While clutter is normal in any home, if it becomes difficult to move around your living space because of the number of possessions in one place, you may have a hoarding disorder.
What is Hoarding Disorder?
Hoarding disorder is also called compulsive hoarding. Hoarding disorder is a clinically recognized mental illness. You have hoarding disorder if you have persistent difficulty discarding possessions because of a perceived need to save them. You don’t care if the items have value or not.
People with hoarding disorder have an excessive need to acquire new items, and save old items that are potentially broken or do not hold value. Hoarding causes clinically significant distress when you try to let go of these items.
Hoarding behavior can start at a young age, and has a tendency to become severe and more distinct as you get older. Hoarding disorder is more common in people over 60 years old. It is also common for those with psychiatric diagnoses like anxiety and depression.
Hoarding vs. Collecting
Collecting and hoarding are very different. Collectors acquire possessions with intent. They organize their possessions in an orderly fashion to be displayed for admiration. Collectors acquire items with a consistent theme.
Hoarders, on the other hand, tend to make impulse decisions when selecting items to store in their homes. Hoarders are triggered by the desire to own an object that catches their attention. They acquire random items without a consistent theme.
The biggest contrast one can notice between a collector and a hoarder is the presentation and organization of acquired possessions. A collector is organized, while a hoarder is best represented with disorganized clutter.
Living with Hoarding Disorder
People with hoarding disorder are very much overwhelmed by the volume of the possessions they can’t let go of. The clutter limits your livable space at home. This may also lead to family disputes.
It is very common for many to be sentimental and hold on to certain belongings. However, hoarders tend to put meaning to every single possession they have. To some degree, some hoarders may assign more than one meaning for each object. Because of this, they are unable to rightfully manage the associations they have attached to each item.
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Characteristics of Hoarding Disorder
There are three major characteristics of hoarding disorder.
- The first characteristic is the difficulty of parting with material possessions.
- The second characteristic is the excessive and compulsive acquisition of new possessions.
- The last characteristic is the inability to avoid clutter. Hoarders are extremely disorganized. They are prone to leaving random stuff anywhere in the house.
Causes of Hoarding Disorder
The cause of hoarding disorder is still unknown. However, there are some studies that indicate hoarding disorder can run in the family. If you have a family member who has hoarding issues, it is most likely that you can have these issues too.
Extreme stress in life and the death of a loved one can make your symptoms worse. People with hoarding disorder hold on to their possessions for the following reasons:
- They think the items are unique and rare that they could be used in the future.
- They attach emotional significance to their possession. These items remind them of happy memories, their beloved pets, or loved ones.
- They feel secure when these possessions surround them.
Signs You May Have Hoarding Disorder
The signs and symptoms of hoarding appear similar across cultures and races. Both men and women can experience hoarding. Hoarding can cause serious problems in your social relationships. It can also be problematic in maintaining a safe environment for others.
Here are the signs and symptoms for hoarding diagnosis:
- Excessive acquisition of unnecessary items
- Persistent difficulty discarding possessions regardless of their value
- They have the perceived need to save these items and feel upset thinking with the thought of parting with the object
- The active living spaces of their home are not useable because of clutter
Here are some assessment questions to determine if you may have hoarding disorder:
- Are you having a hard time discarding, recycling, donating, or selling your possessions?
- Due to so much clutter, how difficult is it for you to use the rooms in your home?
- How is hoarding stuff affecting your daily activities?
- How distressed are you because of the symptoms?
The risk factors for hoarding disorder are:
- Indecisiveness: Individuals with hoarding disorder can be indecisive.
- Family history: Hoarding disorder can run in the family. A person may grow up in an environment where the parents teach the importance of caring for your things. That’s one reason the hoarding disorder may be a passed-on trait in the family.
- Stressful life event: When a person is going through a difficult time and stressed out, they may develop a hoarding disorder. Stressful life events could be the death of a loved one, divorce, losing a job, losing a home, or losing all your possession due to fire or calamity.
Example of Hoarders
A hoarder’s excessive need to acquire possessions should be carefully monitored. Hoarders may also be perfectionists and procrastinators.
Animal hoarders adopt or acquire a large number of animals. In animal hoarding situations, animals may be confined in a smaller living space than would be appropriate for the number of pets. The living conditions might be unsuitable due to large amounts of animal soil in the area.
A compulsive shopper loves shopping and buying things that are unnecessary. Compulsive shoppers and hoarders buy new clothes or shoes without even the thought of using them. They end up buying new clothes, without even using the recent clothes they just used.
An object hoarder is interested in a particular item to hoard. These could range from paper, books, houseware, clothes, or even garbage.
Consequences of Hoarding Disorder
Having a hoarding disorder may cause problems in your relationships. Serious hoarding can have potential consequences on health and safety concerns. Such concerns include fire hazards, tripping hazards, and health code violations.
A hoarding disorder can cause strain and conflicts within the family. Because of the disorganized clutter in your home, you may feel isolated, lonely, and unwilling to accept guests. You are also unable to perform usual house chores like cooking and bathing.
When a hoarder resists discarding their possessions, it can result in piles of items. There could also be a buildup of trash that is very unsanitary. Hoarders can be very disorganized. This can be paralleled to having disorganized cognitive functioning. Studies have shown that people with hoarding disorder lack sustained attention, problem-solving skills, organization, and can have difficulty remembering day-to-day tasks.
Hoarders also have low visuospatial ability. People with hoarding disorder may have difficulties making detailed decisions regarding what items are of importance. Hoarders believe that every single clutter is important.
Public Health Concerns
Hoarding is also considered a public health issue. Due to too much clutter, homes of hoarders can be a breeding ground for pests. Pest management may be very difficult in these situations.
Individuals with hoarding behaviors may tend to isolate themselves from everyone. Their doors and windows are often blocked, and hallways are impassable. This situation can make it very hard for firefighters if a fire may break out.
There are a number of cities that have organized task forces focusing on this issue. It is not surprising that hoarders may avoid the help of the task force. Hoarders may not understand that the goal of the task force is not to stop them from hoarding. Rather, they are tasked to keep homes safe.
Other Mental Health Disorders and Hoarding Disorder
Some hoarders can have other mental illnesses such as depression, anxiety disorders, ADHD, OCD, or alcohol use disorder. Roughly, about half of people with hoarding disorder also have a comorbid disorder.
Hoarding disorder is recognizable from other mental disorders because it requires the intervention of the community.
Classification of Hoarding Disorder in Mental Disorders
Only in 2013, the hoarding disorder was given diagnostic criteria by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Having its own set of criteria, many mental health professionals can have a better sense of commonness.
Since having criteria of its own, according to the American Psychiatric Association, it has been determined that about 2.5% of the general population have hoarding disorder. Hoarding disorder was used to be defined as a subset of Obsessive-compulsive disorder (OCD).
Mental Health Professionals and Hoarding Disorder
There are some people who are aware and acknowledge that they might have a hoarding disorder. Some would likely visit a professional to be properly diagnosed, while some might not realize it.
If in case the patient is unaware that they could have a hoarding disorder, family members or friends could refer a mental health professional. With permission, they can ask the family members and friends of the hoarder some questions. These questions are designed to assess the hoarder’s level of functioning.
Treatment of Hoarding Disorder
Hoarding disorder is a complex mental health disorder. This is a hard-to-treat case, but many psychologists have been making progress. Many psychologists have a better understanding of the cognitive and neural foundations of the disorder. The treatment goal for hoarding disorder is to reduce the acquisition of clutter in your home.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is considered an effective treatment for hoarding disorder. With the help of CBT, you learn to let go of unnecessary possessions gradually. CBT can help you change your beliefs about hoarding. You can also learn how to organize your things. CBT helps improve your decision-making skills and relaxation techniques.
Hoarders who have undergone CBT showed a decrease in hoarding symptoms. It greatly affects their discarding behavior. Though, there are still some that have retained their hoarding behaviors even after treatment.
There are studies that show, CBT may not be fully effective in treating hoarding disorder. However, CBT is effective in treating related disorders such as anxiety disorders and major depressive disorder. CBT may not be the best option for many. CBT is helpful in young hoarders but may not be for older ones.
According to Dr. Ayers, hoarding is common and often progresses in older people. Dr. Ayers studies hoarding symptoms and behavior in adults. In treating hoarding disorder in older people, Dr. Ayers made a treatment plan based on cognitive rehabilitation. This was modeled after the intervention plan for a traumatic brain injury.
Dr. Ayers teaches hoarders how to organize, plan and solve problems. They learn how to let go of their material possessions one-by-one. By doing this, older hoarders eventually tolerate the distressing feeling of discarding some of their possessions.
They have noted great improvement in their patients. There have been reductions in compulsive hoarding symptoms. More improvements are observed even after six months during follow-up sessions.
Motivational interviewing is a method typically used for addiction therapy. This method, when used in treating hoarding disorder, can also be beneficial. This is used when your insight is poor, and you are hesitant to change.
There are limited studies done on medication treatment. There are limited case studies done to support the efficacy of certain medications. It is always best to seek professional help regarding medication.
When a person feels depressed, they know they need to seek professional help right away. Treating hoarding disorder is difficult because hoarders don’t feel sad or depressed. On the contrary, they feel happy about buying new stuff. Hoarders only feel distressed when people ask them to get rid of their stuff. Researchers are studying if it is possible to include decluttering training as part of treatment.
Coping with Hoarding Disorder
Aside from seeking counseling services and medical treatment for hoarding disorder, there are coping strategies you can use. These coping strategies can help manage your hoarding symptoms and improve your mental health.
Social isolation is common with hoarders. Being socially isolated makes it very difficult for you to reach out for help and support. If you are uncomfortable meeting people inside your home, you can decide to meet elsewhere.
Talk to someone you trust. Talking to another person can relieve you of stress and help you feel better. Engaging in a conversation with another person can help you manage the anxiety that comes with hoarding disorder.
Develop self-care practices
It is important that you have healthy eating habits. Good hygiene is also very important. It is important that you start clearing your kitchen, dining room, and bathroom. It can be hard, but it is possible and doable.
Being able to take care of yourself more will make you happier and would encourage you always to keep your home clutter-free.
Take it one step at a time
Letting go of your possessions can be very difficult. This is a process, and it doesn’t happen overnight. But progress and recovery are possible if you take it one step at a time.
If everything feels very overwhelming, you can break down your big goals into smaller goals that you can easily accomplish. Feeling a sense of accomplishment can make you feel better and happier.
Help is welcome
Decluttering and organizing your home alone can be very difficult and overwhelming. Ask for help when you need it. Call your friends or loved ones to help you out. You also have the option to hire professional cleaning services.
Seek Professional Counseling Services
A professional counselor or therapist can be instrumental in treating hoarding disorder as well as any co-occurring diagnoses. Kentucky Counseling Center offers online, Telehealth counseling services in the state of Kentucky. If you are living in Lexington, Louisville, or any surrounding city in the state, you may fill out our form to book an appointment with a therapist to discuss your concerns with hoarding disorder, or to seek help for a loved one suffering from mental and emotional effects of this disorder.
Hoarding disorder is a complex mental illness. You don’t have to feel the burden alone. Treatment and support are available to help you get better. Kentucky Counseling Center (KCC) and our team of therapists and counselors are highly skilled and knowledgeable in treating and managing hoarding disorder.