.

OCD obsessions are persistent or repeated unwanted thoughts, images, or urges that cause distress or anxiety. Those struggling may try to ignore these thoughts by performing compulsive behavior or rituals. Some people believe that by not fulfilling these desires, they will experience adverse outcomes. Unfortunately, the obsessions will slowly take over your life.

The most common symptoms include:

  • Unwanted thoughts, which include aggression, sexual, or religious subjects
  • Images of hurting yourself or others that make you uncomfortable
  • Fear of being contaminated if you touch an object or contaminating someone else
  • Doubting that you’ve locked the door
  • Severe stress when objects aren’t orderly or facing a certain way
  • Distressing sexual images that repeat in your mind

Is OCD Genetic?

OCD has been proven genetic, but what has not been proven clear is which genes are affected. OCD is thought to be caused by a combination of different genes. In these cases, you may be more vulnerable to a given disease depending on various versions of genetics you inherit from your parents. While we have found the missing link, your environment may play a more significant role in the illness than we once thought.

Someone that is genetically vulnerable to lung cancer, for example, may only develop the disease if they smoke cigarettes or are exposed to pollution. The same can be said for OCD – there is an argument about nature versus nurture, and experts indicate that our genes “load the gun,” while it is our environment that pulls the trigger.

If the OCD runs in your family, it may be in your best interest to speak with a professional to determine what can be done. OCD is a complex condition that can be debilitating, and your best defense is to educate yourself and figure out options to combat the disorder.

What Causes OCD?

Is OCD genetic? Is OCD hereditary? Unfortunately, the precise cause of OCD has yet to be determined, but scientists believe genetics plays a significant role in its development. Experts suggest that OCD involves issues with communication between the front part of your brain and its deeper structures. These brain structures use the neurotransmitter serotonin, and the brain circuits in those diagnosed with OCD will stabilize once medications that affect serotonin levels are prescribed. Cognitive behavioral therapy is another option, usually used with medication to correct the chemical imbalance.

Is OCD genetic or learned is another common question. Now that we’ve established that most research points to it being genetic, you might wonder if it’s something learned. OCD runs in families, but it’s only a piece of the puzzle. No one truly understands what other factors influence the disorder. Could it be an illness that kicks off symptoms? Is it typical daily stress that activates the genes associated with OCD symptoms? Unfortunately, despite tons of research on the topic, much is still left to learn.

Some other potential causes of OCD include the following:

  • Changes in your living situation, such as getting married or divorced, moving, or starting a new job or school
  • The death of a loved one or significant emotional trauma
  • A history of getting abused
  • Issues at work or school
  • Illness, such as contracting COVID or the flu, which renews a cycle of obsessing over germs, causing you to wash compulsively
  • Low serotonin levels
  • Overactivity in specific areas of the brain
  • Issues in your relationship

Those who specialize in OCD and look into the genetics of OCD believe that it starts in childhood. However, the symptoms children present are much different than adults. Below, we’ll examine the difference between OCD symptoms in children and adults.

  • A child with OCD has specific obsessions.
  • A child with OCD obsessions seldom emphasize sexual theme like adults, but adolescents experience a more significant incidence of sexual obsessions.
  • Rituals in children with OCD are more likely to be centered around family members.
  • Children with OCD will hoard items more frequently than adults with the condition.
  • Children with OCD have a higher risk of attention-deficit hyperactivity disorder (ADHD) and tic disorders.

Below are the symptoms of OCD in adults:

  • Intense fear of making mistakes
  • An irrational fear of dirt or germs
  • Fear of harming yourself or others
  • Fearing that you’ll embarrass yourself in public
  • Feelings of disgust and doubt
  • The need for constant reassurance
  • Sexual thoughts that society deems unacceptable
  • A need for neatness, order, and perfection

How Is OCD Treated?

While some symptoms of OCD are mild, individuals can easily endure severe and debilitating symptoms. If your OCD disrupts your life, it’s time to speak with a healthcare provider specializing in these disorders. Someone trained in mental illness, OCD specifically, will offer the following treatment strategies:

  • Cognitive Behavioral Therapy (CBT): Cognitive behavioral therapy is an extremely effective and popular form of psychotherapy. It’s used to treat various conditions and has proven its success with OCD. During a session, you’ll speak with a therapist that will help you understand your thoughts and emotions. Throughout your treatment, you’ll learn how to stop negative habits and replace them with a healthier means of coping.
  • Medication: While CBT will help change your actions, those with OCD often have chemical imbalances in their brain, which means only medication can treat this part of the disorder. SRIs, SSRIs, and tricyclic antidepressants can help as they increase serotonin levels in your brain.
  • Exposure and Response Prevention (EX/RP): This form of therapy will consist of you doing the activities that cause anxiety. The doctor or therapist will then prevent you from responding with a compulsion, which retrains your brain.


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