Every time you return from grocery shopping, you arrange canned vegetables in alphabetical order facing the same way. When leaving for vacation, you check the doors and windows multiple times to ensure they’re locked. Your spouse laughs and says, “I bet your grandmother did that, too.” You may have obsessive-compulsive disorder, but is it hereditary?
What is OCD?
Obsessive-compulsive disorder (OCD) is a mental health ailment known by features called obsessions and compulsions. Obsessions are intrusive thoughts, mental pictures, or urges to do specific actions. While the obsessions differ widely, they commonly include fear of illness or getting contaminated, an urge for symmetry, or intrusive thoughts about religion, intimacy, or aggression. Compulsions contain the repetitive performance of certain things, acting out specific procedures, or seeking assurance. These are mostly done to relieve anxiety.
How Many People Have It?
Obsessive-compulsive disorder is a rare illness. According to the U.S. National Institute of Mental Health and results of the National Comorbidity Survey Replication:
- An estimated 1.2% of U.S. adults had OCD in the past year.
- Past year prevalence of OCD was higher for females (1.8%) than males (0.5%).
- OCD affects the following age groups: Adults 18 to 29 years old (1.5%), 30 to 44 (1.4%), 45 to 59 (1.1%) and people aged 60 and older (0.5%).
Know the Symptoms
Symptoms of obsessive-compulsive disorder are categorized as obsessions and compulsions. Obsessions are mostly theme-based, like fear of dirt or having something in symmetrical order. Compulsions also have themes, often related to things like checking and counting.
Common obsession symptoms may include:
- Fear of being dirtied by touching something other people have touched
- Worries that you’ve closed the windows or turned off the furnace
- Extreme stress when something isn’t orderly or facing a specific way
- Visions of ramming your car into a crowd of pedestrians
- Unpleasant adult images
- Avoiding something that could trigger obsessions, like shaking hands
Common compulsions may include:
- Handwashing until your skin is raw
- Checking windows repeatedly to make sure they’re closed
- Checking the stove constantly to ensure it’s off
- Counting in specific patterns
- Silently saying a phrase, prayer, or word
- Placing your canned goods so they face the same way
Genetics & OCD
The U.S. National Institutes of Health describes OCD as a psychiatric disorder with familial connections, meaning that it has a genetic component and can be inherited. But there may be other causes, too.
Twin and family studies offer compelling evidence for the influence of genetics on the formation of OCD. Still, data strongly suggests “that biochemical/biological factors are important for the manifestation of OCD.”
The inheritance pattern of OCD is unclear. Overall, the risk of developing this condition is higher for first-degree relatives of people who have it, such as siblings or children, when compared to greater society. But we still don’t know why the risk of inheriting the disorder seems to be more prevalent in some groups than in others. It’s important to note that most people with a blood relative with OCD will not get the condition themselves.
Because obsessive-compulsive disorder tends to run in families, it’s reasonable to conclude that genes probably have a role in someone getting the disorder. But genes are only partly responsible, as other factors are in play. No one knows precisely what those factors might be, but there could be an illness or even everyday life stresses that may persuade the activity of genes linked to the symptoms of OCD.
Some experts believe that OCD that starts in childhood could be different from the obsessive-compulsive disorder that appears in adults. For example, one recent review of twin studies indicates that genes “play a larger role when OCD starts in childhood (45-65%) compared to when it starts in adulthood (27-47%).”
Diagnosis & Treatment
Ways to help diagnose OCD may include:
- Psychological evaluation. This means discussing your feelings, symptoms, thoughts, and behavior patterns to decide if you have obsessions or compulsions that restrict your quality of life. Your healthcare provider may also ask permission to talk to your family or friends.
- Comparing your symptoms to diagnostic criteria for OCD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, published by the American Psychiatric Association.
- Physical examination. This may be required to help confirm or rule out other problems triggering your symptoms and check for any related complications.
After diagnosis, you may be referred to psychotherapy and medicine like ketamine.