OCD in India — Why It Goes Unrecognised in Mumbai & What to Do About It

Obsessive Compulsive Disorder (OCD) affects approximately 2–3% of the Indian population — meaning there are likely over 3 million people with OCD in Maharashtra alone. Yet OCD remains dramatically underdiagnosed and undertreated in India. People with OCD in Mumbai often suffer for years — sometimes decades — before receiving an accurate diagnosis and effective treatment. Here is why, and what to do about it.

Why OCD is Misunderstood in India

• The “cleanliness” misconception — Most Indians (and many doctors) associate OCD only with excessive hand washing or cleaning. In reality, OCD presents in many forms — intrusive thoughts about religion, harm, sex, contamination, symmetry and “just right” feelings that have nothing to do with cleanliness.
• Religious obsessions are especially common in India — Scrupulosity (OCD focused on religious fears, sinning, blasphemy) is particularly prevalent in the Indian context but often attributed to genuine religious concern rather than OCD.
• Shame and secrecy — OCD intrusive thoughts are ego-dystonic (feel alien and horrifying to the person). People are often too ashamed to reveal thoughts about harming loved ones or sexual themes — and so they hide their OCD for years.
• Misdiagnosis — OCD is frequently misdiagnosed as anxiety, depression or psychosis in Indian clinical settings where OCD-specific training is limited.

Forms of OCD Commonly Seen in Mumbai

• Contamination OCD — fear of germs, pollution, illness; excessive washing, avoidance of touching surfaces
• Checking OCD — compulsively checking locks, gas, appliances; reassurance-seeking from family members
• Harm OCD — intrusive thoughts about harming family members (completely unrelated to actual desire to harm)
• Religious/Scrupulosity OCD — intrusive blasphemous thoughts during prayer; excessive religious rituals
• Pure O (Purely Obsessional) — OCD without visible compulsions; mental rituals and reassurance-seeking
• Relationship OCD (ROCD) — constant doubt about whether partner is the right one; obsessive checking of feelings

The Gold-Standard Treatment for OCD in Mumbai

Exposure and Response Prevention (ERP) is the most effective treatment for OCD — with 60–85% of patients achieving significant, lasting improvement. ERP involves gradual, systematic exposure to feared situations or thoughts, while resisting the compulsion to perform rituals. This retrains the brain’s fear response. ERP requires a trained OCD specialist and can feel challenging — but it is transformative. Combined with SRI medication (clomipramine, fluoxetine, fluvoxamine), outcomes are even better.