What Causes OCD?
It’s natural for parents to look for the cause of OCD when they see their child suffering from this disorder. In some cases, parents blame themselves for the child’s behavior, or wonder what they did to cause such a heartbreaking mental problem. And sometimes other family members, neighbors or friends reinforce this concern.
Parents don’t cause OCD in their children by some flaw in their parenting abilities. OCD isn’t caused by how you talk with your kids, how you discipline them, whether or not both parents work or there is a stay-at-home Mom or Dad, whether parents are divorced or if a parent remarries after divorce. Stress may make OCD worse in a child already predisposed to the condition, but your actions didn’t cause the OCD.
Brain Differences
Using a specific type of brain scan (a positron emission tomography or PET), scientists have shown that functioning in some areas of the brain is different between individuals who have OCD and those who don’t.
Research shows that the disorder may involve communication errors that take place between the orbitofrontal cortex (front part of the brain) and the basil ganglia and thalamus (deeper parts of the brain). Abnormalities in the serotonin and other neurotransmitter systems—chemicals that send messages between brain cells—may be at the root of the disorder.
A study funded by the National Institutes of Health examined DNA, and the results suggest that OCD and certain related psychiatric disorders may be associated with an uncommon mutation of the human serotonin transporter gene (hSERT). People with severe OCD symptoms may have a second variation in the same gene. Other research points to a possible genetic component—about 25 percent of OCD sufferers have an immediate family member with the disorder.
Sometimes OCD symptoms may begin after a brain injury, which also suggests a connection between brain function impairment and OCD.
The Gene Connection
Although research shows that there could be a genetic component to OCD, it’s not clear that this is the only cause of OCD. Many families have a child or relative with OCD, but many others in the family or extended family do not have OCD. Even identical twins are not predictable—if one twin has OCD the other may not.
There is no way to predict the exact probability of OCD occurring in children, even if one of the parents has OCD or has a family history of OCD. In most cases, the chances are small that OCD will occur in children. If you are a prospective parent, and have concerns about whether your future children could inherit OCD, it’s best to talk with your doctor. Many major medical centers have genetics counselors on staff or by referral who can discuss this issue with you.
Scientists continue to research the area of genetics and OCD, and new developments are announced often.
Sudden Onset of OCD Symptoms
Note: The information in this section is adapted from the article “Sudden and Severe Onset OCD - Practical Advice for Practitioners and Parents” by Dr. Michael Jenike and Susan Dailey. The full article is available in the Expert Perspectives section of this web site.
Some parents have reported that OCD symptoms occurred almost overnight, as if a switch were flipped; their child went to bed as the child they knew and woke up a stranger. For many years, this sudden onset of symptoms has been thought to occur in conjunction with a strep infection, which triggers OCD and/or tic symptoms in children who are genetically predisposed to the disorder. This type of sudden-onset OCD came to be known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections, or PANDAS.
In the more recent past, researchers and clinicians have found that although strep can be a trigger for OCD, it may not be the only trigger. Non-strep diseases such as Lyme disease, mononucleosis and the flu virus (e.g., H1N1) could also cause similar neuropsychiatric illnesses in vulnerable children. As a result, researchers have changed the name of the disease to Pediatric Acute-Onset Neuropsychiatric Syndrome, or PANS. The two major criteria for PANS are (1) an abrupt and dramatic onset of OCD symptoms that is associated with significant impairment, and (2) the simultaneous, rapid onset of other symptoms from at least two of seven categories: anxiety, emotional instability and/or depression; irritability, aggression, and/or oppositional behaviors; behavioral regression; sudden deterioration in school performance; sensory or motor abnormalities, especially handwriting difficulties; and somatic, or physical signs and symptoms.
Currently, PANDAS and PANS are extremely under researched. Until the time that appropriate treatment targeted specifically at PANS is available, treatments traditionally implemented in the treatment of PANDAS (e.g., antibiotics, exposure and response prevention, selective serotonin reuptake inhibitors) may be beneficial, depending upon the individual needs of the child.
If Your Child Does Have OCD - Next Steps
If your child does have OCD, what matters most is what you do about it, not dwelling on what may have caused it. Your child is suffering and you can help him or her get relief from OCD symptoms.
Effective treatment is available for your child, and you will need to learn how to help your child manage the symptoms. Talk with your doctor about treatment, and also read the information on this web site about choosing a therapist.
There really is light at the end of the tunnel, and many thousands of children who have OCD really do learn to control the “monsters” in their heads.
Read personal success stories from children and parents
Back to Helping A Child Who Has OCD
