Everything You Need to Know About Hoarding Disorder & Treatment
Updated: Jul 26, 2022
Sometimes it’s tough to throw something away even if you know you don't need it, but at what point does it become a mental health concern? Hoarding is the persistent difficulty discarding or parting with possessions, regardless of their actual value. A person with a hoarding disorder may feel distressed even at the thought of getting rid of their possessions. With the excess accumulation of items filling the home, large stacks of clutter can create potentially dangerous living situations for people with hoarding disorder.
Hoarding can range from mild to severe. It can seriously affect the emotional, physical, social, financial, legal, and mental well-being of those who hoard as well as friends and family. Hoarding is often associated with compulsive behaviour, such as shopping and buying or compulsive hoarding.
Compulsive hoarding includes all three of the following:
A person collects and keeps a lot of items, even things that appear useless or of little value to most people, and
These items clutter the living spaces and keep the person from using their rooms as they were intended, and
These items cause distress or problems in day-to-day activities.
Hoarding vs. Collecting
Hoarding is different from collecting. Though both can accumulate large amounts of items, collectors generally enjoy and take pride in their possessions. They like to display their collection and experience joy when talking about it. These collections are typically kept very organized.
In hoarding, on the other hand, this is seldom the case; possessions are usually kept in disarray, and there is often embarrassment and shame surrounding the clutter. People who hoard may not feel comfortable when others see their clutter.
Signs & Symptoms of Compulsive Hoarding
Difficulty getting rid of items
Severe anxiety when attempting to discard items
A large amount of clutter in the office, at home, in the car, or in other spaces (i.e., storage units) makes it difficult to use furniture or appliances or move around easily
Great difficulty categorizing or organizing possessions
Losing important items like money or bills in the clutter
Feeling overwhelmed by the volume of possessions that have taken over the house or workspace
Distress, such as feeling overwhelmed or embarrassed by possessions
Excessively acquiring items that are not needed or for which there's no space
Being unable to stop taking free items, such as advertising flyers or sugar packets from restaurants
Obsessive thoughts and actions: fear of running out of an item or of needing it in the future; checking the trash for accidentally discarded objects
Buying things because they are a “bargain” or to “stock up”
Not inviting family or friends into the home due to shame or embarrassment
Refusing to let people into the home to make repairs
Tending indecisiveness, perfectionism, avoidance, procrastination, and problems with planning and organizing
Who is at Risk for Compulsive Hoarding
Hoarding behaviours tend to develop in the teenage years (11-15) and usually worsen with age. However, the average age of people seeking treatment for hoarding is 50 years old. Meaning most people with hoarding disorder (1 in 50 people) struggle with the negative consequences of hoarding for a lifetime before seeking help.
Though there is no one clear cause of hoarding, some risk factors may include:
Personality: Many people who have hoarding disorder have a temperament that includes indecisiveness.
Family history: There is a strong association between having a family member with a hoarding disorder and having the disorder yourself.
Stressful life events: Some people develop hoarding disorder after experiencing a stressful life event for which they had difficulty coping. Some examples include the death of a loved one, divorce, eviction, or losing possessions in a fire.
Many people with hoarding disorder also experience other mental health disorders, such as:
Obsessive-compulsive disorder (OCD)
Obsessive-compulsive personality disorder (OCPD)
Attention-deficit/hyperactivity disorder (ADHD)
Dementia or schizophrenia
Complications of Compulsive Hoarding
Excessive acquiring and refusing to discard items may result in:
Disorganized piles or stacks of things, such as newspapers, clothes, paperwork, books, or sentimental items
Possessions that crowd and clutter your walking spaces and living areas and make the space unusable for the intended purpose, such as not being able to cook in the kitchen or use the bathroom to bathe
A buildup of food or trash to unusually excessive, unsanitary levels
Significant distress or problems functioning or keeping yourself and others safe in your home
Conflict with others who try to reduce or remove clutter from your home
Difficulty organizing items, sometimes losing important items in the clutter
As mentioned earlier, there is quite a lot of shame and embarrassment associated with hoarding behaviours. Still, it can also contribute to a diminished quality of life. Having tons of clutter in the home removes functions of living space, which makes it harder to move around and feel comfortable in their own home. Broken appliances and things that need repair are often left unfixed because coping with malfunctioning systems is more comfortable than allowing a qualified person to come into the home and fix it.
Anger, resentment, and depression can build up in family members, especially children, affecting their social development. Without a functional living space, separation or divorce, eviction, loss of child custody, serious financial problems are more likely to occur.
Hoarding disorder can cause a variety of other complications, including:
Increased risk of falls
Injury or being trapped by shifting or falling items
Loneliness and social isolation
Unsanitary conditions that pose a risk to health
Poor work performance
Legal issues, such as eviction
Treatment for Hoarding Disorder
Strategies to treat hoarding include:
Challenging the hoarder’s thoughts and beliefs about the need to keep items and about collecting new things
Going out without buying or picking up new items
Getting rid of and recycling clutter. First, by practicing the removal of clutter with the help of a clinician or coach and then independently removing clutter
Finding and joining a support group or teaming up with a coach to sort and reduce clutter
Understanding that relapses can occur
Developing a plan to prevent future clutter.
Attempts to forcibly de-clutter a hoarder's home will be unsuccessful. It will only work to cause unnecessary and harmful distress to the one suffering from hoarding disorder. Plus, cleaning out the home isn't addressing the underlying issues causing the hoarding behaviour. Therefore, the problem is likely to keep re-occurring until the deeper issues are addressed.