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Take it seriously – hoarding is a psychological disorder

Conflict between the man and the woman

Wow. When I wrote my first post about hoarding, I had no idea it would generate such passion and interest. I started to write individual responses to all of you who have posted your comments, but there were so many common themes in the comments that I realized it was time for me to write a new post that includes updated information about hoarding.

All of you who posted have really educated me. In my original post, I suggested strategies like, “give your hoarder his or her own room,” or “set rules about common spaces,” and so on. From all of you, I realized that strategies like these don’t work.

Here’s why.

Hoarding is a serious psychological disorder, and until that issue is addressed and treated, nothing will change. It’s plain and simple.

Hoarding is so serious that it now has it’s own designation in Psychiatry’s standard guidebook—the Diagnostic and Statistical Manual of Mental Disorders. It recently recognized hoarding as a disorder in its own right, along with depression, anxiety and other disorders such as obsessive compulsive disorder (OCD). Hoarding was previously thought of as a subset of OCD, but it is now seen as distinct.

Indeed, brain scan imaging has confirmed that a hoarder’s brain is different from other brains. A study reported in Scientific American says that neuroimaging studies and case reports have revealed divergent patterns of brain activity and various cognitive peculiarities common to many hoarders.

Here’s what’s important: The very act of deciding what to keep and what to throw away causes them great anxiety, and hoarders form unusually strong emotional attachments to inanimate objects. Traditional therapies have largely failed to help compulsive hoarders but researchers have developed new promising treatments.

I’m telling you this because the plain and simple truth is that you cannot fix your hoarder’s behavior by trying to set limits or by cleaning the mess on your own, and your hoarder can’t fix the problem on his or her own, either.

Hoarding is serious business

What you absolutely need to know is that if you want to remain in the relationship with your hoarder, then you need to spend your energy trying to get him or her to acknowledge the problem and get professional help.

If you are unable to get your hoarder to accept help, then you’ll have to make a big decision for yourself – can you live with hoarding for the rest of your life? Does your love for your hoarder outweigh the hoarding that you’ll have to live with? Because without help, your hoarder will continue hoarding, no matter how much pleading, helping or yelling you do – and the hoarding will get worse over time.

Your hoarder is not doing this to spite you, or because he or she doesn’t care about you (ie if he cared about our relationship, he’d clean up). Your partner’s behavior has nothing to do with you – it’s a mental disorder that requires treatment.

But how do you know whether your person is a hoarder or just a “collector” or “slob,” or “disorganized?”

Hoarding is defined as the excessive accumulation of stuff and the refusal to discard it, resulting in problematic clutter. In addition to interfering with daily activities such as cooking and sleeping, extreme clutter often increases health risks from poor sanitation, makes it more difficult to get out of the house in a fire or other emergency and puts the hoarder in danger of eviction.

For those of you who are reading this for the first time, I suggest you breeze through the comments at the end of my post, HELP! My partner is a hoarder! What can I do? They are hugely illuminating and you’ll begin to understand whether your person is a hoarder or not.

Hoarding is not “collecting”

Often, hoarders don’t see that they have a problem and a lot of them call themselves “collectors.” But if they are unable to stop their collecting, if their “collecting” is taking over the house, if you’ve tried every which way to get them to stop but nothing changes  – then your person is probably a hoarder. The main question is this: is his or her stuff interfering in your life? If so, you have a hoarding problem on your hands. Please take it seriously.

Compulsive hoarders often have other mental illnesses as well as the hoarding: 50 percent have major depressive disorder and 48 percent have either anxiety or social phobia, according to various surveys.

Scientific American detailed the story of one hoarder named Lee Shuer who got help and then went on to help create the program, Buried in Treasures. His hoarding started in his youth—baseball cards, coins, cool rocks—but his childhood collections never became unusually large or disorderly. After college he bounced from place to place with few possessions. But when he settled down in an apartment in Northampton, Mass., in 2000 he began collecting much more avidly than in the past. He spent his weekends and spare time visiting Goodwill, the Salvation Army and tag sales in search of his next acquisition—the more intriguing and unusual, the better. Sometimes he would visit a thrift shop on his lunch break rather than eat.

The objects and bric-a-brac that he collected provided a sense of comfort, helping him overcome his social anxiety. He was not confident that he was interesting and likeable—but he knew his collection was. If he offered a guest a cup of coffee in an eccentric mug, for example, he could depend on the mug itself to spark a conversation. Soon enough, he  had filled his newfound space with enormous piles of stuff. His roommates were remarkably patient, given the circumstances, but they repeatedly gave him an ultimatum: Clear up this mess or we will throw everything out. He would move some items from the common space into his room and continue collecting. The thought of discarding even a single item caused him too much pain—a mingling of sadness and worry that he might need the object one day.

Help through Buried in Treasures

Lee originally found help through a hoarding study that his wife discovered. He learned to catch himself in the act of acquiring something he does not have the space for, to challenge his beliefs about the true value of his possessions, and to gradually get rid of things he does not need without mourning their loss.

He then went on to co-found The Buried in Treasures program, which also became a book, titled Buried in Treasures. The book has become the basis for organized support groups for people with problematic clutter—especially for those who cannot afford one-on-one therapy.

In typical Buried in Treasures workshops, which are often but not always free, between six and 12 participants complete many of the same exercises and homework assignments central to hoarding-specific cognitive behavior therapy (CBT) over a period of 16 sessions, guided by a  facilitator. In trials of the Buried in Treasures workshops, symptoms of hoarding declined by between 22 and 27 percent and, in one study, an inspector judged more than 70 percent of participants as “much” or “very much” improved after visiting their homes. For more information on Buried in Treasures workshops and to locate a workshop in your area, contact Lee Shuer at his website

Another treatment is to ask patients to write a list of pragmatic questions that they might ask themselves when deciding whether to buy something—Can I afford this? Do I have the space for this object? Do I really need it?—and to keep the list with them. Whenever they get the urge to buy or otherwise acquire something, patients are supposed to bring out the list and answer the questions in order to make smarter decisions.

Tolerance-building exercises gradually teach patients to resist the urge to acquire. At first, patients simply drive by a store they would like to visit without stopping to go inside. Then they learn to walk right past the store. In the final stage they enter the store, pick up an item that they really want to buy, put it down and leave. Similar exercises teach hoarders to discard items they already have and do not need. Helping hoarders declutter their homes bit by bit is far more effective than hiring a cleaning service to remove everything in one shot: the sudden and dramatic loss can enrage hoarders or plunge them into depression; some go into hoarding hyperdrive to replace what was taken from them.

What the Mayo Clinic says about treatment

How else can you find help for your hoarder? Here’s what the Mayo Clinic says about treatment:

Treatment of hoarding disorder can be challenging because many people don’t recognize the negative impact of hoarding on their lives or don’t believe they need treatment. This is especially true if the possessions or animals offer comfort. If these possessions or animals are taken away, people will often react with frustration and anger and quickly collect more to help fulfill emotional needs.

The main treatment for hoarding disorder is cognitive behavioral therapy. Medications may be added, particularly if you also have anxiety or depression.

Psychotherapy

Psychotherapy, also called talk therapy, is the primary treatment. Cognitive behavioral therapy is the most common form of psychotherapy used to treat hoarding disorder. Try to find a therapist or other mental health professional with experience in treating hoarding disorder.

As part of cognitive behavioral therapy, you may:

  • Learn to identify and challenge thoughts and beliefs related to acquiring and saving items
  • Learn to resist the urge to acquire more items
  • Learn to organize and categorize possessions to help you decide which ones to discard
  • Improve your decision-making and coping skills
  • Declutter your home during in-home visits by a therapist or professional organizer
  • Learn to reduce isolation and increase social involvement with more meaningful activities
  • Learn ways to enhance motivation for change
  • Attend family or group therapy
  • Have periodic visits or ongoing treatment to help you keep up healthy habits

Treatment often involves routine assistance from family, friends and agencies to help remove clutter. This is particularly the case for the elderly or those struggling with medical conditions that may make it difficult to maintain effort and motivation.

Medications

There are currently no medications approved by the Food and Drug Administration (FDA) to treat hoarding disorder. Typically, medications are used to treat other disorders such as anxiety and depression that often occur along with hoarding disorder. The medications most commonly used are a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs). Research continues on the most effective ways to use medications in the treatment of hoarding disorder.

I hope this helps. Please let me know.

Categories: FamilyHomeNewsRelationships

View Comments (22)

  • Hi, what happens when you take the hoarder to live/ stay at some other place like an Airbnb or vacation rental? A place that is clutter free and attractive. After a few days or a week, I think that person will admit that they like fresh sheets, uncluttered floors and counter space . That the openness is refreshing and energizing . Granted, your the place you live might be tight, outdated and a little depressing without the clutter. The point is to allow the border to experience the freedom and energy of a clutter free setting. You might even bring photos of your living areas filled with clutter to compare to where you are. I think it helps to give people a choice. Even most crazy people when give a choice of a dark dirty glass of water and a clear glass of water will choose the clear.
    I loved the Times I went car camping. I would sit in our campsite in amazement that the tent was our shelter, our clothes and sleeping bags were are possessions and the picnic table/ bench was our furniture. Two folding flat chase lawn chairs was our versatile lounge chairs, beach chairs and cot. All this fit nicely in the back of a hatchback Honda Civic that resembled a breadbox.

    These vacations allowed me to see how free of things we could live and what was really important.

    • My husband does the same thing everywhere we go. He is utterly incapable of keeping an area tidy. He'll take the desk in a hotel room, for example, and receipts, pens, debris from whatever store he just went to for "snacks" sits there. His clothes are not hung up or folded, they land wherever he happens to be standing. I've taken to "allocating" a spot for him in a hotel room, but that doesn't work well unless I continue to dump his debris back onto his area. Drives. Me. Bonkers. I'm the opposite... a tidy minimalist.

  • My husband has consumed about 85% of our home with his stuff. There are no flat surfaces left to even sit to write a check to pay the bills. There is no place to sit together to eat, because he has taken it up with is stuff. It isn't even behind closed doors any more, because our front porch is covered with his stuff. Our yard looks like a jungle while he pulls weeds out of our driveway...and our neighbor's (whose name we do not even know). Oh, yeah, it is a mental disorder, alright. But, he doesn't think he has a problem. I hate being in my own home. I have given up trying to keep order and clean in here. I want out! I am SO GLAD to finally see an article that acknowledges that this is not just a matter of "collecting" or being "messy". It is WAY more serious than that. I truly feel hopeless, and am just waiting for one of us to die. If I go first, I will be done living like this. If he goes first, this stuff is out of here in a week!

  • I was surprised when you said that around 50% of hoarders also suffer from major depressive disorder. I've been struggling with hoarding tendencies ever since I moved to my new place a few years ago. Reading your article helped me see my problem for what it is, and now I feel more motivated to start tackling the issue by seeking psychological help and hiring a hoarding cleanout service.

  • I cannot begin to describe the weight that is being lifted over me just to realize I am not alone nor selfish for feeling the way I do. Reading all these comments have me wondering why I did not look into getting help sooner. I have been married for 24 years to a HOARDER and I HATE it!! I also feel trapped, depressed, tired and absoutely hopeless. NO matter how many times he tells me he is working on it the mess stays the same. To add insult to injury we had to move in with my HOARDER parents 8 years ago made worse by him losing his job 3 years ago and only getting temp jobs so far. I am beginning to think this may never change. I don't want to spend the rest of my life living like this: never having friends or family over to my own ( & parents) home (too much clutter everywhere, getting up day after day going to work then coming back home to this pit of despair). My adult children have been severely affected by this as well. I love my husband and believe he means well but he truly lacks the resources and tools/help to really make a change that lasts. He can't go anywhere without picking up bottle caps or rocks off the ground. A major compulsion and always makes excuses or justifications for his behavior (ie: he's an artist and sees projects everywhere nevermind that he doesn't have a steady or stable job) It's truly maddening when you feel powerless to live normal or healthy and just keep hoping something will change. It's like waiting for a genie to show up and grant your wish, ridiculous! I hoep we can get some serious therapy soon or I may be forced to change tactics and rescue myself.

  • The comments in this post just reaffirm my worst fears, that no quality I have could make living with me, a reluctantly and embarrassed beyond belief hoarder, worth it because “we” hoarders are so loathsome. It’s not that I’m “crazy” or stupid, I’d love to live without clutter and I know I have a problem. Several problems, in fact. As a disabled vet with PTSD, anxiety disorder, and major depressive disorder, it makes it even more difficult to physically keep up with decluttering and not only does it feel futile, you people all seem to think it’s better to give up. But there is no help available to the hoarder, everything is support for the family that “have” to put up with them. I would rather my husband leave than hoard resentment like you all do toward your partners. Of course I want it to work out, I want to feel like my efforts are making a difference, but it’s so hard to dig out. Not everyone is happy living in a mess, most of them are probably miserable too. Admitting you have a problem does no good if everyone just tells you it’s nearly impossible to fix.

    • I've never met a hoarder who was willing to admit they have a problem. You're already on your way to decluttering, by admitting there's a problem.

      From what I understand, it's only hopeless if the hoarder won't acknowledge that the clutter is a problem. I hope you can reach out to get the help you need.

  • My partner has a slightly different version. She wants to save to world by keep things from landfills. She used to keep tabs on a FB page where folk posted stuff they wanted to get rid of and if she thought she couldn't find a home for it she went to get it. And granted some things did find home, good homes. But other stuff is still here.

    Now she works at the local tiny general store. When food passes the best buy date and has to be disposed of, she brings it home. If it can go in the freezer, we do use it later. But produce.... She tries to keep up by salvaging the what can be salvaged and makes jams, cakes, pies, sauces and chutneys (much of which we really don't eat, so the fridge is full of that, but at least she can also give it away). When she can't keep up, the stuff just rots. So there are boxes of produce in various stages of decay on the veranda and in the kitchen.

    She also brings home the recycling; cardboard, plastic, outdated newspapers and magazines, etc.... The cardboard she uses to heat the house, which is fine I guess but it takes a lot more time then using firewood (which we also have plenty of). The plastic she sorts and takes to recycling, which is also very time-consuming and as we live far from such centers, the stuff piles up until she has an opportunity to drive out there for other errands. Some of the paper stuff she has regular people to take them to, but others wait in piles until she can find someone.

    I know her doing this is coming from a good place in her heart, and she does keep it for the most part in only certain parts of the house (kitchen, veranda, basement) and everywhere else is not bad, but I hate to go into those parts of the house because the odds of my finding something gross or disgusting is great.

    Is this hoarding? I don't know but it is hard to live with.

  • My husband goes from one hobby to another. When he decides he is interested in the hobby, he starts being everything related to it: electronic devices, supplies, etc. He will invest in bulk purchases if some of these items.
    Then, when he decides he is tired if the hobby, he moves on to another one, investing in materials and supplies the same way. Our home is bursting with these supplies, which he saves for the next time he might “get back into” the hobby. Can anyone relate?

  • My wife claims she is not a hoarded, just unorganized. We have a 10x10 rental space outside the home. Two storage spaces in cellar (we rent the apartment), one is 8x10 the other is 8x8. My sons old bedroom if filled 8x8. living room is half full, 8x15 bedroom only has a small walk space to get out of bed. Must move toteS to get out the front door. Living room has walkway 12 feet by 8 inches. We can't pass each other in the kitchen. I had a space for my stuff next to bed. Every day for 2 months, every time she put something there I would put it elsewhere I just gave up. My one tote is now 4 of hers and 1 of mine.

  • My husband has taken hoarding to a new level, although after reading all the comments I think he is an amateur! He loves to find stuff on the side of the road when he rides his bicycle! It used to be an occasional tool, etc., but now it’s all manner of stuff, e.g. can openers, phones, mostly small stuff, but he brings it home, and insists on saving it. If something is too big to carry on his bike (don’t ask), he places it behind a bush or something and goes to get it later. This may sound harmless, but this “collecting” is combined with an inability to throw anything out, donate, etc….I cannot reason with him, and after reading these articles, perhaps I understand it better. But, I don’t like it. 52 years married, but this is a relatively new development.
    SAS

  • I lived with a hoarder for 14 years. I tried everything from compassion, to sneaking things into the garbage (she found out), to trying to reason with her. Nothing worked. I moved out 8 months ago, and ended the relationship. I loved her very much, but for my own mental and physical health, I had to get out.

    This is a great article, and the fact stated that the "stuff" provides comfort to the hoarder is absolutely true. Thank you Janet. The pain of not having her in my life is difficult, but a step I had to take.