Is It Something In the Air? Understanding Environmental Factors That Influence OCD

What caused my OCD? It’s a question that almost everyone who has Obsessive-Compulsive Disorder (OCD) has asked at some point. 

The fact is, while research has revealed so much about OCD, there is still a lot we don’t know about it. Just what causes OCD is not fully understood. Twin and family studies have found that about 50% of OCD can be attributed to genetic factors. However, that leaves about half of people with OCD who do not have a first-degree relative with OCD. 

Environmental factors are non-biological influences that are found in the person’s surroundings and experiences. While it’s widely recognized that genetic and neurobiological factors contribute to the development of OCD, a growing body of research suggests that environmental influences can play a significant role too. 

Understanding the Basics of OCD

OCD is a chronic mental health condition marked by intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) done in an attempt to reduce distress or prevent something bad from happening. People with OCD are often fully aware that their thoughts and behaviors don’t make logical sense, but they are often irresistible even with the most valiant efforts to avoid them. 

Although OCD most often develops in late childhood or early adulthood, its onset and severity can be influenced by multiple factors including genetics, brain structure, immune responses, and environment.

Gene-Environment Interaction

As with most disorders, genes alone don’t fully account for who develops OCD. Family history doesn’t always mean someone will develop OCD and some people with no known family history do develop OCD. That means there are other factors to consider.

This discrepancy has led researchers to explore environmental factors that might interact with genetic vulnerabilities. This concept is known as the gene-environment interaction, where inherited traits may increase susceptibility, but environmental triggers play a crucial role in the onset, intensity, and progression of OCD symptoms.

Key Environmental Factors Linked to OCD

While no single environmental factor causes OCD, researchers have identified several environmental influences associated with OCD. 

Adverse Childhood Experiences (ACEs) 

Adverse Childhood Experiences or ACEs are potentially traumatic events that occur in childhood. These experiences can include violence, abuse, neglect, or growing up in a family with mental health or substance use problems. According to the Centers for Disease Control (CDC), the toxic stress that results from ACEs can impact brain development and affect how the body responds to stress. ACEs have been linked to chronic health problems, mental illness, and substance misuse in adulthood.

One of the most studied environmental risk factors for OCD is trauma, particularly in childhood. A 2021 meta-analysis found that individuals with OCD are more likely to report a history of childhood trauma thana people without that history. While trauma doesn’t directly cause OCD, it may contribute to heightened sensitivity to distress and maladaptive coping patterns such as obsessive thoughts and compulsions. 

Infections and Autoimmune Responses 

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is a condition characterized by a sudden and severe onset of OCD Researchers have found evidence that streptococcal infections seem to sometimes provoke an autoimmune response that affects the basal ganglia. This area of the brain is involved in motor control and behavior regulation. While the exact mechanism is unclear, it is thought that when the immune system fights the infection, it may mistakenly attack healthy areas of the body, including the brain, which can lead to the sudden development of OCD, tics, and other symptoms of PANDAS. 

Stressful Life Events

Significant stress, particularly during vulnerable periods of life, can act as a trigger for OCD symptoms. Stressful life events can include:

• Loss of a loved one
• Relationship ending
• Academic or occupational failure
• Moving or other major life transitions

It is well-documented that people with OCD often report experiencing stressful life events prior to the onset or worsening of OCD symptoms. These stressors may not cause OCD, but they can exacerbate pre-existing vulnerabilities or precipitate the expression of latent symptoms in genetically predisposed individuals.

Parenting Style and Family Environment

No. Your parents didn’t cause your OCD, even if they have OCD themselves. 

However, it is generally accepted that the dynamics within a family can influence mental health outcomes, including OCD. A number of family dynamics have been linked to OCD:

• Overprotective or controlling parenting
• High levels of expressed emotion (criticism, hostility)
• Low levels of warmth or support

Research suggests that rigid, perfectionistic parenting in particular seems to influence the development of OCD in children. 

While much of the focus is on the unidirectional (one way) outcomes of parenting, many researchers note that the relationship may actually be bidirectional with a child’s own temperament and genetic predispositions may influence outcomes too. 

Cultural and Social Factors

How mental health is experienced and expressed is highly influenced by cultural and social dynamics. For example, in some cultures, there are significant associations between religiosity or spirituality, personal beliefs and mental health. These factors can influence how a condition is viewed and managed. 

Studies have shown that while the core symptoms of OCD are consistent across cultures, the content of obsessions and compulsions can vary. For example, religious-themed obsessions (scrupulosity) are more commonly found in highly religious societies. While content of obsessions may vary, consistency in core symptoms supports the underpinnings of neurobiology in OCD. 

Prenatal Factors

One area that has drawn attention from researchers is that of prenatal experiences. A number of prenatal factors have been linked to OCD:

Maternal Distress During Pregnancy

High levels of maternal stress, anxiety, or depression during pregnancy have been linked to an increased risk of mental health issues like OCD and other neurodevelopmental disorders in children. It is thought that stress hormones like cortisol can cross the placental barrier and may influence fetal brain development, especially in areas involved in emotion regulation and compulsivity, such as the amygdala and basal ganglia.

Maternal Infections and Immune Activation

Prenatal exposure to infections (viral or bacterial) during pregnancy may increase the risk of OCD, possibly due to maternal immune activation. Inflammatory cytokines released during infection could disrupt fetal brain development.

Obstetric Complications

Complications during pregnancy and delivery, including preterm birth or low birth weight, have been associated with an elevated risk of developing OCD.

Other factors that have long been associated with maternal health include smoking and nutritional deficiencies.

Are Environmental Factors Sufficient to Cause OCD?

While they can influence OCD, the science suggests that environmental factors alone are not sufficient to cause OCD. Most researchers agree that OCD arises from a combination of factors including genetic susceptibility, neurobiological factors, and environmental exposures. So, the bottom line is while environmental factors can play a pivotal role in the expression or exacerbation of OCD symptoms, they generally do not cause the disorder outright.

What You Can Do

While they don’t cause OCD, environmental influences matter and as with anything, it’s important that you manage your environment as best you can for optimal health. You can:

• Reduce and manage stress
• Nurture your resilience
• Seek treatment that is tailored to your unique needs 

Understanding your unique risk factors and needs opens the door to individualized and more effective strategies for managing your OCD. And you don’t have to do it alone. 

Effective therapies like Exposure and Response Prevention (ERP) can help you learn to manage your symptoms in healthy ways and break free from the cycle of OCD. StopOCD has a team of expert therapists ready to work with you to understand your unique situation and get you on the path to healing and wellness. If you’re ready to take control of your OCD, StopOCD therapists are here to help. 

And, if you’re worried about making time to see a therapist, online therapy can be a viable, affordable alternative. Online therapy eliminates a lot of common barriers to therapy like location, scheduling, and geographic availability. And, online therapy has been proven to be as effective as in-office therapy for many mental health issues, including OCD. 

Whether or not your OCD was influenced by your environment is less important than this: you can find ways to manage it successfully.  And that makes recovery possible.

References

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2. Geller, D. A., Homayoun, S., & Johnson, G. (2021). Developmental considerations in obsessive compulsive disorder: Comparing pediatric and adult-onset cases. Frontiers in Psychiatry, 12. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.678538/full#B12

3. Preventing adverse childhood experiences. (2021, August 23). Centers for Disease Control and Prevention. https://www.cdc.gov/vitalsigns/aces/index.html

4. Ou, W., Li, Z., Zheng, Q., Chen, W., Liu, J., Liu, B., & Zhang, Y. (2021). Association between childhood maltreatment and symptoms of obsessive-compulsive disorder: A meta-analysis. Frontiers in Psychiatry, 11. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2020.612586/full

5. PANDAS—Questions and answers. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/publications/pandas

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8. McGrath, C.A., Abbott, M.J., Mantz, S.C. et al. (2025). Parent–Child Interactions in Context: A Comparison of OCD and Non-clinical Families. Child Psychiatry Hum Dev. https://link.springer.com/article/10.1007/s10578-025-01823-5

9. Hu, P., Liang, P., Liu, X., Ouyang, Y., & Wang, J. (2023). Parenting styles and obsessive-compulsive symptoms in college students: the mediating role of perfectionism. Frontiers in psychiatry, 14, 1126689. https://pmc.ncbi.nlm.nih.gov/articles/PMC10360192/

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