Hoarding disorder is a pattern of behaviour that is characterised by excessive acquisition and an inability or unwillingness to discard large quantities of objects that cover the living areas of the home and cause significant distress or impairment.

Signs and Symptoms:

  • They hold onto a large number of items that most people would consider useless or worthless, such as:
    • Advertising mail, old catalogues, magazines, and newspapers
    • Worn out cooking equipment
    • Things that might be useful for making crafts
    • Clothes that might be worn one day
    • Broken things or trash
    • “Freebies” or other promotional products
  • Their home is cluttered to the point where many parts are inaccessible and can no longer be used for intended purposes. For example:
    • Beds that cannot be slept in
    • Kitchens that cannot be used for food preparation
    • Tables, chairs, or sofas that cannot be used for dining or sitting
    • Unsanitary bathrooms
    • Tubs, showers, and sinks filled with items and can no longer be used for washing or bathing
  • Their clutter and mess are at a point where it can cause illness, distress, and impairment. As a result, they:
    • Do not allow visitors in, such as family and friends, or repair and maintenance professionals, because the clutter embarrasses them
    • Are reluctant or unable to return borrowed items
    • Keep the shades drawn so that no one can look inside
    • Get into a lot of arguments with family members regarding the clutter
    • Are at risk of fire, falling, infestation, or eviction
    • Often feel depressed or anxious due to the clutter

Diagnosis:

The DSM-5 diagnostic criteria for hoarding disorder are:

  1. Persistent difficulty discarding or parting with possessions, regardless of the value others may attribute to these possessions. (The Work Group is considering alternative wording: “…, regardless of their actual value.”)
  2. This difficulty is due to strong urges to save items and/or distress associated with discarding.
  3. The symptoms result in the accumulation of a large number of possessions that fill up and clutter active living areas of the home or workplace to the extent that their intended use is no longer possible. If all living areas become decluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, authorities).
  4. The symptoms cause clinically significant distress or impairment in social, occupational, or other critical areas of functioning (including maintaining a safe environment for self and others).
  5. The hoarding symptoms are not due to a general medical condition (e.g., brain injury, cerebrovascular disease).
  6. The hoarding symptoms are not restricted to the symptoms of another mental disorder (e.g., hoarding due to obsessions in Obsessive-Compulsive Disorder, decreased energy in Major Depressive Disorder, delusions in Schizophrenia or another Psychotic Disorder, cognitive deficits in Dementia, restricted interests in Autism Spectrum Disorder, food storing in Prader–Willi syndrome).

Causes:

People hoard because they believe that an item will be useful or valuable in the future. Or they feel it has sentimental value, is unique and irreplaceable, or too big a bargain to throw away. They may also consider an item a reminder that will jog their memory, thinking that without it they won’t remember an important person or event. Or because they can’t decide where something belongs, it’s better just to keep it.

Hoarding is a disorder that may be present on its own or as a symptom of another disorder. Those most often associated with hoarding are obsessive-compulsive personality disorder (OCPD), obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and depression.

Those who have suffered a traumatic loss may be more likely to become hoarders than those who haven’t. Some people develop hoarding tendencies after experiencing a stressful life event that they had difficulty coping with, such as the death of a loved one, divorce, eviction or losing their possessions in a fire.

Treatment:

Cognitive behavioural therapy (CBT) is the most effective psychological treatment. It can help you to change the thoughts and feelings that drive you to hoard.

The therapist will help you understand what makes it difficult for you to throw things away. You then agree to not hoard more items during the treatment. There is no point clearing things away if you replace them with others. You and your therapist start clearing out items together. You will find that the longer you spend thinking about it, the more difficult it becomes. The therapist helps you to look at your thoughts and feelings about possessions. As hoarding has often been going on for years, treatment can take a long time. The aim is to use the 3 Rs – Reduce, Recycle and Reuse.

SSRIs are also used to help people who hoard. Selective serotonin reuptake inhibitors (SSRIs) are antidepressant medications which are used to help anxiety and obsessional problems. Improvement usually happens slowly over weeks or even months.

Research continues into other medications which might be helpful in hoarding disorder. One group of drugs blocks the action of dopamine, a chemical in the brain. They can be used with SSRI medication if the SSRI alone does not seem to be helping enough.

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27 thoughts on “Psychology of Hoarding

  1. We are in the process of cleaning up after a hoarder. It’s awful. She moved away with a 16 ft truck filled with stuff only from her bedroom if that gives you an idea of how sick she is. She thinks it’s normal. Now she’s buying furniture like crazy at this new home and kitchen stuff. The guy she moved in with is also a hoarder. I don’t know what we are going to do when she does. This is my mother in law.

    Liked by 1 person

    1. I’m sorry to hear that! It can be difficult to live with a person who hoards. It can also be very difficult for them to realise it is an issue as removing items can cause great anxiety. In order to avoid the anxiety of throwing away unneeded items, they will deny they have a problem.

      Liked by 3 people

    2. This is not your problem and you would not be popular if you interve ned. Do not feel bad about it. It is what it is. It is up to them to sort out their own problems. There is no magic wand. They need to be motivated to get professional help and that could take time.

      Liked by 2 people

  2. Hereditary? I helped a friend clear out her father’s hoardish house after his death, and in the middle of the job, her three uncles showed up… “You aren’t going to throw THIS away are you? Someone could use this! They would have kept every item in the house.

    Liked by 3 people

  3. Years ago I went to a conference on hoarding. I learned some of what your post covered, although less on treatment. I did learn that someone else just going in and throwing away a lot of the hoarder’s stuff can be traumatic for the hoarder. And that one way to help a hoarder let go is to gather all the “like” items, say hats or clocks, together, then let them pick some to keep and some to dfind a good home for. Giving the items to someone who would appreciate them is helpful as well.

    Liked by 2 people

  4. Cool article! I’m not a hoarder, but I do display some of those tendencies. The spare bed in my office and closets are a good example of it. Hard to get around that feeling of tossing something that could be potentially useful, or that has sentimental value attached (despite it really just being a piece of garbage…). Thankfully my wife keeps me in check and has been helping to slowly purge “the collection”.

    Liked by 4 people

    1. There can be a fineline between clinically problematic behaviour and personal tendencies. I’m glad you have someone to support you and help you make the decisions of what to keep and what to throw out. Thank you for your comment 🙂

      Liked by 2 people

  5. I am a hoarder. I talk about it as a non monetized blogger who loathes social media, to dispel stigma.
    As well as I was a mother who was a horrific hoarder, where I had children in the home.

    In my case, when my hoarding was at it’s worst, I had both a child protection and an adult protection case.

    12 years ago when this happened had a mandatory clean up, a la like the show hoarders and it was a horrible thing to go through.

    There is a clear difference that most cannot detect that differentiate between people who hoard and people who just don’t like to clean.

    I was an extreme case because I had hoarded even garbage, at my worst.

    In my case, like others, the few of us who talk about it, I was in both medical and mental health crisis, but with a predisposition to hoard less severely, most of my adult life.

    In my case and I’m sure it applies to others, that my living space becomes a manifestation of their heads, i.e. thought clutter that came from undiagnosed and untreated bipolar 2 disorder.

    I liken it as well, as a non clinically trained professional but activist as a “symptom” versus an end diagnosis.

    Because like I know as an activist and blogger who is a former bariatric patient is fully aware that when it comes to mental health issues and addiction, for example if food becomes something a patient can abuse or be addicted to, it doesn’t stop addictive trait type of behavior.

    It transfers itself, untreated to something else.

    The problem with hoarding is that it’s so stigmatized most people who are hoarders have trouble accepting that they are due to stigma, as we’re kind of lumped in as the worst of the worst of people.

    Because it’s literally a “dirty” secret, one of the worst that the hoarders themselves and those who love them, can have.

    Especially in my case, where I came from an upper middle class family, there wasn’t CD issues that were to play with my hoarding or other psych issues.

    I try to get across as an activist as well as a parent who both hoarded and then a year later tried to commit suicide, it wasn’t a lack of love for my children of why I did both of those things.

    People can love their children but not love themselves that leads to drastic behaviors like sucidality and hoarding in my case.

    But for family who literally have to clean up messes both literally and figuratively left by hoarders and with untreated and unchecked mental illness, it’s a lot harder to understand and obviously, to not take personally.

    Especially in cases where hoarders become defensive about their stuff (which I did at my worst) and not acknowledging their dysfunctional thought processes and behaviors (which I didn’t at my worst, because I was too scared as a mother in crisis, but at the same time I was also terrified of losing my children).

    I am not trying to make this about me.

    I just as an “armchair” activist hate the stigma that goes around, but even more than that and where it helps others, which is why I write about it, that there are loved ones of people who were hoarders or survivors of a parent who tried to commit suicide and they think that their parent and/or adult child didn’t love them, is too much to bear for me, so I try to make some good of what happened when things were at the worst for me, just so what my children, family and I went through wasn’t in vain.

    And what can really happen to people who are in crisis, when it’s so stigmatized who love others but don’t love themselves, it can heartbreakingly adversely effect the ones we love the most.

    And because I can articulate I do and it’s helped those who had loved ones who couldn’t.

    Whether it’s parents and children of loved ones who have a parent who hoarded or died of suicide who didn’t know they were sick and they never got the appropriate closure for that.

    Or for parents and children with severe mental illness who don’t realize the damage even, if unintentional and non violent, of what hurt it caused, because their too sick with their illness to acknowledge it exists and the hurt it caused the ones they love the most.

    This was though a good necessary blog, I’m glad I found it and look forward to reading other blogs of yours

    Peace.

    Liked by 2 people

    1. Thank you so much for sharing your story with me. I know non-hoarders cannot understand completely what it feels like to be in your shoes. I am glad you write about your story as it helps others going through the same thing and helps the general public sympathise with what is no doubt as much of a problem for the hoarder as it is for their loved ones. No one intentionally wants to cause harm to the people closest to them. People need to feel safe enough to ask for help and these parents need to be approached with kindness instead of the threat that their children will be taken away.

      I’m glad you’re still with us and I hope you stay well. Take care.

      Liked by 2 people

  6. A great read and really relate. I am so on this spectrum and having kids and no time to sort has made me worse. My second child has started school now so hoping with one at home I can get back on top! I think keeping some stuff is healthy (?) or life can seem to clinical maybe if that makes sense. But clutter really slows life down when it gets to a certain level and clogs up life. Feels great filling up the charity bags at last!

    Liked by 1 person

    1. I agree. I don’t think keeping things is a problem in itself but when the collection gets in the way of life, affects your relationships and wellbeing then it is a problem. I hope you get some ‘me’ time now your second child is in school! Mummy-ing is hard work! 🙂

      Liked by 1 person

  7. I have always attracted hoarders for some reason. They have not been like the grand scale hoarders that I have seen television yet they definitely hoard. If I had a dollar for every time one of them said that something would be worth money one day I would be rich! Thanks for posting this.

    Liked by 1 person

  8. Very informative, I remember once I graduated highschool I kept all my notes and books since freshmen year thinking they would be helpful, I kept notes written between friends and classmates, essentially useless junk until finally I said “enough! I’m not going to use this stuff” and I threw it away.

    Liked by 1 person

    1. I think it can be hard to part with things like notes because you have put so much work into them and then suddenly you have to get rid of the evidence of your labour? It’s a little heartbreaking! But it’s good to realise they are no longer of use to you and they have served their purpose.

      Like

  9. I am hoarding in case of a no-deal Brexit. As Brexit is likely to be highly inflationary, my theory is that collecting a few tins of nutritious food makes good commercial sense. Money can be a poor store of value, and buying the tins from the supermarket gives me a hobby. The strategy also allows me to debate why Brexit is a really negative idea. If people find the hoarding is a symptom of anxiety then I humbly suggest that they try to stop Brexit. Joining the Labour Party always makes sense- the social aspect is good for well-being and participation may allow you to articulate anti-Brexit views effectively.

    Liked by 1 person

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