Hoarding

Hoarding is similar to obsessive-compulsive disorder. Hoarding and obsessive-compulsive disorder are types of anxiety disorders in which obsessions (worries and thoughts) and compulsions (behaviors) cause significant impairment in people's lives. People who struggle with hoarding cannot stop collecting and saving things. Their fear that they may need an item someday prevents them from throwing items away or distinguishing between valuable and useless items.

People who hoard may collect almost anything, sometimes even pets. In severe cases, things that people hoard pile up and completely fill their homes. Just moving around may become difficult. Their homes can become unsafe. It may become difficult to walk without tripping. Exits may get blocked, and the home may become a fire hazard.

RISK FACTORS

  • Family history of hoarding.

  • Beginning to collect things when still young.

  • Depression.

  • Anxiety.

  • A painful or very scary event early in life.

  • Social isolation.

  • Difficulty paying attention.

  • Lack of organizational skills.

  • Difficulty making decisions.

  • Obesity.

SYMPTOMS

Most symptoms of hoarding start by the age of 13 years. Some symptoms begin as early as age 3 years. Onset of symptoms usually is gradual, although a stressful life event may contribute to a sudden (acute) onset. Hoarding can be long-lasting (chronic) and symptoms can come and go over time. Symptoms include:

  • A pattern of buying things and then never using them.

  • Fear of wasting anything.

  • Emotional attachment to objects.

  • A sense of comfort from the hoarded items.

  • Difficulty discarding or parting with possessions, regardless of the values others may attribute to these possessions.

  • An accumulation of a large number of possessions that fill up and clutter active living areas.

DIAGNOSIS

To confirm signs of hoarding, your caregiver probably will:

  • Ask about the condition of your home.

  • Ask about your ability to give or throw things away.

  • Ask if family members or friends have complained about the condition of your home.

TREATMENT

Treatment may include:

  • Cognitive behavioral therapy. This helps people change underlying beliefs that contribute to collecting and saving, and helps reduce the anxiety related to letting items go.

  • Family therapy. People who struggle with hoarding are often brought into treatment by a family member. Family members may try to shame or push their loved one into giving things away. Although this comes out of concern for their loved one, this approach usually is not effective in helping the individual make changes.

  • Medicine. Antidepressant medicines called selective serotonin reuptake inhibitors may be used. They help block symptoms of depression and hoarding. This is most effective when combined with psychotherapy.

  • Help at home. People who struggle with hoarding may need help to make their homes safe. Items may need to be removed from the home. Repairs might need to be made. A pest service may be needed. They may need help finding new homes for extra pets. A professional organizer may be able to help sort through things and put a system in place to keep things in order.