A 42-year-old male patient with a "Specific phobia with Obsessive Compulsive Disorder with Moderate depressive episode with paranoid schizophrenia". During the interview, the patient reported that he is having fear of crowded places, height & blood, low mood, low self-esteem, repetitive thoughts, Nightmares about a snake, excessive cleaning rituals, suspiciousness towards surrounding people, and hearing voices. Measures and outcome: The Psychological assessment TCI indicates "obsessive-compulsive personality disorder", Rorschach fulfilled the 'coping deficit index', TAT indicates fear of the environment, people or negative judgment by others, felt the anxiety of disapproval and punishment, Y-BOCS indicates "Moderate category of Obsession" and "Mild category of compulsive symptoms", BDI-II indicates "Moderate depressive symptoms", HAM-A indicates "Mild anxiety symptoms" and BPRS indicates "Mildly ill". The MSE revealed that the patient had checking & sexual obsession, dirt & contamination obsession and cleaning compulsions, Agoraphobia, claustrophobia, hemophobia, acrophobia, hypnogogic hallucination, delusion of reference, delusion of persecution and delusion of infidelity, depressed mood and affect, suicidal thoughts, fair judgment with Grade 4 insight. The patient was diagnosed with "Specific phobia with obsessive-compulsive disorder with Moderate depressive episode with paranoid schizophrenia" by a psychiatrist and was prescribed Pharmacological and psychological treatment. Management: The pharmacological treatment through SSRI continued and specific symptom-based psychological therapy and intervention including relaxation therapy has been planned and given to the patient. Implications: This case study reinforces the importance of a thorough psychological evaluation to rule out other disorders. Further, it also presents a case with the progression of illness and treatment plan.