What is Hoarding Disorder

Hoarding disorder is a mental illness. People with this disorder have a persistent need to save things, and they have great difficulty letting go of what they have saved.

They save anything and everything. Eventually, the living spaces in their homes cannot be used because they are filled with items that have been collected. Moving around in the hom may become difficult or unsafe. Exits may get blocked. The home may become a fire or health hazard.

Hoarding disorder can interfere with daily activities and personal relationships. A stressful life event can cause this condition to start (can trigger it) or make it worse. People with this illness often have another mental illness, such as depression, anxiety, an eating disorder, or alcohol use disorder.

What are the causes?

The cause of this condition is not known, but family history, brain chemistry, and certain personality traits are often involved.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Having a family member who has the condition.
• Having little or no interaction with other people (social isolation) and having a tendency to avoid stressful situations.
• Going through a sudden traumatic event.

What are the signs or symptoms?

Symptoms of this condition usually start during the teenage years, and they gradually worsen over time. Symptoms include:

• Having persistent trouble getting rid of things that most other people would throw away, donate, sell, or recycle.
• Saving things because they might be useful or valuable in the future.
• Saving things because of emotional attachment.
• Buying or stealing things that are not needed or for which there is no space.
• Feeling comfort or safety in being surrounded by hoarded items.
• Feeling distress at the thought of throwing away hoarded items.
• Accumulating a large number of possessions that fill up and clutter active living areas.
• Receiving complaints or concerns from family members or friends about the cluttered condition of your home.
• Renting additional storage space for hoarded items.
• Feeling shame and having negative conversations with yourself about yourself (negative self-talk).

How is this diagnosed?

This condition is diagnosed through an assessment by your health care provider. Your health care provider will ask questions about:

• Your ability to give away or throw away things.
• The condition of your home.
• How your life is affected by your hoarding behavior.

Your health care provider may also ask about:

• Your mood.
• How your loved ones feel about your behavior.
• Your other behaviors, such as isolation and avoiding other people.
• Your medical history.

Other mental illnesses and certain brain disorders can cause similar symptoms. Your health care provider may refer you to a mental health professional for evaluation.

How is this treated?

Treatment for this condition is usually provided by mental health professionals. Treatment options may include:

• Cognitive behavioral therapy (CBT). This is a form of one-on-one counseling, or talk therapy. It can help you identify and change underlying beliefs, thoughts, and emotions that contribute to collecting and saving items. This treatment can also help reduce the anxiety that is related to letting items go.
• Medicine. Antidepressant medicines called selective serotonin reuptake inhibitors (SSRIs) may help to lessen symptoms of hoarding. Medicine is most effective when it is used along with psychotherapy.
• Family counseling. This is a form of group talk therapy for family members of people with hoarding disorder. It helps family members understand that hoarding disorder is an illness. It also helps them:
  • Identify problems that the illness is causing.
  • Find healthy ways to help their loved one who has the disorder.

Follow these instructions at home:

• Get help at home. You may need help with creating a plan to:
  • Make your home safe.
  • Remove what you have collected.
  • Make needed repairs.
  • Get rid of pests. A pest service may be needed.
  • Organize things. A professional organizer may be able to help sort through things and put a system in place to keep things in order.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Where to find more information

• International OCD Foundation: https://hoarding.iocdf.org  

Contact a health care provider if:

• Your symptoms get worse.
• Your loved ones are refusing to live with you or visit you anymore.
• You are not able to take your medicines as prescribed.

Get help right away if:

• You have serious thoughts about hurting yourself or others.

If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. You can go to your nearest emergency department or call:

• Your local emergency services (911 in the U.S.).
• A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

• Hoarding disorder is a mental illness. People with this disorder have a persistent need to save things, and they have great difficulty throwing away, donating, or recycling what they have saved.
• People with hoarding disorder feel great anxiety and distress if they attempt to get rid of the items they have collected.
• Cognitive behavioral therapy(CBT) is a form of talk therapy that can help to identify and change underlying beliefs, thoughts, and emotions that contribute to collecting and saving items.
• Family counseling helps family members understand that hoarding disorder is an illness.