At first glance, hoarding may seem like a relatively simple problem to solve. But hoarding is an often misunderstood mental health disorder that can put a person’s health and safety at risk.
What is hoarding disorder?
Hoarding is a mental health problem characterized by an inability to get rid of certain possessions to the point of accumulating them in unhealthy ways. A person with hoarding disorder acquires an excessive number of items they do not need and stores them out of order.
The items accumulated vary from person to person. Someone could accumulate boxes, magazines, containers, bags or old clothes. A person with hoarding disorder thinks that the items might be useful to them one day, or they derive great joy from their possessions and are reluctant to throw them away.
Because hoarding items accumulate in excess and chaotically, the living space of a person with hoarding disorder is often cluttered. Clutter can reach an extreme level, so that the living space can no longer be used as intended. For example, a kitchen table becomes so cluttered that there is no space to put a table on it, or a hallway is so full of possessions that it is difficult to walk through.
The sheer amount of clutter can affect the relationships, hygiene, or work of someone with hoarding disorder. This can create an unsanitary situation, leading to an infestation of pests such as cockroaches or rodents. People with hoarding disorder may avoid having visitors. In some cases, clutter can present physical hazards such as a fire hazard, trip hazard, or other hazards due to the inability to navigate the space safely.
Who is at increased risk for hoarding disorder?
Hoarding disorder affects approximately 2 to 6 percent of the adult population and occurs equally in men and women. Hoarding is more common among people who have a family member with the disorder and is more often seen in people living alone.
Studies have shown that the first symptoms of hoarding disorder usually appear during adolescence, and symptoms worsen over time. Hoarding is not common among children because their parents take a more active role in controlling their environment.
Hoarding occurs three times more often among older adults than in the general population. This is particularly concerning because hoarding can exacerbate older adults’ risks of falling or misplacing important items such as medications or prescription glasses.
More than 60% of people with clinically significant hoarding also have another psychiatric disorder. The most common coexisting psychiatric disorders are major depressive disorder, generalized anxiety disorderAnd social phobia. In some cases, conditions such as dementia or a stroke may be responsible for hoarding behavior.
Symptoms of Hoarding Disorder
In 2013, the American Psychiatric Association (APA) recognized hoarding as a disorder on the obsessive-compulsive disorder spectrum. According to the APAHoarding disorder is characterized by persistent difficulty giving up possessions, regardless of their actual value. This is motivated by a strong need to keep objects and anxiety about throwing them away.
As a result, belongings pile up, clutter living spaces and interfere with their normal use. If these areas remain clear, it is usually because family, friends or professional cleaners have intervened. Hoarding also causes considerable distress or challenges in daily life, affecting relationships, work, and the ability to maintain a safe living environment.
Stressful life events can intensify hoarding symptoms.
Why do people with hoarding disorder feel compelled to accumulate?
Although hoarding has been studied for more than two decades, there is still much to learn about the disorder, including why people with hoarding disorder feel compelled to hoard. Although research indicates a link between hoarding and difficulties with information processing skills such as planning, problem solving, memory, learning, attention and organization, this deficit doesn’t adequately explain the problem. need hoard.
Many people who accumulate don’t see a problem with it. They have little awareness of how it affects their lives or the lives of those around them. Some studies have found that family members of individuals who hoard tend to rate the severity of hoarding behavior significantly higher than how they think the person who hoardes would rate their own symptoms.
Treating Hoarding Disorder
Hoarding disorder is a difficult condition to treat, but with the right support, individuals can make significant progress toward changing their habits.
Cognitive Behavioral Therapy (CBT) for Hoarding
The most effective treatment for hoarding disorder is cognitive behavioral therapyor CBT. CBT is a type of talk therapy in which an individual works over an extended period of time with a trained therapist to treat emotions, thoughts, and behaviors related to problematic conduct.
In someone with hoarding disorder, CBT would help them better understand why they need to hoard items, as well as provide training on decision-making, sorting, and discarding , as well as on the organization.
Relaxation techniques can also be incorporated into therapy. CBT does not involve cleaning houses, nor does it target the social consequences of hoarding.
Drugs
There are no FDA-approved medications for the treatment of hoarding disorder. However, a class of medications called selective serotonin reuptake inhibitors (SSRIs) are often prescribed to people who have hoarding disorder and also suffer from anxiety or depression.
Coping with Hoarding Disorder
Coping with hoarding disorder can be difficult, but there is help. Getting support from a therapist, including through cognitive behavioral therapy (CBT), can help you understand why it’s difficult to let go and teach you strategies to avoid clutter.
If you or someone you know is suffering from hoarding disorder, contacting a medical professional or mental health professional is the first step in finding support. It can also help to surround yourself with supportive friends or family members. Progress takes time, but each step can lead to a safer, more comfortable space.