New Delhi: At a virtual discussion on Thursday, clinicians and people with lived experience discussed OCD’s hidden symptoms, delayed diagnosis, and recovery.
Obsessive-compulsive disorder, or OCD, affects an estimated 1-3 per cent of the global population. Beyond excessive handwashing and checking behaviors, its symptoms include intrusive thoughts, reassurance-seeking, and a need for certainty.
The virtual conversation, organised by Amaha, with Asia Society’s India Centre as outreach partner, began with a keynote address by Dr Lavanya P Sharma, Lead of Neuromodulation and the Amaha OCD Programme.
She described a cycle: unwanted thoughts trigger anxiety, guilt or unease; compulsions bring temporary relief and reinforce the behaviour; then thoughts return. People may recognise fears as excessive yet struggle to resist compulsions. Sharma also discussed disruptions in brain circuits that regulate thoughts and behaviour, saying evidence-based treatment and structured support can achieve remission rates exceeding 50 per cent.
When the ordinary becomes overwhelming
This was followed by people sharing their experiences of living with OCD. The first testimony came from Pranay, who feared contracting rabies after a bat encounter. He repeatedly sought reassurance and got rabies shots until forced to stop. After diagnosis, he became obsessed with treating OCD. Ordinary five-minute tasks took him 30 minutes, he said. His account showed how OCD extends beyond the “neat freak” stereotype and can transcend to new obsessions after one fear is overcome.
The second testimony was shared by A, who was diagnosed with contamination OCD in Class 11. He stopped taking selective serotonin reuptake inhibitors (SSRIs) in college, worried how they would affect his academic performance. He called the aftermath “the worst period of my life.” OCD can sometimes bring the treatment itself under the shadow of doubts. Not reacting to anxious thoughts became a useful, if not perfect, strategy for him. He stressed on avoiding isolation and tolerating uncertainty instead of seeking reassurance. Medication eased palpitations and digestive problems; recovery meant living well despite anxiety, not eliminating it.
Hussain, founder of The Struggling Warrior, a mental health and advocacy platform that helps people tackle OCD, said religious and harm-related OCD began at age seven. He hid it for over a decade, fearing others’ reactions. By adolescence, it had severely affected his life; he was bedridden during college.
He tried to “man” through the symptoms and bottle them up. When he told his family, they asked, “Why did you keep it to yourself for so long?”
Hussain warned against trying to “fight” OCD and urged distinguishing unwanted thoughts from intentions to act. His thoughts had not caused feared outcomes in 10 years, despite social expectations. Exposure and response prevention (ERP), facing fears while resisting compulsions, became central to recovery. And exercises involving knives were a turning point.
Writer and lecturer Sakina J Neemuchwala, author of Touch Me Not: A Memoir of OCD, Hope and Resilience, described more than two decades of OCD involving menstrual hygiene and painful cleaning. She was called “manipulative” and “too much”. Limited discussion of menstrual health reinforced her belief that her behaviours were valid despite the physical suffering. “Giving into compulsions is like winning a battle but losing the war,” she said. Gamma-ray radiosurgery brought little benefit for her treatment-resistant OCD, but also no side-effects. This, she said, shows the importance of not treating OCD like a curable disease.
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Delayed diagnosis, strained relationships
Prashant Verma, who discusses OCD and anxiety on his Instagram page, said his symptoms began in 2018 with breathing obsessions and repeated checking. For 18 months, he was irritable, and drank and lashed out at service workers, delivery boys. A local doctor misdiagnosed him; another did it correctly, likening untreated OCD to “carrying a fracture for one and a half years”, Verma recalled.
Krishna Gopakumar, Senior Consultant Psychologist at Amaha Health, said stereotypes miss OCD’s range, particularly religious obsessions, which can be difficult to disclose in India, where religion has a strong personal and societal role.
Dr Uma Maheswari Ganesh, Lead Clinical Psychologist for the Amaha OCD Programme, said popular culture depicts OCD as an obsession with order and cleanliness. She highlighted understaffed clinical services despite OCD affecting 2-3 per cent of the population. Moderator Malika Noor Mehta, psychotherapist, mental-health advocate and M Collective founder, warned that practitioners’ dismissal of symptoms can frustrate the search for help.
Dr Ganesh cautioned against “accommodation”: relatives reassuring someone, performing rituals or changing routines to prevent distress. Though comforting, such actions reinforce compulsions. Supporters can acknowledge distress without confirming fears and help loved ones engage with therapy and resist rituals. Ganesh noted that stress and environment can affect symptoms.
Sharma, meanwhile, outlined options for those who do not respond to initial treatment: cognitive behavioural therapy with ERP, medication, and transcranial magnetic stimulation. Surgery is a last resort for severe, treatment-resistant OCD, intended to augment, not replace, existing treatment. Family or trusted people can be trained to support structured treatment exercises.
Recovery means reducing intrusive thoughts’ power over decisions, relationships and routines, not eliminating them. As the panellists often repeated, “Do nothing!”
(Edited by Aamaan Alam Khan)