Hoarding Disorder

Hoarding is a disorder characterized by an ongoing resistance to discarding one’s belongings, even those with no value, like junk mail, old newspapers, and materials that most people would consider to be garbage. Hoarders also hold on to personal possessions that they no longer use, either because they feel emotionally attached to these items, or because they believe they will need them in the future. People with this condition may give in to the urge to acquire excessive amounts of objects that fill out their living space. The accumulation of clutter and lack of order and cleanliness can cause health and safety risks within the home. Hoarding disorder can create social, professional, and functional problems that affect not only the individual, but also the people around them.

Symptoms

The hoarding tendency often begins in adolescence and only continues to worsen as the person gets older. Unlike someone who is a collector of objects generally recognized as collectable with some known value, a person with hoarding disorder collects random items and is overly attached to personal possessions that may or may not have any value. Although they may be convinced to give up or throw away some of the items, doing so causes the person great distress. Ultimately, almost every surface in the home of a hoarder, including floors, furniture, counters, and other fixtures, will be covered in growing piles of clutter. The hoarder will have only a narrow path left clear for walking through the living space, which for the most part is no longer usable. Hoarders often experience difficulty with personal hygiene and are at greater risk of falling and of their belongings catching fire. The more cluttered and blocked their home becomes, the more stress the hoarder feels, because of the chaos within the living space and often because of complaints from family members, neighbors, and even local law enforcement.

Causes

The cause of hoarding disorder has yet to be found, although there are known risk factors. People who experience a traumatic event, have difficulty making decisions, or have a family member who hoards are at risk of developing the disorder. The majority of people with hoarding disorder also suffer some type of depressive or anxiety disorder. Some also have obsessive-compulsive disorder(OCD). In fact, hoarding disorder was once thought to be a symptom of OCD, and there are some similarities between the two; however, hoarding is now recognized as a separate condition. None of the symptoms of hoarding disorder are due to any other mental health condition, nor are they due to a medical problem. One study found that among the reasons people gave for hoarding, avoiding waste was the most common.

Treatment

Although hoarding may persist for a lifetime, proper treatment can help reduce the need to hold on to unnecessary items; it can also improve decision-making, stress-reducing, and organizational skills. The primary treatments used to relieve symptoms of hoarding disorder include cognitive-behavioral therapy and antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs). One or the other, or both, may be employed.

References

  • American Psychiatric Association. Understanding Mental Disorders: Your Guide to DSM-5. 2015. American Psychiatric Publishing.
  • Anxiety and Depression Association of America website. Hoarding: The Basics. https://www.adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/hoarding-basics Accessed March 28, 2017.
  • Frost RO, Steketee G, Tolin DF, Sinopli N, Ruby D. Motives for acquiring and saving in hoarding disorder, OCD and community controls. Journal of Obsessive-Compulsive and Related Disorders. January 2015;4:54-59. http://www.sciencedirect.com/science/article/pii/S0165178113008196
  • Morein-Zamir S, Papmeyer M, Pertusa A. et al. The profile of executive function in OCD hoarders and hoarding disorder. Psychiatry Research. 30 March 2014;215(3):659-667. http://www.sciencedirect.com/science/article/pii/S0165178113008196

Last reviewed 04/07/2017