Obsessive-Compulsive Disorder (OCD): A True Life Case Study from India
Obsessive-compulsive disorder (OCD) is a chronic and often misinterpreted mental illness. It entails obsessions—persistent, unwanted, and intrusive thoughts—and compulsions, which are repetitive behaviours or mental rituals performed to prevent the anxiety generated by those obsessions. The actions seem irrational or unreasonable, yet individuals with OCD believe they cannot stop them.
While everyone will have a worried thought now and then, those with OCD experience them so frequently and so intensely that it interferes with daily life, work, school, and personal relationships. But what exactly does OCD look like in day-to-day life? How does a person burdened with intrusive, obsessive thoughts and compulsive behaviours regain control and get back to a normal life?
This case study of OCD from India is significant in that it provides key information about the nature of the disorder, including causes (etiology), symptoms, diagnosis, and treatment methods such as cognitive behavioural therapy and medication.
Whether a student, caregiver, or healthcare provider, this case study provides practical information about OCD and shares a case of hope and healing for anyone dealing with similar issues.
Patient Information
- Name: Ananya (Name has been changed to ensure confidentiality)
- Age: 24
- Gender: Female
- Location: Delhi, India
- Occupation: Sociology postgraduate student
- Family Environment: Middle-class traditional family, not initially aware of mental health issues
History or Cause
Ananya's symptoms of OCD began when she was 17, but her family initially believed they were simply personality traits. She had an extremely severe contamination phobia, and therefore, she washed her hands more than 25 times a day. Most common daily activities became extremely difficult. She avoided public spaces, buses, and trains, and didn't even want to use her college restroom.
Her compulsions grew stronger during the COVID-19 pandemic, when everyone was concerned about hygiene. Ananya started disinfecting whatever she could lay her hands on and washing clothes every single day. She also had intrusive thoughts, like she would assume that something bad would occur to her parents if she didn't repeat tasks like counting or touching objects again and again.
Her studies began to suffer, and she isolated herself from her peer group. Her college counsellor later recognised her changes and recommended a psychological test. This was a turning point for her.
This OCD case study in India is an example of how cultural stigma, lack of awareness, and extrinsic pressures like the pandemic could result in the delay of treatment and diagnosis.
Diagnosis
Ananya had a professional psychiatrist session in Delhi, where a comprehensive evaluation was done:
- Clinical Interviews: Several sessions to clarify her mental health history, behavioural patterns, and emotional issues.
- Yale-Brown Obsessive Compulsive Scale (Y-BOCS): She had a score of 29/40, which is characteristic of severe OCD.
- DSM-5 Diagnostic Criteria: She did have her OCD diagnosis confirmed, with contamination obsessions and cleaning/checking compulsions.
In addition, a psychological assessment eliminated other comorbidities such as depression or generalised anxiety disorder, though mild anxiety symptoms were present.
Treatment
Approach
The treatment was multi-disciplinary and holistic in its strategy, with the use of a combination of medication, therapy, lifestyle modification, and family education. It aimed at lessening compulsions, working against obsessive thoughts, and enhancing Ananya's daily functioning.
Program Details
Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ERP)
- She was gradually exposed to triggers (e.g., manipulating public objects) without ritual performance.
- As per the instruction of the therapist, Ananya fought hand-washing compulsions or overcleaning compulsions.
- Techniques used were thought-stopping, journaling, and cognitive restructuring of distorted perceptions.
Medication
- Fluoxetine (Prozac) was initiated at a dose of 20 mg/day and subsequently was raised to 40 mg/day.
- Medication compliance was reinforced by regular follow-ups and for side effects.
- Vitamin B12 and Vitamin D supplements were also given based on routine blood work.
Family Therapy
- Mother and brother joined bi-weekly sessions.
- They were taught not to facilitate or enable her rituals.
- Education reduced conflict and enhanced family communication.
Group Therapy
- Ananya attended a teen group with OCD every week.
- She told stories, gained peer acceptance, and learned social skills.
Lifestyle Changes
- Started yoga and meditation on mindfulness to help cope with stress.
- Restricted screen time, particularly for health news.
- Promoted an established routine of sleeping and exercising.
Improvements / Recovery Timeline
Week 1–2:
- Medication initiation.
- Rapport-establishing sessions with the therapist.
- Kept a thought journal to monitor triggers.
Week 3–4:
- ERP exercises began.
- Could touch "dirty" items such as doorknobs without first washing hands.
- Anxiety was extreme, but no rituals were done under the therapist's guidance.
Week 5–8:
- An obvious decrease in compulsions.
- Ritual time in the daily schedule decreased from 5+ hours to under 2 hours.
- Anxiety began decreasing after exposure.
Week 9–12:
- Returned to college part-time.
- Finished social tasks without avoidance.
- Started mentoring new members in group therapy.
Week 13–16:
- Y-BOCS score reduced to 14 (mild OCD).
- Received weekly therapy and regular medication.
- Recovered self-confidence and resumed personal activities.
Our Success
Influence on the Patient's Life
Ananya changed dramatically. She had been virtually housebound and under the tyranny of rituals before treatment. Within 4 months of goal-directed therapy, she went back to college, befriended others once more, and OCD no longer ruled her life.
She even gave a short lecture at her college on mental health awareness, narrating what she had experienced so that she could inspire others.
Family and Community Support
Her parents, who were originally sceptical about the therapy, became firm believers in mental illness. Her little brother was her immediate support system, assisting her with the exposure therapy drills and social integration. Her case also opened her wider family members' eyes, shattering previous stigmas regarding mental illness.
The Final Thought
This obsessive-compulsive disorder case history illustrates how OCD can ruin a person's life, particularly when the symptoms are left undiagnosed or untreated. Jagruti Rehab offers a special OCD program, devised therapy, medication, and family support, not only can recovery be facilitated, but it can also be sustained.
This OCD case study of India also highlights the necessity for mental health education throughout India. Despite cultural taboos and a lack of quality psychiatric care, individuals are discouraged from receiving help. But, as in Ananya's situation, with prompt intervention, education, and emotional support, even extremely severe instances of OCD can be effectively treated.
If you or your loved one is displaying symptoms of OCD, do not overlook it. Consult an expert—early bird catches the worm is the principle for everything that comes next.
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Jagruti Rehabilitation Centre is a leading facility specializing in mental health, dementia, and addiction recovery. The team of psychiatrists, psychologists, and caregivers is committed to empowering individuals on their journey to recovery.
