Your Brain Is Not Broken
It’s common to hear that obsessive–compulsive disorder (OCD) is a neurological disorder, a genetic disorder, a chemical imbalance, or a neurodivergent condition caused by a “different” kind of brain. These claims sound scientific—but when you look closely, each turns out to be inaccurate, exaggerated, or simply meaningless.
Let’s start with the idea that OCD is a neurological disorder. Every thought, feeling, and behavior we have is linked to brain activity—so of course OCD shows some differences in the brain. Research using brain scans has found small, inconsistent variations between people with and without OCD. But that doesn’t make OCD a brain disease. In the International Classification of Diseases (ICD), neurological disorders are defined as diseases of the nervous system—conditions like Parkinson’s or multiple sclerosis that involve identifiable physical pathology in the brain or nerves. OCD doesn’t appear in that section for a reason: those brain differences are minor, inconsistent, and of unknown significance. If OCD is a brain disease, it’s a disease with no diagnosable brain pathology.
Genetic Disorder?
What about a genetic disorder? Again, every psychological trait—from shyness to intelligence—shows some degree of genetic influence. Certain clusters of genes have been linked to mental disorders, but not strongly or consistently enough to be useful for diagnosis. A genetic disorder is a condition caused by a specific mutation or abnormality in genes. Such disorders are listed in the “congenital malformations, deformations, and chromosomal abnormalities” section of the ICD. OCD is missing from this section for a reason. There’s no evidence that OCD is caused by any genetic mutation. At most, some people may be more predisposed to anxiety in general—a far cry from a “genetic disease.” If OCD is a genetic disorder, it’s one with no identifiable mutation.
Chemical Imbalance?
OCD is often said to result from a chemical imbalance—an idea so familiar it sounds like settled science, but it’s not. A chemical imbalance means an abnormal level of a specific substance in the brain, like the neurotransmitter serotonin. No chemical imbalance has ever been demonstrated in OCD, or any mental disorder for that matter. In fact, the notion of a “chemical imbalance” is problematic because we don’t even know what a “chemical balance” would look like to begin with. Some studies have shown differences in brain chemicals between people with and without OCD, but these are small and don’t necessarily tell us anything about the cause of the condition. Experts have called the “chemical imbalance” idea a “useful metaphor,” but metaphors shouldn’t be mistaken for facts—especially when shared with vulnerable people. If OCD is a chemical imbalance disorder, it is one with no diagnostically useful test of brain chemicals.
Nuerodivergent?
How about the idea of a neurodivergent brain—a brain that supposedly functions differently from what’s “typical”? This idea emerged from a social movement to reduce stigma and celebrate human diversity. Those are inspiring goals. However, the practice of categorizing people as “neurotypical” or “neurodivergent” is problematic. Scientifically, we have no agreed-upon definition of a “typical” brain or a valid medical test to determine whether a brain is “atypical.” The neurodiversity concept basically replaces “person” with “brain” and assumes that a person with “different” psychology has a “different” brain. By this logic, a person with OCD is automatically considered neurodivergent simply because their psychology differs from others’. For that matter, since every person is unique, don’t we all have “different” brains? The idea that OCD is caused by a “neurodivergent brain” is a political stance, not a valid scientific claim.
The Evidence
So, what does the evidence really tell us? When researchers compare people diagnosed with OCD to people without the diagnosis, they find only small, inconsistent differences in brain scans or genetics—none that can diagnose OCD or explain its cause. That’s why there’s no brain scan, blood test, or biological marker that can diagnose OCD. Professionals diagnose it by talking to people and understanding their thoughts and behaviors—because OCD is, by definition, a mental (psychological) disorder.
It’s important to note that research on the biological aspects of OCD almost always compares people diagnosed with OCD to people without an OCD diagnosis, as opposed to people with similar diagnoses like generalized anxiety disorder or illness anxiety disorder. A “dirty little secret” in the field is that it’s so difficult to distinguish similar mental disorders that researchers rarely even try. These conditions are hard to tell apart, even for trained clinicians. Contrast this with medical diseases which are defined by clear physical pathology and can usually be distinguished from one another with ease. Bronchitis and lung cancer might both cause a cough, but doctors can easily tell these conditions apart because they have different causes that can be shown in medical tests.
In short, the notion that OCD is caused by a broken or different brain, a chemical imbalance, or a genetic defect is a story—a story that sounds convincing but isn’t supported by reliable scientific evidence. If OCD really had a proven biological cause, it wouldn’t be listed as a mental disorder in diagnostic manuals. It would be classified with the diseases of the nervous system or congenital abnormalities. It isn’t.
The “broken brain” story of OCD is like the idea of a “broken heart.” When someone loses a loved one, we say their heart is broken. It’s a compassionate metaphor that captures emotional pain—but nobody believes their heart is literally broken. If they did, they might behave as though they had heart disease—avoiding exertion, seeking unnecessary medical treatments, living in fear. Taking the metaphor literally could make them sicker and shorten their life. Such harm caused by belief in a false story would be tragic—and entirely preventable.
The take-home message is this: YOUR BRAIN IS NOT BROKEN! The “broken brain” account of OCD is a story masquerading as scientific truth. It may sound compassionate, but it risks trapping people in a false, hopeless narrative about their condition. It can also drive people away from effective therapy and sabotage their ability to benefit from it.
The truth is much more hopeful: your brain is not broken. OCD isn’t evidence of a damaged or defective brain—it’s evidence of a brain doing what it’s designed to do: learn from experience. OCD arises when normal learning processes lead a person to overestimate threat (obsessions) and try to neutralize it with avoidance and safety-seeking behavior (compulsions). This understanding forms the basis of the most effective treatment we have for OCD: Exposure and Response Prevention (ERP). ERP assumes the brain is functioning exactly as it should—responding to learning experiences—and teaches people new ways to respond to anxiety.
