When does clutter shift to hoarding?
Posted September 24, 2019 | Reviewed by Abigail Fagan
Welcome back to Conquer the Clutter! Our blog provides information and recommendations based on Elaine’s 17 years of experience working exclusively with people who hoard, those who care about them, and the professionals trying to help who feel ill prepared.
What Is Hoarding Disorder?
Here is a thumbnail outline of the criteria for Hoarding Disorder (and all three must be present even to a minimal degree):
- Excessive accumulation and failure to discard proportionately (things and/or animals).
- Activities of daily life are impaired by spaces which cannot be used for the intended purpose.
- Distress or impairment in functioning to the person hoarding or others. Even if “others” don’t know about the hoard, they would have reason to be concerned.
It also important to note that:
- Hoarding is found in all cultures, income, education levels, and for different reasons.
- Hoarding situations continue to deteriorate until the health and safety of the individual and community are put at risk.
In a situation that meets the standard for Hoarding Disorder, the only difference between an excessive accumulation of perceived valuable things and non-valuable things is the price tag on the items. The key factor is the excessive accumulation and the failure to resolve that excessive accumulation because of the risk it creates.
Conservative estimates indicate that over 21 million people suffer from Hoarding Disorder in North America today.
Types of Hoarding
There are three types of hoarding disorder:
1. Standardized hoarding, with three subtypes:
- Anything can be hoarded; e.g., valuable items all the way to human waste.
- Items are what most people save.
- Insight and motivation fluctuate greatly.
- Usually results in chaotic piles.
- Saves one or more specific categories of items; for example, books, figurines, art, paper, clothing. (We will discuss the 10 most common things hoarded in a future blog post.)
- Items have high attraction value for the person and are given high importance.
- Rarely displayed as “collections” to be enjoyed with acquaintances.
Combined hoarding generally occurs when discriminate hoarding exceeds the person’s ability to manage desired items from the everyday clutter in their environment.
2. Diogenes Syndrome – is often found in our aging population and is hallmarked by two criteria:
- Self-Neglect – lack of clothing, poor nutrition, medical, and dental care even when they can afford it
- Domestic Squalor – makes residence unhealthy and unsafe
3. Animal Hoarding – Accumulation of animals to the extent that there is:
- Failure to provide minimal nutrition, sanitation, and veterinary care.
- Failure to act on the deteriorating condition of the animals or the environment.
- Failure to act on or recognize the negative impact of the collection on your own health and well-being.
Why Is Hoarding More Than a Mental Health Issue?
Effective May 2013, Hoarding became a discrete disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). It is however, more than a mental health issue. Hoarding can also become a legal, personal, and public health and safety issue. Without identification and treatment, people living with Hoarding Disorder are at higher risk to experience further deterioration to both their mental health status as well as their living conditions. Without hoarding-informed supportive interventions, they can put themselves and others at risk.
Hoarding is widely acknowledged to be a compulsive behavior, so as it progresses, the following conditions can be created:
- Unhealthy living conditions due to deterioration, infestation, and or contamination. For example, compromised breathing conditions can be created due to poor air quality, extreme dust, mouse scat or mold.
- Unsafe living conditions due to fire, flood, tripping, or toppling. One example is mice chewing on electrical cords which could start a fire. An excessive accumulation of things creates an increased risk due to the fuel load. If for any reason items become wet, they can put an excessive load on the structural integrity of the building. If the environment is shared, such as an apartment or side-by-side dwelling, neighbors are also put at risk.
Hoarding vs. Cluttering
Hoarding and cluttering are often used interchangeably. There are two differences:
- Clutterers are more likely to discard things more easily.
- Their clutter does not debilitate their lives to the same degree.
Here’s what we don’t know. Is cluttering really a stage in the life cycle of hoarding?
Every person who has clutter does not necessarily go on to hoard. But, in the 17 years Elaine has worked with those who hoard, every single person has told her that creating clutter was a starting point.
You decide. Is your clutter manageable?
In our next post, we’ll talk about some common misconceptions about hoarding and those who hoard.
Timpano, K.R., Exner, C., Glaesmer, H., Rief, W., Keshaviah, A., Brahler, E., & Wilhelm, S. 2011. “The epidemiology of the proposed DSM-5 hoarding disorder: Exploration of the acquisition specifier, associated features, and distress.” Journal of Clinical Psychiatry, 72 (6), 780-86. http://dx.doi.org/10.4088/JCP.10m06380.