OCD (obsessive-compulsive disorder): symptoms, ERP therapy and treatment
What OCD really is, common obsessions and compulsions, how it is diagnosed, why exposure and response prevention works, and where to get help in India.
Also known as: Anancastic neurosis; Anankastic neurosis; Hoarding; OCD; Obsessive-compulsive neurosis
What OCD is
Obsessive-compulsive disorder (OCD) is a mental health condition in which a person has unwanted, distressing thoughts, images or urges (obsessions) and feels driven to do repeated actions or mental rituals (compulsions) to reduce the anxiety or prevent something bad happening. The relief is brief, so the cycle repeats, taking up time and getting in the way of daily life.
OCD is not the same as being neat, tidy or particular. People with OCD usually know their fears are excessive but feel unable to stop. Having an intrusive thought does not mean a person wants to act on it — in OCD, these thoughts are distressing precisely because they go against the person's values. OCD is treatable, and many people improve a great deal.
Symptoms
Common obsessions
- Intrusive thoughts of harm coming to loved ones, or of causing harm by mistake
- Fear of contamination by dirt, germs, body fluids or 'impurity'
- Doubts about whether doors are locked, the gas is off or tasks were done correctly
- Unwanted sexual or religious thoughts that cause guilt or fear
- A need for symmetry, order or things feeling 'just right'
Common compulsions
- Excessive washing, bathing or cleaning
- Repeated checking of locks, switches, taps or the gas
- Arranging, counting or repeating actions until they feel right
- Repeated prayers, mantras or mental reviewing to cancel a bad thought
- Seeking reassurance again and again from family
- Avoiding places, people or objects that trigger fears
OCD can start in childhood, adolescence or adulthood. It can also begin or worsen during pregnancy or after childbirth, often with intrusive thoughts about the baby's safety.
Causes and who is at risk
The exact cause is unknown. Genes, differences in brain circuits and life experiences all seem to play a part. Risk is higher with:
- A family history of OCD, anxiety or tic disorders
- Stressful or traumatic life events
- A personality that is very careful, perfectionistic or has a strong sense of responsibility
- Pregnancy and the months after childbirth
- In children, rarely, a sudden onset after a streptococcal infection
OCD often occurs alongside depression, other anxiety disorders, tics or body-focused habits such as skin picking.
How it is diagnosed
OCD is diagnosed through a clinical assessment with a psychiatrist or clinical psychologist, who will ask about your thoughts, rituals, how much time they take and how they affect your life. Rating scales such as the Y-BOCS (Yale-Brown Obsessive Compulsive Scale) are used to measure severity and track progress. There is no blood test or scan for OCD.
Many people feel embarrassed about their thoughts and keep them secret for years. Clinicians who treat OCD hear these thoughts often and will not judge you. Telling them the details helps them plan the right treatment.
Which professional to see
A psychiatrist diagnoses OCD and can prescribe medicines. A clinical psychologist trained in exposure and response prevention provides the main talking therapy. Many people benefit from seeing both.
You can find psychiatrists in Bengaluru and clinical psychologists on The Doctor Index. The Mental Healthcare Act, 2017 gives every person in India a right to access mental health care and treatment from services run or funded by the government.
Treatment
Therapy
Exposure and response prevention (ERP), a form of cognitive behavioural therapy, is the most effective psychological treatment for OCD. With a therapist, you gradually face situations that trigger your obsessions, starting with easier ones, while resisting the urge to perform compulsions. Over time, anxiety falls on its own and the urge to ritualise weakens. It takes effort and regular practice between sessions, but the benefits tend to last.
Medicines
SSRIs (selective serotonin reuptake inhibitors), such as fluoxetine, fluvoxamine, sertraline and escitalopram, are the main medicines for OCD. In OCD they are often needed at higher strengths and take longer to work than in depression — sometimes several weeks to a few months. Clomipramine is another option. For OCD that does not respond, a psychiatrist may add another medicine or consider specialised treatments such as rTMS.
Living with OCD
Family members often get drawn into rituals by giving reassurance, washing extra or changing routines. This is understandable, but it keeps OCD going. A therapist can help the family step back gradually in a supportive way. Regular sleep, exercise and stress management help. Setbacks happen; using the skills learned in therapy helps you get back on track.
When it is an emergency
Get help immediately — call 112, go to the nearest emergency department, or call Tele-MANAS on 14416 — if:
- You have thoughts of suicide or have harmed yourself
- OCD has led to not eating or drinking, or being unable to leave a ritual for long periods
- Skin is badly damaged or infected from repeated washing
- A new mother has thoughts that she cannot separate from reality, or seems confused — this needs urgent assessment
Questions to ask at your appointment
- Is this OCD, or could it be another condition?
- Can I get exposure and response prevention, and how many sessions will I need?
- Would medicine help me, and how long before it works?
- How should my family respond to my rituals and requests for reassurance?
- What should I do if symptoms get worse?
- How long should I continue treatment?
Common questions
Questions people ask
- Does having violent or sexual intrusive thoughts mean I am dangerous?
- No. Intrusive thoughts in OCD are unwanted and go against what the person values, which is why they cause so much distress. People with OCD are not more likely to act on them. Telling a clinician about these thoughts is safe and helps treatment.
- Is OCD just being very clean or organised?
- No. Many people like order, but OCD involves distressing obsessions and time-consuming compulsions that a person feels unable to stop and that interfere with daily life. It can involve many themes besides cleanliness, such as harm, doubt or religion.
- Can OCD be treated without medicines?
- Yes, for many people. Exposure and response prevention is highly effective on its own for mild to moderate OCD. Medicines are added when OCD is severe, when therapy is not available, or when depression is also present. Your clinician will help you choose.
- What is Tele-MANAS?
- Tele-MANAS is the Government of India's free mental health helpline, reached by dialling 14416 at any hour. Callers can choose their language and speak to trained counsellors, who can connect them to mental health professionals for further care.
This condition is usually assessed by a psychiatrist. Every profile shows the doctor’s registration and what has been checked.
Psychiatrists in Bangalore
A few psychiatrists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Obsessive-Compulsive Disorder; ask the clinic whether the doctor sees it.
Related conditions
- Anxiety
- Attention Deficit Hyperactivity Disorder
- Bipolar Disorder
- Depression
- Panic Disorder
- Postpartum Depression
- Schizophrenia
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Obsessive-Compulsive Disorder
- NHS — Obsessive compulsive disorder (OCD)
- Press Information Bureau, Government of India — Tele-MANAS launched with 24/7 toll-free helpline 14416
- India Code — The Mental Healthcare Act, 2017
- MedlinePlus, National Library of Medicine — Obsessive-Compulsive Disorder — Public-domain health-topic summary
- MedlinePlus Genetics — Obsessive-compulsive disorder — Public-domain Genetics summary
OCD (obsessive-compulsive disorder): symptoms, ERP therapy and treatment is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-1735.