Related Case Studies
Obsessive Compulsive Disorder Case Study: A Real-Life Journey of Overcoming OCD in India
Obsessive Compulsive Disorder (OCD) is a chronic mental health issue characterised by unwanted and intrusive thoughts (obsessions) and/or ritualised behaviours or mental acts (compulsions). Some compulsions may be undertaken rationally to lessen anxiety or prevent an event.
In this case study, we describe a woman from India who received successful treatment for her severe OCD after seeking help from Jagruti Rehab. The case illustrates the symptoms, diagnosis, treatment and recovery phase accurately with the intention to help relieve distress and uncertainty for others who may be experiencing the same issues.
Patient Information
- Patient number: Ms. A (name changed for confidentiality)
- Patient age: 26
- Patient gender: Female
- Patient address: Pune, India
- Patient employment: Secondary School Teacher
- Family type: Lives at home with mother, father, and younger sibling
- Lifestyle type: Academically driven, socially withdrawn, detail-oriented, sensitive
History or Cause
OCD first presented in Ms. A in her last year of college. Initially, she experienced vague symptoms including:
- Excessive cleaning
- Changing clothes multiple times a day
- Hanging in the bathroom for long periods of time
Ms. A has a significant exacerbation of symptoms during COVID-19, with obsessions surrounding contamination and being seen in the community as a "cleaning angel." Eventually, her compulsions became more pronounced and included:
- Checking Compulsions: Examination of doors, gas knobs, and electrical appliances at home up to 50 times a day
- Contamination Obsessions: Hand washing with antiseptics up to 50 times a day
- Obsessive Order/Symmetry: Placing things in rigidly determined arrangements (for example, putting items back on shelves with specific relative positions to create order)
- Intrusive Thoughts: Fears around harming loved ones accidentally
As a result of her OCD, she stopped attending school, started to avoid social situations, and became both driven and highly distressed if her compulsive rituals were disrupted. Family members initially believed she simply had strange behaviours or habits. After two years, she gradually became more distressed, developed insomnia, lost a significant amount of weight, and developed symptoms of depression.
Diagnosis
Upon admission to the Pune neuropsychiatric institution at Jagruti Rehab, a full psychiatric evaluation was completed for Ms. A. A diagnosis was made using the DSM-5 diagnostic criteria for OCD and was confirmed through validated measures.
Diagnostic Process
- Clinical Interview: conducted by a psychiatrist and a psychologist
- Yale-Brown Obsessive-Compulsive Scale (Y-BOCS): A score of 28 fell into the severe range
- Structured Clinical Interview for DSM-5 Disorders (SCID-5)
- Co-morbidity screening: Generalised anxiety disorder (GAD), with mild depressive symptoms
Final Diagnosis:
- Primary: Obsessive Compulsive Disorder (Severe)
- Concurrent: Anxiety, mild depressive features
This diagnosis marked a watershed moment for the patient and her family. It provided them with a name for the problem that had been destroying their lives.
Treatment
Jagruti Rehab’s treatment was comprehensive, multidisciplinary, and individualised. The neuropsychiatric team developed an inpatient treatment plan consisting of:
- Psychotherapy
- Medication
- Behavioral therapy
- Family therapy
Length of Treatment
- Inpatient: 12 weeks
- Outpatient follow-up: 6 months
Psychiatric Interventions
- Fluoxetine (SSRI): titrated slowly to 40 mg/day
- Clonazepam: as needed for sleep and as an anxiety medication (low dose 0.25 mg)
- Side-effect monitoring: vitals weekly and monitoring for side effects
While the medications constituted an important part of treatment, they were helping to stabilise the patient; they were not the entirety of the treatment plan. The medication was utilised along with intensive psychotherapy.
Psychotherapy
Cognitive Behavioural Therapy (CBT) with ERP
ERP (Exposure and Response Prevention) was the primary psychological intervention used to gradually expose Ms. A to her feared stimuli while helping her resist the compulsive rituals.
Examples of ERP:
- Touching a dusty surface and not washing her hands afterwards
- Leaving home without going back to check multiple times that the doors were locked
- Having a 'messy' organisation on her desk
Every task completed was measured and recorded. Over time, she was able to increase her distress tolerance and resist her compulsions without prompting.
Acceptance and Commitment Therapy (ACT)
- She learned non-judgmental acceptance of her intrusive thoughts.
- She developed increased psychological flexibility and self-compassion.
Mindfulness Based Stress Reduction (MBSR)
- Each day, meditating decreased Ms. A's hyper-arousal.
- She also learned focused breathing skills for the surges of anxiety.
Family Involvement
One of the key ingredients in the success of this OCD case study in India was the level of family support around the patient.
Family support included:
- Regular psychoeducational sessions.
- Training to help the family avoid complicity in compulsions.
- Learning about effective support strategies.
This changed the patient’s home environment for the better in terms of helpfulness in her recovery.
Group Therapy and Recreational Interventions
Group therapies provided Ms. A the opportunity to connect with others with OCD and related disorders, decreasing her feeling of isolation.
Counselling by peers aided her in getting in touch with her progress.
Recreational therapies, like engaging in expressive art and journaling, helped improve her emotional regulation.
Improvements/Recovery Timeline
| Week | Summary of Progress |
|---|---|
| 1-2 | Participated in orientation and rapport building, and an adjustment in medications. Baseline measure of OCD = 28 |
| 3-4 | Started ERP (with habit) with handwashing and checking triggers. Score reduced to 25 |
| 5-6 | Reduced compulsive behaviours from 5 hours to 2 hours per day. Improved sleep. |
| 7-8 | Beginning to resist symmetrical arrangements and intrusive thoughts. Score = 20 |
| 9-10 | Went out in public without ritual prep. The family noted marked changes in behaviour. |
| 11-12 | Score dropped to 14 (mild). Began discharge planning. |
Month 4 (Outpatient)
Returned to work part-time. Daily compulsions were less than 30 minutes.
Month 6
Stable status maintained. Started planning travel and social activities without supportive interactions.
Our Success
Ms. A's story is a testament to what violence-free, evidence-based treatment can accomplish. Today, she is leading a balanced life amidst continuing therapy and contributing to awareness drives for mental health in her community.
Patient Impacts:
- Autonomy and self-confidence regained
- Return to work and social life
- Enhanced coping skills
This OCD case study illustrates the impact of neuropsychiatric care and the value of family involvement in recovery.
Why Jagruti Rehab for OCD and Psychiatric Treatment
Jagruti Rehab is recognised as one of the most reputable mental health institutions in India. With multiple locations across the country, we provide world-class evidence-based care for OCD, depression, bipolar disorder, and more.
Reasons to Choose Us:
- Experienced Team: Including psychiatrists, psychologists, therapists, and social workers
- Evidence-Based Treatments: Including ERP, CBT, ACT, and mindfulness-based therapies
- Flexible Programs: Including inpatient, outpatient, and home-based rehabilitation programs
- Family-Centred Approach: Making your loved ones a part of your care
- Long-Term Services: Including relapse prevention plans and follow-ups
Whether you need treatment for bipolar disorder and ADHD or help for OCD, Jagruti Rehab is equipped to provide the comprehensive care required for true healing.
FAQs
Can you have OCD and anxiety together?
Yes. OCD frequently co-occurs with anxiety disorders. In fact, anxiety often drives the obsessive thoughts and compulsive behaviours.
What are the 5 common signs of OCD?
- Intrusive, repeated thoughts (obsessions)
- Compulsions - washing, checking, counting
- Fear of contamination or harming others
- Need for order or symmetry
- Avoidant behaviours to limit distress
What percentage of people with OCD get better?
More than 70% of people receive significant improvement with a combination of medication and therapy. With long-term management, individuals can live fulfilling, empowered lives.
What’s the best form of OCD therapy?
CBT with ERP is the gold standard treatment. It gives patients the opportunity to gradually address their fears and learn how to refrain from responding to their compulsions.
Is OCD curable?
While OCD cannot be “cured” in a traditional sense, it is extremely manageable. Many people achieve complete recovery with ongoing support.
Dr. Amar Shinde, founder of Jagruti Rehab, is a renowned psychiatrist in India with over two decades of experience in mental health, addiction recovery, and neuropsychiatry, dedicated to holistic, compassionate patient care.