Just a year into his marriage to his college sweetheart and girlfriend of three years, the employee of a Calcutta bank asked for a divorce. The reason? “She was a neatness freak,” shudders the 23-year-old. Soon after they got hitched, he found that his house-proud bride not just nagged him about keeping the house tidy, but took ‘cleanliness’ to absurd levels, spending most of her time at home dusting, sweeping or doing laundry. It was as though she was being driven by an invisible force. “The ritual before we made love was the most off-putting. We had to remove our clothes, fold it up in perfect piles and place it on the shelf in the closet. It consumed all my passion. I decided I simply could not deal with it,” says the distraught man.
This banker blames his ex-wife for her horrible quirk, but psychologists diagnose her condition as Obsessive Compulsive Disorder or OCD, a mental illness characterised by an obsessive compulsion to do, say and think things in a certain—usually repetitive—pattern, over which the victim has absolutely no control. “It is a condition ostensibly rooted in the quest for perfection, which the sufferer’s mind interprets as insatiable,” explains clinical psychiatrist Debashish Ray. “But OCD patients have no choice over the directions their thoughts are taking and subsequently the patterns of their actions and speeches.”
He points out that though OCD patients can lead perfectly normal lives in some situations and display abnormal behaviour in others, it often renders them socially dysfunctional or worse, physically debilitated. In the worst, though rare, scenario, OCD can be fatal. What is worrying is that cases of OCD—according to Indian and foreign medical experts—are on an alarming upswing. In a recent report, psychiatrist Dennis B. Kottler lists OCD as one of the “major health threats of our society”, one which has reached “epidemic proportions”.
Medical experts in India go a step further to declare, as Ray does, that “India could be on its way to becoming the OCD centre of the world”. In terms of the number of cases coming up, he compares it to India’s record as the “diabetic centre of the world”, with a 36 per cent rise in cases reported in just ten years. Indeed, a section of psychiatrists claims that by 2020, every Indian household will have at least one, if not multiple members suffering from OCD or displaying some signs of it. In that, Calcutta comes out worse off. According to Ray, in terms of the sheer number of cases that psychiatrists and psychologists are receiving daily, Calcutta is the OCD capital of India.
Though he cites the inconclusive nature of several studies and the lack of exhaustive evidence, a member of one of India’s renowned psychiatric societies tells Outlook about the startling findings of a recent study which indicated that “almost every Indian living in urban areas has been found to have displayed one or more signs of OCD”. He points out that “in most cases, the degree of OCD is mild to almost insignificant, but is nevertheless OCD”. The cases increase gradually in degrees of severity—finally, in extreme cases, crossing a crucial borderline into danger.
A Calcutta man just cannot abide dirty bank notes, yet is forced to handle some every day. His obsessive cycle to deal with it is shown here—he washes the note, dries it, and only then deigns to put it in his purse.
Interviews with psychiatrists and going through patients’ files reveals heartrending stories. Predictably, most people have asked that their names be kept secret as the condition—considered a psychological deviation—continues to be stigmatised. A creative director of a television channel, who jokes about her own OCD with friends, confesses, “I have a completely colour-coordinated kitchen. Which sounds normal but is not, because it is not a simple case of a red or blue or green themed kitchen. For me, if any colour other than red or black goes into the kitchen, I will not be able to function—work or even sleep—until I have removed it.” So much so that when the red dishwashing liquid she used went off the market, she panicked. Then she decided to pour the green one that was available into a black container.
Other cases are more extreme still. A homemaker in north Calcutta, for instance, wipes her refrigerator down with cow dung before going to bed every night. “Cow dung is considered holy and is a pure disinfectant. Since we keep eggs, fish, meat and other non-vegetarian food, I feel a compulsion to do so,” she says. Obsession with coordinating colours and a finical pursuit of cleanliness is known to be amongst the commonest forms of OCD. Another manifestation of the cleanliness OCD is the repetitive washing of hands. A boarder at the women’s dormitory of a prestigious Calcutta college recounts how, faced with taunts from fellow roommates for “hogging the washroom”, she was forced to vacate her room. “It’s normal to wash your hands with soap and water, say, before a meal or if you have touched something dirty. But do you know what it feels like when something beyond your control compels you to make your way to the bathroom sink every five minutes, lather up and keep rinsing till the skin on your fingers feels like it is going to peel off?” she asks.
“The anguish of the sufferer cannot be comprehended by the non-sufferer, who considers it as crazy behaviour that can be stopped if the person wants it to. In reality, they cannot,” says a psychiatrist. Often being laughed at or misunderstood is the least of the victim’s problems. The danger to their own physical well-being, over and above the traumatic psychological experience, looms large. A host of physiological problems, from diabetes to high blood pressure or even cancer, has been related to the anxiety caused by OCD. Eating disorders such as bulimia or anorexia too have been linked to the obsessive compulsiveness.
In a case delineating the more serious manifestation of OCD, a woman became obsessed with getting rid of the imperfections that she felt marked her appearance. Severe pain forced the Calcutta-based theatre actress to be hospitalised when the fourth plastic surgery on her face did not go off well. “In spite of repeated requests and warnings by medical experts, she kept insisting on various cosmetic surgeries. From getting rid of moles to treating eyebags, her need for the removal of imperfections was unstoppable,” says her doctor. Aniruddha Bose, a renowned plastic surgeon of Calcutta, says: “Out of every ten patients who come to me seeking plastic surgery, I find that six are suffering from obsessive preoccupation with their imperfections. I dissuade them. They are clearly OCD sufferers and should be treated for psychological disorder.”
Experts claim that medical science has not yet gained considerable understanding of certain causes of OCD. However, it has been linked to modern-day stress and unhealthy lifestyles, as well as the pressures of severe competition in work that impels people to push for perfection. “One of the reasons why India figures right on top of the list of countries where the epidemic is growing could be because India is an aspiring nation, competing in the global market—whether socially, politically, economically or otherwise. This is the macro picture. Individuals are the microcosm experience, subject to pressures permeating through the environment,” says sociologist Bela Bhadra. She points out that Calcutta, which has prided itself on being India’s intellectual capital, is losing its air of leisurely gentility and is now more in the rat race and more driven to reach the top.
The most important drug for the victim of Obsessive Compulsive Disorder, say doctors, is understanding from family, friends and society in general. There are various treatments for OCD, including therapy and counselling. But yoga, meditation and related relaxing techniques like pranayam too have helped. But all this helps only if OCD is recognised as a medical problem in the first place. Jack Nicholson in his Oscar-winning role of a writer with OCD in As Good As It Gets (1997) may have been deemed endearing, but in real life, hapless patients under the terrible thrall of their illness are often infuriating, and either ridiculed or shunned as such.