Hoarding Disorder

Patient Story: Hoarding Disorder

Lainie was a 47-year-old single woman referred to a community mental health team for treatment of depression and anxiety. She had never taken any psychiatric medication but had undergone CBT for depression 5 years earlier.

Lainie had a college degree and worked as a part-time sales assistance in a charity thrift shop. She said she had dated in college but had “some-how been too busy” in recent years. She was clearly in a down mood. She complained about poor concentration and problems getting organized. She said she hadn’t abused any substance.

The mental health care provider noticed that Lainie’s purse was filled with bills and other papers. When asked, she first shrugged it off, saying that she “carried around my office.” But when asked again, Lainie admitted she had a hard time throwing away business papers, newspapers, and magazines for as long as she could remember. She felt that it all started when her mother got rid of her old toys when she was 12 years old. Now, many years later, Lainie’s apartment had become filled with books, stationary, crafts, plastic packages, cardboard boxes and all sorts of other things. She said she knew it was a little crazy, but these items could be handy one day. She also stated that many of her possessions were beautiful, unique, and irreplaceable, or had strong sentimental value,. The thought of throwing out any of these items caused her great distress.

Over a series of interviews, the mental health care provider learned that rooms in Lainie’s apartment had begun to fill when she was in her early 30s, and by the time of the interview, she had little room to live. Here kitchen was almost entirely full, so she used a mini-fridge and a toaster oven that she had wedged between piles of paper in the hallway. She ate her meals in the only open chair. At night, she moved a pile of papers from the bed onto that chair so she could sleep. Lainie kept buying items from the charity thrift store where she worked and also picked up daily free newspapers that she planned to read in the future.

Ashamed by the state of her apartment, she had told no one about her behavior and invited no one into her apartment for at least 15 years. She also avoided social functions and dating, because—despite being friendly and very lonely—she knew she could not invite anyone to her home. She did not want the mental health care provider to visit her home but showed some photographs from her phone’s camera. The pictures showed furniture, papers, boxes and clothes piles from floor to ceiling.

Lainie was diagnosed with hoarding disorder. She has had problems throwing away possessions for as long as she can recall, which have resulted in living space that she can barely live in.