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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)

frost-expert.jpg

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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MAY 121 2021

How does hoarding disorder differ from ordinary collecting?

Cyprus Mail

In this video, Dr. Jenny Yip, a clinical psychologist specialising in obsessive-compulsive disorder and anxiety, identifies the characteristics of hoarding disorder and explains how it differs from more mundane collecting. Hoarding disorder is where someone acquires an excessive number of items and stores them in a chaotic manner, usually resulting in unmanageable amounts of clutter. It can cause problems in relationships, social and work activities and other important areas of functioning. 

APR 29. 2021

Inside The Mind Of A Hoarder: ‘We Are Isolated. We Are Shunned.’
CBS-LA

Timpano said most U.S. cities fail miserably at addressing hoarding by simply forcing a clean-up. “Because what you’re doing is that you’re just bandaging it up,” she said. “You’re not actually treating the wound, you’re not actually treating what gave rise to the problem to begin with.”  There are no medications to treat hoarding, with therapy as the only treatment. Obando said he and his wife saw a therapist, but that was years ago. “If it weren’t because we’re afraid and feel hopeless, we would not have reached out,” Obando said.  

APR 26, 2021

COVID-19 the 'perfect storm' for people battling hoarding disorder
CBS News

Lockdowns keep those who hoard from getting the in-person help they need. Canadians who hoard have been finding it difficult to control their disorder this past year due to COVID-19 restrictions that have cut them off from the support they need. They are "already among our most isolated clients ... and the pandemic just made that all so much harder," said Lucie Hager. When the pandemic hit, his in-person sessions were cancelled and his anxiety increased. "The hoarding gets worse because you're not really cleaning up because you're depressed," LeBlanc said.  

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Physician Reviewed

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