HOARDING DISORDER: AN ADDICTION TO CLUTTERING TOO MUCH STUFF
May 24, 2019
Compulsive hoarding, also known as hoarding disorder, is a behavioural pattern or a mental health disorder where someone acquires an excessive number of items and stores them in a chaotic manner, usually resulting in unmanageable amounts of clutter. The items can be of little or no monetary value.
Hoarding disorder is common and potentially disabling. It occurs in an estimated 2 to 6 percent of the world’s population and often leads to substantial distress and problems functioning. It is more common in older adults than in younger adults.
Hoarding disorder results to a person having a persistent difficulty discarding or parting with possessions because, of a perceived need to save them. A person with hoarding disorder experiences distress at the thought of getting rid of the items.
Hoarding is not the same as Collecting
Hoarding is different from collecting. Collectors deliberately search out specific items, such as model cars or stamps, and will organise or display them. A collection is usually well ordered, and the items are easily accessible. People with hoarding disorder save random items and store them haphazardly. In most cases, they save items that they feel may be needed in the future, are valuable or have sentimental value. Some may also feel safer surrounded by the things they save. A hoard is usually much disorganised, takes up a lot of room and the items are largely inaccessible. Typical hoarded items include newspapers, magazines, paper products, household goods, and clothing. Sometimes people with hoarding disorder collect a large number of animals, which they may not be able to look after properly. More recently, hoarding of data has become more common. This is where someone stores huge amounts of electronic data and emails that they're extremely reluctant to delete.
Hoarding often creates such cramped living conditions that homes may be filled to capacity, with only narrow pathways winding through stacks of clutter.
Countertops, sinks, stoves, desks, stairways and virtually all other surfaces are usually piled with stuff. And when there's no more room inside, the clutter may spread to the garage, vehicles, yard and other storage facilities. Although collections can be large, they aren't usually cluttered and they don't cause the distress and impairments that are part of hoarding disorder.
Hoarding ranges from mild to severe. In some cases, hoarding may not have much impact on your life, while in other cases it seriously affects your functioning on a daily basis.
Signs and Symptoms
Getting and saving an excessive number of items, gradual buildup of clutter in living spaces and difficulty discarding things are usually the first signs and symptoms of hoarding disorder, which can start as early as the teenage years and gets more noticeable with age.
As the person grows older, he or she typically starts acquiring things for which there is no immediate need or space. By middle age, symptoms are often severe and may be harder to treat.
For many, hoarding becomes more problematic in older age, but the problem is usually well established by this time. Most cases, significant clutter has developed by the time it reaches the attention of others.
Signs and symptoms may include:
Excessively acquiring items that are not needed or for which there's no space
Inability to get rid of possessions, regardless of actual value
Extreme stress about throwing out items
Anxiety about needing items in the future
Building up of clutter to the point where rooms become unusable
Living in unusable spaces due to clutter
Become extremely attached to items
Distrust of others touching possessions and refusing to let anyone borrow them
Reluctance or unable to return borrowed items
Having a tendency toward indecision, perfectionism, procrastination, and problems with planning and organizing
Withdrawing from friends and family
Excessive acquiring and refusing to discard items results in:
Disorganised piles or stacks of items, 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
Buildup of food or trash to unusually excessive, unsanitary levels
Significant distress or problems functioning
Inability to perform daily tasks such as cooking and bathing in the home
Increased risk of fire, falling, infestation, or eviction
Injury or being trapped by shifting or falling items
Not allowing visitors in, such as family and friends, or repair and maintenance professionals, because the clutter embarrasses them
Keep the shades drawn so that no one can look inside
Conflict with others who try to reduce or remove clutter from your home
Difficulty organising items, sometimes losing important items in the clutter
Loneliness and social isolation
Why someone may hoard
People with hoarding disorder may typically save items because:
They believe these items are unique or will be needed at some point in the future
The items have important emotional significance such as serving as a reminder of happier times or representing beloved people or pets
They feel safer when surrounded by the things they save
They don't want to waste anything
While the reasons for someone to hoard, are not fully understood. It can be a symptom of another condition. For example, someone with mobility problems may be physically unable to clear the huge amounts of clutter they have acquired, and people with learning disabilities or people developing dementia may be unable to categorise and dispose of items.
Mental health problems associated with hoarding include:
psychotic disorders, such as schizophrenia
obsessive compulsive disorder (OCD)
When to see a doctor
If you or a loved one has symptoms of hoarding disorder, talk with a doctor or mental health professional as soon as possible.
As hard as it might be, if your loved one's hoarding disorder threatens health or safety, you may need to contact local authorities, such as police, fire fighters, public health workers or child/elder protective workers.
What Causes Hoarding Disorder?
It's not clear what causes hoarding disorder, but researchers have identified a number of risk factors. They include:
Having a relative with the disorder
Brain injury that triggers the need to save things
Stressful or Traumatic life event, such as the death of a loved one
Mental disorders such as depression or obsessive-compulsive disorder
Uncontrollable buying habits
Inability to pass up free items such as coupons and flyers
Diagnosing Hoarding Disorder
For diagnosis, your mental health professional may use the criteria for hoarding disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
People often don't seek treatment for hoarding disorder, but rather for other issues, such as depression or anxiety. To help diagnose hoarding disorder, a mental health professional performs a psychological evaluation. In addition to questions about emotional well-being, you may be asked about a habit of acquiring and saving items, leading to a discussion of hoarding.
Your mental health professional may ask your permission to talk with relatives and friends. Pictures and videos of your living spaces and storage areas affected by clutter are often helpful. You also may be asked questions to find out if you have symptoms of other mental health disorders.
Treatment for Hoarding Disorder
Many people who hoard frequently do not see it as a problem, or have little awareness of how it's affecting their life or the lives of others, thereby, making treatment challenging. But intensive treatment can help people with hoarding disorder understand how their beliefs and behaviours can be changed so that they can live safer, more enjoyable lives.
Some may realise they have a problem but are reluctant to seek help because they feel extremely ashamed, humiliated or guilty about it, and here is where it is really important to encourage a person who is hoarding to seek help. If not tackled, it's a problem that will probably never go away.
The main treatment for hoarding disorder is psychotherapy, also called talk therapy. Cognitive behavioural therapy (CBT) is the most common form of psychotherapy used to treat hoarding disorder.
Medications may be added, though, there are currently no medications approved to treat hoarding disorder, medications used are to treat other disorders such as anxiety and depression that often occur along with hoarding disorder. The medications most commonly used are a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs).
Although hoarding may persist for a lifetime, proper treatment can help reduce the need to hold on to unnecessary items, and it can also improve decision-making, stress-reducing, and organizational skills. Many people who receive treatment for hoarding disorder learn to manage their possessions. Learning new behaviours allows them to feel less anxiety. Reducing these symptoms leads to an improved quality of life.
Can Hoarding Disorder Be Prevented?
Because little is understood about what causes hoarding disorder, there's no known way to prevent it. However, as with many mental health conditions, getting treatment at the first sign of a problem may help prevent hoarding from getting worse.