Indore, MP
OCD traps you in cycles of intrusive thoughts and repetitive behaviours. It is not about being 'particular' or 'organised', it is a neurobiological condition. Effective, evidence-based treatment is available.
Recognising the Signs
If you experience any of the following, talk to a professional.
Immediate support
The stereotype of OCD as wanting things neat or organised is misleading and harmful. OCD can involve any theme, contamination, harm, religion, sex, relationships, identity. The common thread is unwanted intrusive thoughts that cause distress, and repetitive behaviours performed to reduce that distress. If your thoughts feel out of control and distressing, that is worth discussing with a specialist, regardless of the theme.
Understanding the difference
| Feature | Personality Trait | OCD |
|---|---|---|
| Distress | Preferences cause no significant distress | Obsessions cause intense anxiety, guilt, or fear |
| Control | You can easily skip your preferred way | Skipping feels impossible or catastrophic |
| Time | Takes minutes, does not disrupt life | Can consume hours daily, severely limiting functioning |
| Thoughts | Preferences, not intrusive thoughts | Unwanted, repetitive,ego-dystonic thoughts you cannot stop |
| Relief | No anxiety cycle, just preference | Temporary relief after compulsion, followed by more anxiety |
About this Condition
Obsessive-Compulsive Disorder (OCD) is widely misunderstood in India. Many people who live with OCD have been told they are just 'too particular', 'overthinking', or 'too organised'. This framing is not only inaccurate, it prevents people from seeking the specific, effective treatment that exists for this condition. If you think you might be affected, you can start with the Y-BOCS screening.
OCD involves two core components. Obsessions are unwanted, intrusive thoughts, images, or urges that cause significant anxiety or distress. Compulsions are repetitive behaviours or mental acts performed to reduce the anxiety caused by obsessions, or to prevent something bad from happening. The relief is temporary, and the cycle perpetuates itself.
The World Health Organization ranks OCD among the top 20 causes of illness-related disability worldwide. In India, an estimated 1.8% of the population lives with OCD (NIMHANS, 2015-16), meaning approximately 25 million Indians are affected. Yet the condition is chronically underdiagnosed and undertreated, most people wait 7-10 years from symptom onset to receiving appropriate treatment.
Common OCD themes include:
Contamination fears, persistent anxiety about germs, dirt, chemicals, or illness, leading to excessive washing, cleaning, or avoidance. Doubt and checking, a nagging feeling that something is not right (door unlocked, stove on, made a mistake), leading to repeated checking even when you know it is fine. Symmetry and order, an overwhelming need for things to be 'just right', arranged in a specific way, or performed a certain number of times. Harm obsessions, intrusive thoughts about accidentally or intentionally harming yourself or others, despite having no desire to do so. These are among the most distressing OCD themes because the thoughts conflict sharply with your values. Taboo or religious obsessions, unwanted thoughts about religion, morality, sex, or relationships that cause intense guilt or shame.
A critical point: OCD thoughts are not desires. People with harm obsessions are not violent people, they are people terrified of violence. People with religious obsessions are not bad at faith, they are people whose anxiety has hijacked their relationship with faith. Understanding this distinction is essential.
OCD is a neurobiological condition. Brain imaging studies consistently show differences in the cortico-striato-thalamo-cortical circuit in people with OCD. It runs in families, with first-degree relatives of people with OCD having significantly higher rates of the condition. It is not caused by parenting, personality, or lifestyle choices.
Understanding the roots
OCD involves overactivity in specific brain circuits (the orbitofrontal cortex, striatum, and thalamus). These are measurable differences visible on functional brain imaging, not imagination or weakness.
OCD runs in families. Having a first-degree relative with OCD increases your risk 4-8 times. Multiple genes are involved, interacting with environmental factors.
Major life stress, trauma, or significant changes can trigger OCD onset or worsening, particularly in people with a genetic predisposition. PANDAS (a paediatric autoimmune condition) can also trigger sudden-onset OCD in children.
Clinical Profile
These are the most commonly reported signs.
By the numbers
Affected in India
~25M
Indians live with OCD
Source: NIMHANS Mental Health Survey, 2015-16
Average Delay to Treatment
7-10 years
from symptom onset to appropriate treatment
Source: International OCD Foundation
ERP Response Rate
60-80%
of patients show significant improvement with ERP + medication
Source: APA Practice Guidelines
Outcomes
Before Your Visit
Knowing what to expect can ease the anxiety of your first appointment.
The Process
A clear path from your first visit to feeling better.
A detailed 45-60 minute evaluation using standardised tools (Y-BOCS) to measure severity, identify specific obsessions and compulsions, and map your OCD patterns. Understanding your exact themes is essential for effective ERP.
Based on severity, I starts appropriate medication (typically high-dose SSRI) and designs a personalised ERP programme with a fear hierarchy, situations ranked from least to most anxiety-provoking.
Structured exposure sessions, both in-office and through homework, with gradual progression up the fear hierarchy. Regular follow-ups (every 2-4 weeks) monitor progress and medication response.
Once symptoms are substantially reduced, the focus shifts to maintaining gains, building independent ERP skills, and developing a relapse prevention plan. Long-term medication maintenance is discussed based on individual response.
Our Method
The first appointment is a thorough 45-60 minute evaluation. I use standardised assessments (including the Y-BOCS) to measure OCD severity and identify the specific themes and patterns. Understanding the exact nature of your obsessions and compulsions is essential because treatment must be tailored to them.
The gold-standard treatment for OCD is Exposure and Response Prevention (ERP), a specific form of [CBT](/psychotherapy/cbt) that involves gradually facing the situations or thoughts that trigger your obsessions while resisting the urge to perform compulsions. Over time, this process teaches your brain that the anxiety naturally decreases without the ritual. ERP is not about willpower, it is about systematically retraining your brain's fear response.
I combine ERP with appropriate medication for optimal results. SSRIs at higher doses than used for depression are the first-line pharmacological treatment, medications like fluoxetine, fluvoxamine, or escitalopram. Clomipramine, a tricyclic antidepressant with strong anti-obsessional properties, is another option. For severe or treatment-resistant cases, augmentation strategies (adding a low-dose antipsychotic to an SSRI) may be considered.
Treatment is structured and progressive. Exposures are carefully designed, starting with less anxiety-provoking situations and gradually working up the fear hierarchy. The work happens both in session and through homework between sessions, consistency is what drives improvement.
I is direct about what OCD treatment requires: it involves deliberately sitting with discomfort. This is not easy, but it is effective, and patients are never pushed beyond what they can handle. The goal is to help you reclaim the time and mental energy that OCD has been stealing.
Questions
Your Doctor
I have extensive experience treating OCD across its full spectrum, from contamination and checking to the most distressing harm and taboo themes. I combine evidence-based ERP with careful medication management, and provides the direct, non-judgemental environment that OCD treatment requires. My clinic is based in Indore and sees patients from across Madhya Pradesh.
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