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Hoarding disorder

Written by Dr Elaine Ryan

Dr Elaine Ryan PsychD is a highly experienced Chartered Psychologist with 20+ years of experience in treating OCD and Anxiety Disorders. Member of the British Psychological Society (BPS), Division of Neuropsychology | EuroPsy Registered| Member of The UK Society For Behavioural Medicine 

What is hoarding disorder?

A person is said to have a hoarding disorder when they have so much stuff that they live in a chaotic and overwhelmingly cluttered home but cannot get rid of any of their possessions.

Popular television programs have featured compulsive hoarders. You may be familiar with images of rooms piled high with clutter and kitchens and bathrooms that are unusable due to the extensive mess.

These types of programs portray hoarding as being part of OCD, but not all people who hoard have OCD.

Many people incorrectly believe that if they hoard, they automatically have OCD. However, in 2013, hoarding disorder was classified by DSM5 as a condition in its own right instead of falling under the classification umbrella of OCD.

People who hoard may lack essential self-care, have other mental health conditions, or have difficulty managing their homes. This article will help you understand what hoarding is, how it can impact your life and how to seek help should you need it.

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10 Key Facts about Hoarding Disorder:

  1. Beyond clutter: Hoarding isn’t just about having a lot of stuff. It’s an anxiety disorder characterized by excessive clutter accumulation that significantly impairs daily living and causes distress.
  2. Not “messy” people: Individuals with hoarding disorder often feel emotionally attached to belongings, making it difficult to discard them, regardless of actual value or condition.
  3. More than just objects: The cluttered environment can trap people in isolation, prevent essential living needs like cooking or sleeping, and even pose fire hazards.
  4. Not a choice: There are biological and psychological factors involved, not laziness or lack of motivation.
  5. Treatable, not a life sentence: With evidence-based therapies like CBT and support groups, significant progress can be made in managing clutter and improving quality of life.
  6. Self-care matters: Prioritizing sleep, exercise, and healthy coping mechanisms can boost overall well-being and build resilience against the challenges of hoarding.
  7. You’re not alone: Millions of people struggle with hoarding disorder. Connecting with others who understand can offer valuable validation and support. Online communities and support groups can be helpful resources.
  8. Professional help is key: Don’t suffer in silence. Seeking help from a therapist specializing in hoarding disorder is crucial for proper diagnosis, personalized treatment plans, and ongoing support.
  9. Be patient and kind: Remember, progress takes time and effort. Celebrate small victories and avoid harsh self-criticism. Focus on creating a safe and functional living space, one step at a time.
  10. There is hope for the future: Hoarding disorder is manageable. With dedication, support, and the right tools, you can reclaim control of your environment and live a fulfilling life. Remember, your worth is not defined by your belongings.

What is hoarding?

Hoarding is when you acquire so many possessions that you can no longer manage them and cannot dispose of or give any of them away.

Hoarding during the pandemic

Food hoarding increased during the Covid-19 pandemic. You probably held more stock in your home than you usually would or have been guilty of having a cupboard full of toilet rolls.

When faced with a unique scary situation like the pandemic, and due to restrictions where it was challenging to go shopping, human beings try to create a sense of safety and ensure their immediate and future needs are met.

I was undoubtedly guilty of bulk buying in March 2020 when Boris Johnson gave that speech saying we were all to stay home. But does that make us hoarders?

If you had a room full of toilet rolls, dried goods, pasta and pulses, technically, you have hoarded them, but the question is, when does hoarding become a disorder?

When does it become a disorder?

Hoarding becomes problematic if it seriously affects your quality of life.

Hoarding is problematic if;

  • your possessions result in so much clutter that you cannot use areas of your home. For example, if you find it difficult or impossible to cook food due to the mess in your kitchen or cannot access your bath or shower.
  • You cannot get rid of stuff, even though it negatively impacts your life.

What causes hoarding?

People may hoard due to mental health conditions such as depression or OCD.

In this case, hoarding is part of another condition, but problematic hoarding can occur in the absence of other conditions, known as hoarding disorder.

For example, your parents may have been highly disorganised and have grown up surrounded by excessive clutter, and you did not acquire the necessary skills to sort, store and manage your things.

Difference between OCD and hoarding disorder

  • Hoarding used to be classified under Obsessive-Compulsive Disorder (OCD) as a symptom. Still, under the new edition of the Diagnostic and Statistical Manual of Mental Disorders or DSM-5, hoarding is now classified under the category of “Obsessive-Compulsive and Related Disorders”.
  • Hoarding is having difficulty in letting things go, which results in clutter due to the problem in doing so.
  • OCD is characterised by recurrent, intrusive thoughts or images that cause significant distress or impairment.
  • Compulsive hoarding is a disorder in which an individual cannot or will not discard possessions despite having difficulty controlling their acquisition and accumulation of objects.
    For example, people with OCD may have recurring thoughts about contamination or perfectionism, while people with compulsive hoarding may not be able to discard anything, even if it becomes overwhelming.

What are the symptoms of hoarding?

Hoarding disorder is characterised by the excessive acquisition of objects with no perceived purpose.

The disorder is not attributable to another medical condition, and the symptoms of another mental health condition do not better explain it.

Compulsive hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
People with compulsive hoarding often have difficulty discarding possessions, even if they’re not worth anything.

This leads to an accumulation of possessions which clutter the person’s living space and interfere with their use.

Risks and complications of hoarding

Hoarding can have several consequences, including health and safety risks, social isolation, and legal issues.

Compulsive hoarding can lead to family strain and conflicts, isolation and loneliness, and an inability to perform daily tasks. Hoarding can be a sign of mental health problems.

Treatments

Some of the most common treatments are cognitive behavioural therapy (CBT), and exposure and response prevention (ERP)

Cognitive behavioural therapy helps people learn why they hoard, organise their possessions, and decide what to keep and discard.

Exposure and response prevention involves gradually exposing the patient to the things they are afraid of losing or getting rid of without allowing them to engage in their usual hoarding behaviours. This treatment is helpful in compulsive hoarding cases where insight is poor and ambivalence to change is marked.