We’ve seen the TV shows and heard the stories on the evening news about people who live with piles of newspapers, years’ worth of paperwork and items that seem worthless to most, but are invaluable to those who have hoarding disorder. These things are collected and saved, often in haphazard — even hazardous — ways, creating severe congestion in their homes and leading to distress and problems functioning across many areas of their lives.
“Hoarding disorder is a serious mental illness,” says Dr. Larkin Hoyt, director of outpatient services at Sharp Mesa Vista Hospital. “It is characterized by a persistent inability to discard possessions, regardless of the actual value of the object, and can produce major distress and impairment in the lives of those with the disorder.”
According to the American Psychiatric Association (APA), hoarding affects an estimated 2 to 5 percent of people. It is a chronic and progressive disorder most often starting in adolescence. While the causes of hoarding disorder are not wholly understood, genetics and environment likely play a strong role.
“Signs of hoarding can show as early as age 11,” says Dr. Hoyt. “However, it does not usually affect everyday functioning until the mid-20s, possibly because parents may inadvertently interfere with a diagnosis if they regularly clean out spaces where children are hoarding.”
Signs that someone might have hoarding behaviors include the following:
- Excessive collecting of items, both free and purchased
- Difficulty organizing, throwing out or giving away things
- Cluttered and unsanitary areas in living spaces that are difficult to move through
- Unstable, large piles of items, such as newspapers, that are haphazardly arranged and likely to fall over
- Items piled on beds, countertops, stovetops and in other areas of the home, rendering these spaces useless
- Difficulty making decisions and paying attention
- Inability to acknowledge a personal problem with behaviors
“Experts theorize that hoarding is an extreme avoidance behavior connected to temperamental factors, such as indecisiveness,” says Dr. Hoyt. “Not discarding an object allows a person struggling with hoarding disorder to avoid making a decision or worrying that a decision was the right one. It also allows a person to avoid emotional reactions they may experience when having to part with the material possession.”
The consequences of hoarding are considerable:
- Conflicts in personal relationships and at work
- Health and safety hazards, such as fire hazards, tripping hazards, unsanitary conditions and code violations
- Isolation and loneliness
- Inability to perform basic daily tasks, such as bathing and cooking
- Financial and legal problems
- Emotional distress that can lead to depression, anxiety and substance abuse
A special manifestation of hoarding disorder is the hoarding of animals, when someone acquires dozens — even hundreds, in some cases — of animals, often keeping them in unsatisfactory conditions. Animals in hoarding situations can suffer from poor nutrition, sanitation and care, leading to illness, injury or death.
Most people who hoard animals often hoard inanimate objects, as well. However, intervention of government agencies, such as animal control and social services, may be required if the health and safety of animals are at risk.
“All forms of hoarding disorder can be effectively treated,” says Dr. Hoyt. “Evidence-based treatments like cognitive behavior therapy (CBT), gradual exposure therapy and pharmacotherapy (medications) have all been helpful at treating hoarding disorder when done with a team of mental health professionals who collaborate with the patient.”
Talk to your doctor if you or a loved one may exhibit hoarding behaviors. Taking action and receiving treatment can improve the health, safety and quality of life of the sufferer and those around them.