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Help With Hoarding Disorder

Curated and updated for the community by APA

People with hoarding disorder have persistent difficulty getting rid of or parting with possessions due to a perceived need to save the items. Attempts to part with possessions create considerable distress and lead to decisions to save them. The resulting clutter disrupts the ability to use living spaces (American Psychiatric Association, 2013).

Hoarding is not the same as collecting. Collectors typically acquire possessions in an organized, intentional, and targeted fashion. Once acquired, the items are removed from normal usage, but are subject to being organizing, admired, and displayed to others. Acquisition of objects in people who hoard is largely impulsive, with little active planning, and triggered by the sight of an object that could be owned. Objects acquired by people with hoarding lack a consistent theme, whereas those of collectors are narrowly focused on a particular topic. In contrast to the organization and display of possessions seen in collecting, disorganized clutter is a hallmark of hoarding disorder.

The overall prevalence of hoarding disorder is approximately 2.6%, with higher rates for people over 60 years old and people with other psychiatric diagnoses, especially anxiety and depression. The prevalence and features of hoarding appear to be similar across countries and cultures. The bulk of evidence suggests that hoarding occurs with equal frequency in men and women. Hoarding behavior begins relatively early in life and increases in severity with each decade.

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There have been a number of TV shows and other media coverage about people with hoarding behaviors. Has this changed the way people in general view hoarding disorder or peoples’ willingness to get help?

TV shows have raised awareness of the devastating impact hoarding behaviors can have on the individual and their loved ones. It is important for those affected to understand that TV shows, by their nature, may not capture all the time, effort and hard work that is a necessary part of any mental health treatment program. Hoarding, which became a new diagnostic entry in the DSM in 2013, affects about 2-3 percent of individuals. People with hoarding disorder have difficulty parting with possessions, clutter that interferes with normal functioning and marked distress and impairment. More

Are there early signs that a person may have hoarding disorder? Is it primarily a problem among older adults?

The initial start of hoarding symptoms is thought to happen in childhood or adolescence (typical onset is around age 16) and it is chronic and progressive. Hoarding is more common in older than younger age groups.

Below are some early signs that an individual may have hoarding behaviors. These behaviors are typically mild and progress over years. They may become a severe problem in adults in their 50s. However, not every person with hoarding symptoms has a hoarding disorder.

  • Difficulty letting go of things (throwing away, selling, recycling, giving away)
  • Clutter that makes it difficult to move easily throughout the home
  • Piles of items that keep tipping over (newspapers, magazines, mail)
  • Sleeping with items on the bed
  • Trouble organizing and categorizing
  • Trouble making decisions
  • Spending time moving things from pile to pile without letting go of items
  • Problems with attention
  • Excessive shopping or collecting free things
  • Not realizing the seriousness of the problem More

About the Experts:

rodriquez-expert.jpg

Carolyn Rodriguez, M.D., Ph.D.
Associate Chair and Associate Professor
Director, Stanford Hoarding Disorders Research Program
Department of Psychiatry and Behavioral Sciences
Stanford University School of Medicine
Member, Scientific & Clinical Advisory Board, The International OCD Foundation (IOCDF)

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Randy O. Frost, Ph.D.
Harold and Elsa Siipola Israel Professor of Psychology
Smith College
Member, Scientific & Clinical Advisory Board, The International OCD Foundation (IOCDF)

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Editor's Choice

NOV 9, 2021

Hoarding increased during the pandemic. Stress, isolation, and lack of visitors could be why.

Philadelphia Inquirer

For those with hoarding disorder — a clinical diagnosis that includes an extreme reluctance to part with items and a level of accrual that renders living spaces unusable — the pandemic was a perfect storm. Isolation, stress, uncertainty, and grief — combined with extra time at home, the ease of one-click shopping, and the absence of visitors who might suggest curbing the clutter — exacerbated a problem that psychologists say affects up to one in 20 people in the United States. 

OCT 28. 2021

How to intervene when a loved one is hoarding
Santa Maria Times

Considering all the reasons why a person with dementia may feel the need to accumulate things, there are instances when clutter may need to be allowed to provide a sense of comfort. However, unsafe hoarding or hiding will need to be addressed if it puts them or others at risk. Keep in mind that people who hoard may resent your attempt to remove items from the home and even have emotional outbursts. If the situation and risks feel beyond your ability to help, professional help from a qualified practitioner who works with older adults, or a mental health provider may be necessary to call upon.  

OCT 8, 2021

Battling your demons: hoarders clean house der
Ivanhoe Newswire

The pandemic has brought to light many mental health issues. One that it exacerbated … hoarding. It re-enforced some beliefs about the need to save items. But for millions, it’s more than just buying toilet paper and Clorox. For many, it’s a disorder that began in childhood and went undiagnosed for years, and then later in life, took control forbidding its victims from parting with possessions. Now a new therapy is helping these patients regain control of their lives. Ivanhoe has the details.  

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Additional Resources and Organizations

Physician Reviewed

Carolyn Rodriquez, M.D., Ph.D.
and
Randy O. Frost, Ph.D..
 August 2021