Hoarding is the excessive collection of items, along with the inability to discard them. Hoarding often creates such cramped living conditions that homes may be filled to capacity, with only narrow pathways winding through stacks of clutter. Some people also collect animals, keeping dozens or hundreds of pets often in unsanitary conditions.
Hoarding, also called compulsive hoarding and compulsive hoarding syndrome, may be a symptom of obsessive-compulsive disorder (OCD). But many people who hoard don't have other OCD-related symptoms.
People who hoard often don't see it as a problem, making treatment challenging. But intensive treatment can help people who hoard understand their compulsions and live safer, more enjoyable lives.
In the homes of people who are compulsive hoarders, the countertops, sinks, stoves, desks, stairways and virtually all other surfaces are usually stacked with stuff. And when there's no more room inside, the clutter may spread to the garage, vehicles and yard.
Hoarding affects emotions, thoughts and behavior. Signs and symptoms of hoarding may include:
People who hoard typically save items because they believe these items will be needed or have value in the future. A person also may hoard items that he or she feels have important emotional significance — serving as a reminder of happier times, for example, or representing beloved people or pets. People who hoard may report feeling safer when surrounded by the things they save.
It's important to note that hoarding is different from collecting. People who have collections, such as stamps or model cars, deliberately search out specific items for their collections. Collectors often categorize their items and carefully display them. Hoarders, on the other hand, will save random items they encounter in their daily life and store them haphazardly in their homes or surrounding areas.
When to see a doctor
Clutter and difficulty discarding things are usually the first symptoms of hoarding. These early indications of a problem usually surface during the teenage years. As an affected person grows older, he or she typically starts acquiring things for which there is no need or space. By middle age, symptoms are often severe and may be more difficult to treat.
If you or a loved one has symptoms of hoarding, talk with a doctor or mental health provider as soon as possible. Some communities have agencies that help with hoarding problems. Check with your local or county government for resources in your area.
As hard as it might be, you may also need to contact local authorities, such as police, fire, public health or animal welfare agencies, especially when health or safety is in question.
It's not clear what causes hoarding. The condition is far more likely to affect those with a family history of hoarding, so genetics and upbringing are likely among the triggering factors.
Hoarding can affect anyone, regardless of age, sex or economic status. It's not clear, though, how common hoarding is. That's partly because researchers have only recently begun to study it, and partly because some people never seek treatment.
Here are some risk factors and features about hoarding that researchers have come to understand:
Hoarding can cause a variety of complications, including:
Preparing for your appointment
If you or a loved one has symptoms of hoarding, call your doctor. He or she may immediately refer you to a mental health provider, such as a psychiatrist, with experience diagnosing and treating hoarding.
If you are calling on behalf of a friend or relative with symptoms, the mental health provider may ask to first meet alone with you to develop an approach for raising your concerns with your loved one. Many people with hoarding symptoms don't recognize that their behavior is problematic, and are not motivated to seek treatment. A mental health provider can help you prepare for a conversation in which you encourage your loved one to seek help.
In order to consider the possibility of seeking treatment, your loved one will likely need reassurance that no one is going to go into his or her house and start throwing things out.
The information below can help the person with hoarding symptoms prepare for the first appointment and learn what to expect from the mental health provider.
What you can do
For hoarding, some basic questions to ask your mental health provider include:
In addition to the questions that you've prepared to ask your mental health provider, don't hesitate to ask any other questions that may occur to you during your appointment.
What to expect from your mental health provider
Because other mental health disorders often go hand in hand with hoarding, your mental health provider may also ask questions to see if you may have symptoms of depression, social phobia, anxiety or other problems.
Tests and diagnosis
Hoarding isn't yet considered an official, distinct disorder. However, it appears to be more common in people with psychological disorders, such as alcohol dependence, obsessive-compulsive disorder, depression, anxiety and attention-deficit hyperactivity disorder.
To help diagnose compulsive hoarding disorder, mental health providers perform a thorough psychological evaluation. They ask many questions about your obsessions, compulsions and emotional well-being and may also ask your permission to talk with your relatives and friends.
To diagnose hoarding, mental health providers check for three main characteristics:
Treatments and drugs
Treatment of hoarding is often a challenge that meets with mixed success. For one thing, many people who hoard don't recognize the negative impact of hoarding on their lives or don't believe they need treatment. This is especially true if their possessions or animals offer comfort. And people whose animals or possessions are taken away will often quickly collect more to help fulfill emotional needs.
Try to find a therapist or other mental health provider who has experience in treating hoarding. While therapy can be intense and time-consuming, it can pay off in the long run.
There are two main types of treatment for hoarding — psychotherapy and medications.
Lifestyle and home remedies
Hoarding can cause many difficulties in treatment and self-care, especially for people who don't feel that hoarding is a problem in their lives. Whether or not you believe you need treatment for hoarding, here are some steps you can take to try to care for yourself:
Because little is understood about what causes hoarding, there's no known way to prevent it. However, as with many mental conditions, getting treatment at the first sign of a problem may help prevent hoarding from becoming severe.
Last Updated: 2011-05-25
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