Unwillingly obsessed

Published: July 24, 2012

After fully examining the floor to his satisfaction, he looks for creases on his bed sheet. He is obsessed with cleanliness.

Amir* is an A’ Level student. Today is the 24th of the month and also his birthday. He has turned 18 today but does not remember the last time he was happy and not aggravated by someone or something.

It’s not his fault that he is black and blue but people do not recognise this. He is active and healthy around people but also absent at the same time – internally absent. He refers to his ‘problem’ as the ‘black dog’.

His family is getting ready to celebrate his birthday, but Amir has confined himself to his room. He is checking the floor, looking for any specks of dirt he might have missed. He is obsessed with cleanliness. After fully examining the floor to his satisfaction, he looks for creases on his bed sheet. He wants his bed sheet to be free of any folds or creases; he will not be able to sleep on it if it bears the slightest crease. Even worse, if he finds one, he will have to repeat the task all over again.

After completing all these unnecessary tasks, he goes to the bathroom sink to wash his hands thoroughly – as many times as it takes to be content. This time it was six. His mother knocks at his door and tells him to come out. He eventually emerges and his mother asks:

What took you so long?

He answers,

You know, I was doing some routine chores because I want everything to be perfect.

Disgruntled, his mother replies,

Oh, I know what was making you so late. Cut the comedy and get into the car.

Isolated and shunned again.

Emotionally disconnected, Amir feels like even those closest to him – those who are his own – fail to see his torment. He is forced to fight his own battle within himself all alone.

His ‘black dog’ is faithful to him but in a way he despises. He is always around him, overpowering him at most times, but now Amir has to control it.

He fails again.

Before getting into the car, he checks his door lock several times rotating it clockwise and anticlockwise. It takes about ten minutes until he is fully satisfied.

This time, Amir celebrates his birthday with an unusual sense of joy. He tells everyone that he is happy, much to their surprise. When he is asked the specific reason for this sudden jubilation, he replies,

Well, I am 18 now and 18 is an even number. Also, my roll number for my upcoming medical entrance test is 46 which is also an even number and so is the date of my birthday.

His little brother speaks in a low voice,

Oh, dumbski!]

Isolated and shunned yet again.


What exactly is wrong with Amir you might ask? What is a ‘black dog’?

A lot of you may already deem Amir to be neurotic or even a cuckoo. But you are wrong; he is neither.

He is one of the most courageous people known; he battles day in and day out with Obsessive Compulsive Disorder (OCD). Other people who have suffered from this disorder include Albert Einstein, Charles Darwin, David Beckham, Jessica Alba and business magnate, Donald Trump.

OCD can be a very disturbing and dangerous mental illness. A person suffering from it is controlled by the disease and in Amir’s case, that ‘black dog’ controls his whole life.

This disorder leads one to have repetitive or intrusive thoughts, impulses, or images that cause marked anxiety or distress. Compulsions are characterised as ritualistic behaviour or acts that the person feels driven to perform that are aimed to reduce distress.

In the case of Amir, the marked symptoms of this condition include compulsive hand washing and an obsession with cleanliness, even numbers, checking door knobs, locks and cupboards.

Many people make the victims of such mental disorders the butt of their jokes. Few seem to understand that in most cases this can result in the aggravating feeling of isolation and self-loathing.

There is very little awareness about disorders like OCD, dyslexia, Asperger’s syndrome and autism in Pakistan. There is even an unfortunate sense of hesitance to spread awareness or learn more about these disorders. They are rarely spoken about or discussed openly unless in jest. There have been instances where, due to lack of awareness, the indication to these disorders go completely unnoticed and parents fail to provide their child with the right kind of support.

Diagnosing the illness as early as possible – be it OCD or any other mental disorder – is extremely important for the sake of the sufferer. Through adequate awareness, this can be done. The next most important step would be to seek help on a professional platform from specialists who can guide people towards the needs of people who have disorders .

For these people, being part of a rehab centre or support group will give him/her a sense of belonging and a realisation that there are others like them. This will ensure that those like Amir do not have to fight the battle alone; a battle that they may not be able to win on their own.

*Names have been changed to protect identities  


Usman Amjad

A medical student from Multan who is an avid reader and blogger.

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

  • enu

    finally something has been written on OCD. Many people in my family suffer from various levels of OCD and it can be highly destructive. But awareness/acceptance of the problem and some simple medication plus counseling, especially if caught early can be extremely effective. Personally, I wish I was more aware of this condition and its treatment much earlier in my life. I thank the author.Recommend

  • http://blogs.tribune.com.pk/author/430/faraz-talat/ Faraz Talat

    I’ve been saying the same thing for ages.

    Most Pakistanis think there’s only one kind of mental disorder – the kind where you go running around the room making funny noises, sometimes getting aggressive. Pagalpan. That’s the end of it.

    They can’t tell schizophrenia from OCD, depression from moodiness. And this ignorance costs us dearly, as people usually don’t step into a psychiatrist office until the condition has progressed from “bad” to “explosive”.

    Some don’t even see the psychiatrist at all. Haw haye, what will the aunties next door say when they find out our munna has gone crazy? Make the doctor keep doing his “seety-scan, sheety scan” until he finds a physical problem. Let him invent one, if he can’t find any. as our munna is too strong and smart to have become pagal.

    It’s truly heartbreaking…Recommend

  • Hindu Indian

    @Author : Nice ArticleRecommend

  • Ayesha Pervez

    Nice blog Usman!Recommend

  • Sane

    Very informative. It helps to understand a person with OCD in a better way. Would anyone else shall shed more light on this subject?Recommend

  • Alena

    I have gone through something similar and gotten through it successfully. We Pakistanis must understand the importance of counseling, psychotherapy and psychiatry…and not shun their very existence. Ignoring our problems will not get us anywhere. A mental illness is like an illness of the heart or any other organ. If you go to a doctor for those health problems, then why not for a mental illness?
    Here is my story: http://alenasadiq.wordpress.com/2011/05/29/breaking-the-silence/Recommend

  • Sahar

    Dilemma of our family! God it is PAINFUL…& Destructive enough to turn other sensitive family members PSYCHO who are around dat OCD person…Kindly let me know abt some competent psychiatrist in Lahore who could deal with the person with extreme OCD…Recommend

  • Monk

    People might not completely agree with me but the root of OCD, PTSD etc. is and always will be an underlying anxiety condition. It is also safe to say that Stress gives rise to anxiety in some cases. I say this because I have been through something very similar and I thank Allah that I found the Holy Grail of treatment of any such conditions that are a manifestation of an underlying anxiety condition. OCD is not a mental illness. Surprised ?.. I know you would be. OCD, PTSD , High Anxiety are just “behavioral conditions” or in other words “Bad Habits” which we have trained our minds so well to follow that our minds find it instinctual to act and respond that way in which it thinks is appropriate. Its as easy as flicking a switch to the off position and gradually all the symptoms / manifestations will disappear. FACT !

    Its as simple as that, eliminate the inappropriate anxiety, there will be no ground for the symptom / manifestation to exist. I say this out of first hand experience. You can spend thousands on Psychologists, Psychiatrists or perhaps use a popular method that goes by the name of CBT (Cognitive Behavior Therapy) these are all Management techniques. Why manage something when it can be cured 100% without fail, and you can live a fulfilling life. The only person who can cure you is you yourself.

    I cannot tell you how happy I am to finally see some one write about OCD. Great article. Its about time we fed some awareness around.Recommend

  • fizzasaleh

    The article clearly indicates the level of discomfort that person is going through, its very comon that sometimes we are so busy with our selves that we use to ignore these very important things. we should make it clear that these mental disorders should be treated as soon as possible. we should try ourselves to engage in different types of curricular activies such as sports, joining gym or so on.or anything which can make us think something else for a while.Recommend

  • psychedelic

    Read this – quite interesting though the last post was 6 years back..



  • Usman Amjad

    Thanks @Ayesha @Hindu Indian
    As a medical student perspective, OCD is very hard to control. Although the research is being done. It is not fully understood yet. Scientists say that any psychological trauma in the past triggers OCD. I, somehow, agree with this statement. Doctors usually prescribe SSRIs like Sertraline or Fluoxetine for the treatment of this condition. But these SSRIs are just antidepressants and not a particular treatment for OCD. However, I think psychotherapy and counselling are effective ways. Unfortunately, in our society, people do not see that. They consider a person suffering from this condition as being haunted by a ghost or Jinn. Other people do not understand the torment of an OCD sufferer. Only an OCD sufferer understands that.Recommend

  • Big Rizvi

    A nice write up!Recommend

  • imaan.sheikh

    Thank you so much for this blog, Usman. I have been wanting to read something like this. It’s so tragic that people with disorders like OCD are not understood in our society, let alone be cooperated with. I know two people with OCD and it’s not just their disorder that is a nuisance, the attitude and unwillingness of others to understand is the biggest dilemma.

    Thank you again for highlighting this.


  • Monk

    As far as I believe Counseling and Therapy of any sort will only fuel the condition and bring it to the forefront of the conscious mind.

    As mentioned earlier thoughts produce symptoms which fuels thoughts and this goes on in a vicious cycle.

    I don’t think its hard to treat. Its hard to understand in our society. The doctor promptly hands a cocktail of Benzodiazepines to the patient and see’s him / her off which then ends up as a life long addiction. The symptoms worsen and the dosage increases. OCD can be treated without a single medication or prescription. FACT ! It is hard at first but isn’t everything that you don’t know is?

    This is now becoming a serious epidemic in Europe & many developed countries as well. Once you figure out the clockwork of the human mind you cannot imagine the wonders you can do once you put it to use.Recommend

  • Future_of_Pak

    good, important article. would like to see more like these on ET. well done.Recommend

  • Saim Ali

    I agree with you completely and thnx for providing some useful tip on this issue i just wanted some good tips for my friend she is suffering from this disorder and i want to help her Recommend

  • Muhammed

    It feels like the story of my life, just I’m 19 and done with A level’s. However, I’m also suffering from chronic OCD and which makes me feel isolated. All you who do not have OCD or have defeated it, thank god cause you are really blessed!!!Recommend

  • http://blogs.tribune.com.pk/author/1115/usman-amjad/ Usman Amjad

    @Muhammed: Hi Muhammad, It’sthe authorof the article. Plz contact me on my Email address. I want to help you. Recommend

  • elementary

    We only have one word for all psychiatric illnesses —–“PAGAL”. Recommend

  • Mydah Tariq

    Great piece. It is indeed a torture for the individual, and having met a patient under treatment at a Psychiatry Ward, I believe its true that extreme mental stress must be a trigger for the condition, in some way. And then, the aloofness, the way your dearest start repelling you, adds fuel to the misery. There needs to be more and more awareness about mental disorders and a shunning of the hesitance towards seeing psychiatrists. If people can go to ‘peers’ and ‘babas’ for curing of mental disorders, then why not to somebody who holds a certificate and an authentic degree? Beats me.Recommend

  • Concerned

    Hi Usman,
    Thanks for the incredibly informative article. I was wondering if you could answer a question for an outsider to gain some perspective. From what i understand, pk has a very low ratio of qualified psychiatrists to number of patients. Is there any particular reason that mental health in pakistan has such a low number of qualified doctors as practicioners?

    Secondly would you say that there is scope in the field for young doctors to pick mental health as a specialty? Or is it simply the case that it is still such a taboo that it scares away not only prospective patients but also the doctors who could potentially be treating them? Can a career not be built out of this specialty?

    I suppose i want to get my head around such low numbers in the field.


  • Usman Amjad

    @Concerned aka Munesh Kumar:
    In Pakistan, mental health is not being given a proper consideration because people are afraid to talk about mental illnesses or go to psychiatrists. There are very good and competent psychiatrists in Pakistan. It’s just the lack of awareness that people hesitate to talk about these things. People consider other people suffering from different degrees of mental disorders as being haunted by some supernatural entity. There are a lot of people I know personally who are suffering from OCD, OCPD, Bipolar and other panic disorders but other people do not understand and lose their confidence just by calling them pagal. I personally think that without proper public awareness, there is no future of mental health and counselling in Pakistan. Recommend

  • Concerned

    @usman, I have noticed that mental health doctors in pak say that there are not enough doctors to support the load of mental health patients. would you say that the low awareness is the reason why less medical students choose to go into psychiatry?

    Also p.s who is munesh kumar lol?Recommend

  • Omair Ahmed

    people i have OCD too but i want to marry someone.what is the inheritance of OCD.my ocd started at 23 yrs.do you people have ocd at an early age and in familyRecommend

  • Sabahat Naseem

    @Saim Ali:
    it would be better if you make your friend visit a psychologist and seek a proper and professional treatment before her condition gets worse.

    you are right about the behavioral treatment but being a clinical psychologist, let me tell you that there indeed is a dire need of psychotherapy for people suffering from OCD and it works miraculously. FACT :)Recommend

  • http://pakistanigirlsmobilenumbar.blogspot.com Shahid Khan

    Thank you so much for this blog, Usman. I have been wanting to read something like this. It’s so tragic that people with disorders like OCD are not understood in our society, let alone be cooperated with. I know two people with OCD and it’s not just their disorder that is a nuisance, the attitude and unwillingness of others to understand is the biggest dilemma.

    Thank you again for highlighting this.Recommend