Reviewed by Aaron Horn, LMFT
The term hoarding is often used as a joke or as a lighthearted way to tease someone about their spending habits or tendency of holding onto things. Despite being seen as funny or simple, hoarding is not quite as straightforward as people think. Hoarding is actually a recognized disorder, with very real consequences that accompany the symptoms.
What Qualifies As Hoarding?
“I’m a bit of a packrat.” “I just can’t seem to let go of things.” Phrases such as these are not terribly uncommon, whether they come from a well-meaning aunt, an embarrassed mother, or a shy friend. Are phrases like these the warning signs of hoarding? Although the term “packrat” and “hoarder” might be used interchangeably, hoarding and being a packrat are actually two different things, hoarding presents more of a problem than packrat-like behavior. If you are not certain whether your behavior and symptoms are characteristic of Hoarding Disorder or another issue, an online Hoarding Disorder questionnaire can help.
Hoarding is a recognized disorder, simply called “Hoarding Disorder.” It is identified as a mental illness because of the distress and hazards it presents to people who are experiencing hoarding symptoms. Far from simply collecting items or holding onto seemingly unnecessary objects, hoarding presents some amount of distress to the person hoarding. In many cases, hoarders may hold on to items that seem worthless or bizarre and are typically stored haphazardly. In extreme cases, hoarding may present genuine health hazards and may prohibit them from living their lives by blocking access to kitchens, workspaces, or even bathrooms.
Seeking A Diagnosis: Noting And Reporting Symptoms
Many people who display the symptoms of Hoarding Disorder feel ashamed or embarrassed about their situation and are hesitant to reach out for help. The impulses that people with Hoarding Disorder feel are considered compulsive in nature, as the items that are hoarded are frequently not necessary and may even seem like trash to others, such as old newspapers or paperwork that is far too old to continue to serve a purpose. They may be unable to welcome people into their home and may have to seek help from others to get rid of items. Diagnosis begins with reporting symptoms, which may come at the request of a friend or relative who has expressed concern.
Not everyone who keeps a large number of items will qualify for a Hoarding Disorder diagnosis; instead, hoarding symptoms will be evaluated based on the amount of distress and decreased functioning the behavior creates. Signs and symptoms used for evaluation include the following:
- The excessive purchase or consumption of unnecessary items. People with Hoarding Disorder will likely consume or purchase items that greatly exceed what is necessary for them to survive or thrive.
- Difficulty discarding items, regardless of actual value or need. In what is one of the most common symptoms (and most well-known) of Hoarding Disorder, people with the disorder may struggle to discard items, even if they do not have any real value.
- Experiencing a compulsive or overwhelming need to save items. Hoarding Disorder is not characterized by careful, thoughtful decision-making. Instead, most of the disorder's behavior is characterized by compulsion or irrational needto keep items.
- Experiencing clutter as a result of holding onto items, potentially at the expense of health and well being. People with Hoarding Disorder may find that their homes are cluttered almost to the point of being impossible to use. Clutter may line hallways, obscure tables, and other surfaces, impeding the use of necessary facilities, such as kitchens and bathrooms.
- Experiencing difficulty in other areas, including constant procrastinating, a tendency toward perfectionism, a high degree of anxiety, and an inability to make decisions. People with Hoarding Disorder may show symptoms in other areas of their lives, through procrastination, perfectionism, anxiety, and indecision.
People with Hoarding Disorder may not recognize the presence of an issue. For some, the disorder has not yet reached a pitch that makes life difficult. In contrast, for others, the compulsion to hold onto items has become so intrinsic and fully developed that it seems like a rational, reasonable response.
Learning To Let Go: Hoarding And Therapy
Although hoarding can cause a great deal of contention between the hoarder and their loved ones, few people recognize and understand that hoarding very often cannot simply be “gotten over” because it stems from actual mental illness. Instead, hoarding is best treated with legitimate psychotherapy sessions, wherein the roots of hoarding are discovered, potential triggers are identified, and alternate solutions are discussed. Therapy will not change hoarding habits overnight, and the exact route of decluttering may differ from case to case. In most therapy sessions, people with the disorder will learn how to identify items that are actually necessary, develop their decision-making skills, and develop healthy coping mechanisms to combat the impulse to purchase new items.
In some cases, a hoarding will be treated with antidepressants or anti-anxiety medication because anxiety and depression can have a deleterious effect on hoarding symptoms. Although not everyone with Hoarding Disorder will experience depressive symptoms, anxiety is par for the course, and Hoarding Disorder is believed to manifest anxiety. The use of anti-anxiety medication will vary from case to case. A thorough discussion of the benefits and drawbacks between patients and therapists will provide greater peace of mind regarding the decision.
Learning To Let Go: Decluttering A Hoarder
Removing clutter from a hoarder's home may not always be the best solution—especially not all at once. Removing all of the clutter at once could trigger a fresh wave of hoarding from someone with Hoarding Disorder. A more gradual, delicate approach may be best. For others with the disorder, an immediate hoarder cleanup can be cleansing and helpful. Before deciding on a course of action, evaluation, and recommendations from a mental health professional are important. A therapist may be able to identify nuances in a particular case that would indicate the likelihood of success for different decluttering types. Free hoarding clean up may be available to people with Hoarding Disorder in some areas, in addition to paid professional hoarding cleanup services. A search for “hoarding cleanup services near me” may yield professional services without having to expose current living conditions to friends or family and compound the feelings of shame or embarrassment.
For some hoarders, assistance with the clean up can trigger feelings of shame and distress, and the process may require a great deal of time and plenty of stops along the way. Decluttering should not be a mistake for the completion of treatment, nor should it be seen as a definitive indication of healing or the best way to treat hoarding. Because hoarding is a compulsive behavior, removing the result of the compulsion will not heal the reason for the compulsion. Instead, therapy is designed to identify the reason for the compulsion, identify triggers that set off the compulsion, and work on healing the source of compulsive behavior and managing triggers and symptoms.
Hoarding Disorder Outlook
Treating Hoarding Disorder experiences the greatest setbacks at its initial phases. People rarely seek treatment for Hoarding Disorder, instead they normally reach out for help with anxiety or depression symptoms, leading to the identification of hoarding. Despite subsequent identification of hoarding symptoms, many people with Hoarding Disorder are resistant to the idea that their habits need treatment because hoarding provides comfort. Nevertheless, Hoarding Disorder is a treatable condition. People who consistently attend therapy and continually participate in any therapeutic exercises given by their therapists are more likely to experience relief from symptoms and improve the disorder's signs.
Hoarding Disorder may not initially appear to be problematic, but it can cause a great deal of distress to people enmeshed in hoarding symptoms. Hoarding Disorder can cause social isolation and difficulty in relationships. It can even present health hazards, should the hoarded items present a fall risk, increase the risk of a fire, or block access to necessary facilities in the home. Many people with Hoarding Disorder also begin to feel suspicious of the people entering their home and may feel they cannot trust anyone. Hoarding Disorder can be a very lonely disorder. Despite being used as a source of humor in pop culture and even offering morbid fascination in the form of a television show, it is not a disorder to be taken lightly. With continued treatment, Hoarding Disorder management is possible, and people with the condition can create a healthier, fulfilling life and home.