You probably wouldn't want your children to have OCD any more than you'd want them to endure any affliction. On the other hand, would it really be so bad? While OCD can cause unbearable anxiety, and obviously no reasonable person would want her child to suffer from unbearable anxiety, it is also true that OCD is more manageable now than it ever has been.

No one can tell you, of course, whether you ought to have children, or even whether those children would have OCD. It is quite possible that if you have it, then your children will have it too. If your spouse or partner also has it, such a scenario would be probable — but not assured. And, in any case, everyone, with the possible exception of the most cavalier sociopath, must experience some anxiety in life. That's just the way it is. If you're concerned about your chances of passing on the disorder, though, definitely consult a genetics counselor.

What Are the Chances?

According to the OC Foundation, genes play only a part (albeit a significant one) in determining whether a child will have OCD. In pairs of identical twins, they say, when one has OCD, there is an 87 percent — not 100 percent — chance that the other will also have it.

Most experts believe that genetics are one determining factor (and there is certainly enough anecdotal evidence to bear this out). Some believe that the other determining factors are physical, such as environmental toxins or viral infections. “Strep” (streptococcal infection) is often blamed, especially for worsening childhood OCD symptoms that already exist in a milder form.

Attack of the PANDAS?

Earlier in the book, you read about the term PANDAS, which stands for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. In some cases, symptoms seem to come and go with the presence of certain illnesses, giving more credibility to the theory that OCD is a disorder of the brain.

Others believe that the remaining factors contributing to the development of OCD are emotional — a traumatic event, or an upbringing marked by an inflexible insistence on order or rules. Some researchers believe that some types of OCD are inherited, while others are not. But, so far, no one can say with absolute certainty just what causes OCD in every case.