Published on: December 20, 2021
Updated on: December 20, 2025
Author: Kentucky Counseling Center
Most households have a bit of clutter here and there, but if the mess is so overwhelming that you’re barely able to walk through rooms or use certain spaces, you may be dealing with more than ordinary disorganization. Hoarding disorder is a recognized mental illness characterized by extreme difficulty discarding possessions—even those with no apparent value—due to a persistent, perceived need to save them.
In this article, we’ll explore what hoarding disorder is, how it differs from simple collecting, common signs and risk factors, and where to seek help if you or someone you know might be a hoarder.
What Is Hoarding Disorder?
Hoarding disorder, sometimes called “compulsive hoarding,” entails:
- Persistent difficulty in discarding or parting with belongings, regardless of their actual value.
- An excessive need to acquire new items, often triggered by emotional attachment or a sense of potential future need.
- Significant distress or impairment in daily life caused by the inability to let go of these possessions.
Hoarding symptoms often start at a young age but typically worsen over time. It’s most common among people over 60 and frequently co-occurs with conditions like anxiety, depression, and other psychiatric diagnoses.
Hoarding vs. Collecting
Although both hoarders and collectors accumulate objects, the differences are stark:
- Collectors
- Intentional: Acquire items within a specific category or theme (e.g., stamps, coins).
- Orderly Displays: Organize and show off collections, taking pride in their systematic approach.
- Less Impact on Livability: Collections usually don’t hinder use of living spaces.
- Hoarders
- Impulsive: Save random objects with no consistent theme.
- Chaotic Clutter: Items pile up in a disorganized manner, making spaces unusable.
- Significant Distress: Difficulty discarding possessions leads to conflicts with family and potential health hazards.
Living With Hoarding Disorder
People who hoard often feel overwhelmed by the sheer volume of possessions they’ve accumulated. Their living spaces can become unsafe and unsanitary, potentially straining family relationships. It’s not unusual for a hoarder to feel attached to every item—assigning emotional significance (or multiple meanings) to objects, making it nearly impossible for them to part with any possession.
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Characteristics of Hoarding Disorder
Hoarding disorder has three primary hallmarks:
- Difficulty Parting With Possessions
- A deep-rooted belief that they’ll need an item in the future or a strong emotional attachment to the object.
- Compulsive Acquisition
- An impulsive drive to pick up or purchase new items—even if they’re free, broken, or valueless.
- Inability to Contain Clutter
- Items end up scattered in living areas, often blocking hallways or piling up to dangerous or unsanitary levels.
Causes of Hoarding Disorder
The exact cause of hoarding disorder remains unclear, but researchers point to several potential factors:
- Genetic Predisposition: If a family member has hoarding issues, you’re more likely to develop similar behavior.
- Stressful Life Events: Major upheavals, such as divorce or the death of a loved one, can trigger or exacerbate hoarding.
- Emotional Insecurity: Objects can represent comfort and security, leading individuals to surround themselves with possessions.
Signs You May Have a Hoarding Disorder
Not everyone with a cluttered home is a hoarder. To identify possible hoarding disorder, look for these red flags:
- Excessive Acquisition
- Unable to resist free items or constant shopping for unnecessary goods.
- Persistent Difficulty Discarding
- Feelings of anxiety, anger, or distress at the thought of throwing something away or donating it.
- Living Spaces Rendered Useless
- Kitchens, bathrooms, or bedrooms so cluttered they’re difficult or impossible to use.
- Negative Impact on Daily Life
- Household chores, hygiene, or hosting guests become unmanageable due to clutter.
- Emotional Distress
- Difficulty making decisions, constant worry about “not having enough,” or arguments with family members about the state of the home.
Self-Assessment Questions
- Do you find it extremely hard to recycle, donate, or sell your possessions?
- Is it difficult to use certain rooms in your home because of piled-up items?
- How have these behaviors affected your daily life and relationships?
- Do you feel distressed when others suggest discarding your items?
Risk Factors
- Indecisiveness: Difficulty making decisions or procrastinating on what items to toss or keep.
- Family History: Growing up in a hoarding environment or having relatives who struggle with compulsive saving.
- Stressful Events: Divorce, job loss, fire, or other traumatic experiences can intensify hoarding.
Examples of Hoarders
- Animal Hoarder
- Collects large numbers of pets but fails to provide adequate care, leading to unsanitary and unsafe conditions.
- Compulsive Shopper
- Frequently buys clothes, gadgets, or other items without actual need, allowing them to accumulate unused.
- Object Hoarder
- Stashes away random objects—books, magazines, papers, housewares, and even garbage.
Consequences of Hoarding Disorder
Health and Safety Risks
- Fire Hazards: Blocked exits and flammable piles increase the risk of severe house fires.
- Accidents: Stacks of heavy items may topple, or clutter can cause frequent tripping hazards.
- Unsanitary Living Conditions: Rotting food, unmaintained trash, and pest infestations pose significant health threats.
Social Isolation
- Strained Relationships: Constant conflicts with family or roommates about the state of the home.
- Embarrassment: Refusal to allow visitors, leading to loneliness and fewer social connections.
Cognitive Issues
- Limited Focus: Sustained attention and organization skills can deteriorate under the mental burden of hoarding.
- Poor Decision-Making: Seeing every item as “important” hinders the ability to categorize or declutter effectively.
Hoarding as a Public Health Concern
Severe hoarding can impact not just the hoarder, but also neighbors and emergency responders:
- Blocked Entryways: Obstructed doors and windows hamper firefighting or medical rescue operations.
- Pest Management Issues: Dense clutter can harbor vermin or insects, spreading sanitation problems.
Local governments in some areas have formed task forces to address extreme hoarding situations. Their goal is not to confiscate items, but to ensure safety and prevent hazards.
Hoarding Disorder and Other Mental Health Conditions
Hoarding frequently coexists with disorders like:
- Depression or Anxiety
- ADHD (Attention Deficit Hyperactivity Disorder)
- Obsessive-Compulsive Disorder (OCD)
- Substance Use Disorders
Around half of people with hoarding disorder have at least one other comorbid condition. Recognizing and treating these conditions is crucial for a better prognosis.
How Is Hoarding Disorder Diagnosed?
Previously viewed as a subtype of OCD, hoarding disorder now has its own diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To confirm a diagnosis, mental health professionals may:
- Conduct a thorough interview to gauge the individual’s awareness and acceptance of the problem.
- Request information from family or friends about the hoarder’s behaviors and living conditions.
- Evaluate daily functioning, emotional distress, and the specific triggers behind acquiring or refusing to discard items.
Treatments for Hoarding Disorder
While hoarding can be challenging to treat, various methods show promise:
1. Cognitive Behavioral Therapy (CBT)
- How It Helps: Teaches hoarders to identify irrational beliefs (e.g., “I might need this broken toaster someday”), build organizational skills, and gradually let go of possessions.
- Limitations: CBT can be more effective in younger adults, but progress has also been noted in older adults through specialized cognitive rehabilitation programs.
According to Dr. Ayers, who studies hoarding symptoms and behavior in adults, hoarding is common and often progresses in older people. Dr. Ayers also developed a hoarding disorder treatment plan for older people based on cognitive rehabilitation. This was modeled after the intervention plan for a traumatic brain injury.
Therapists practicing CBT have noted great improvement in their patients, like reductions in compulsive hoarding symptoms. More improvements are observed even after 6 months during follow-up sessions.
2. Motivational Interviewing
- How It Helps: Often used in addiction therapy, it addresses a hoarder’s ambivalence toward change—especially when they have limited insight.
- Goal: Strengthen personal motivation to declutter and recognize the benefits of a safer living space.
3. Medication
- Current Research: Limited, with few drug treatments specifically approved for hoarding disorder.
- Possibility: If co-occurring anxiety or depression is severe, doctors may prescribe SSRIs or other medications.
4. Decluttering and Behavioral Training
- What It Entails: A step-by-step approach to cleaning the living space with professional help.
- Why It Helps: Addresses immediate safety and health concerns while reducing the compulsion to hoard.
Coping Strategies for Hoarding Disorder
1. Seek Emotional Support
- Why It Helps: Isolation fuels hoarding; staying connected with friends or a support group provides accountability and stress relief.
- Tip: If you’re uncomfortable with in-home visits, meet your confidant in a neutral place.
2. Practice Self-Care
- Why It Helps: Good hygiene, nutrition, and a regular schedule can enhance mental well-being.
- Tip: Start by clearing essential rooms like the bathroom or kitchen to make daily life more manageable.
3. Take It One Step at a Time
- Why It Helps: Incremental progress can prevent overwhelm.
- Tip: Set small decluttering goals—like tackling one corner or one box each day—to build confidence and reduce anxiety.
4. Ask for Help
- Why It Helps: Professional cleaning services, friends, or loved ones can assist with decluttering tasks.
- Tip: Inform them about any triggers or emotional attachments you have with certain items so they can approach the clean-up sensitively.
5. Seek Professional Counseling
- Why It Helps: Therapists or counselors offer strategies for discarding items, coping with stress, and reframing beliefs about possessions.
- Tip: Kentucky Counseling Center (KCC) provides online telehealth services for residents in Lexington, Louisville, or any surrounding city in Kentucky.
Final Thoughts
Hoarding disorder is more than mere clutter; it’s a mental health condition that can deeply affect your physical environment, relationships, and overall well-being. While it may feel daunting, treatment and support exist. With the help of a mental health professional and a solid support system, you can make tangible strides toward decluttering your home and improving your quality of life. If you suspect you or a loved one has hoarding disorder, don’t hesitate to seek help. Kentucky Counseling Center (KCC) has a dedicated team of therapists and counselors with the expertise to guide you through effective therapies and coping strategies. Contact us today to schedule an appointment and begin your path to a safer, healthier living environment.
