What is Compulsive Hoarding or Hoarding Disorder?

Compulsive Hoarding or Hoarding Disorder is seen in 700,000 to 1.5 Million U.S populations.

Compulsive hoarding is referred to as a kind of mental disorder whereby a person has a great urge to collect and keep items in their home for which the person experiences intense difficulty to dispose them, which makes the items clutter and make life difficult for themselves and others in the home. Recent researches have noted that this behavior is considered as a disorder since it is an abnormal behavior and can cause some problems to the hoarder and to other people around them.

Compulsive Hoarding or Hoarding Disorder

In Compulsive Hoarding or Hoarding Disorder, a person experiences continuous difficulty parting with acquired/ accumulated items because the person feels they should be saved and not thrown away. A person with Compulsive Hoarding or Hoarding Disorder feels so much pain at the idea of parting with their possessions. This leads to more possessions accumulated, whether needed or not.

The situation usually leads to a very compact and crowded living, creating very narrow and tight pathways, and most times items fall over themselves.

Compulsive Hoarding or Hoarding Disorder is said to be a disorder if the following 3 conditions are satisfied:

  1. An individual always collects and stores items that may not be important or needed.
  2. The items collected are muddled up everywhere in the house, restricting proper movement and use of the rooms.
  3. This hoarding creates so much difficulty performing daily activities, causing so much distress and danger.

Types of Compulsive Hoarding or Hoarding Disorder

Hoarding has since been listed as part of Obsessive Compulsive disorder (OCD); an anxiety disorder that causes people to have persistent thoughts that make them do things repeatedly. There are mild to severe types of OCD or Obsessive Compulsive Disorder found in the severe case of hoarding, while there are cases where hoarding may not have any significant impact in the life of the hoarder. On this note hoarding has been found to be of three (3) types. They are:

  1. Pure Hoarding: The hoarder does not experience repetitive thoughts to hoard and the hoarding does no cause much anxiety and distress to the hoarder.
  2. Hoarding plus OCD: In this case, hoarding contains some minimal amount of OCD. The thought to hoarding is not as strong as with a person with a pure OCD.
  3. OCD-Based Hoarding: Hoarding in this case is purely OCD based and the person has repeated thoughts to hoard, experiencing a lot of anxiety and distress.

Most people with hoarding disorder do not think it is a problem to them; this can be a great hindrance to treatment. However, intensive treatment may help the hoarders understand their compulsions and live safer, more enjoyable lives.

Who is a Hoarder?

A hoarder is described a person who acquires and accumulates items unnecessarily for no apparent reason; most often because of emotional attachment or the person feels they will need them in the future.

Is Hoarding a Mental Illness?

Hoarding disorder can be associated with mental illnesses. The act of Hoarding is most often found with people who have various kinds of neuropsychiatric disorders, such as dementia, psychotic disorder, autism, mental retardation, and eating disorders, as well as in people without mental problems. However, it is most frequently associated with Obsessive Compulsive Disorder (OCD).

What is the Difference Between Hoarding and Collecting?

Collection of items such as books, stamps or artifacts may not be considered as hoarding if those items or properly organized and they do not constitute a nuisance or restrict movement and activities. The difference between a hoard and a collection is the manner the items are organized.

A collection is a well-ordered and easily accessible items, while a hoard is usually very disorganized; occupies the most of the spaces in the room practically makes the items utterly inaccessible.

For example, someone who collects newspaper reviews may cut out the reviews they want and organize them in a catalogue or scrapbook. Someone who hoards may keep large stacks of newspapers that clutter their entire house and mean it is not actually possible to read any of the reviews they wanted to keep.

What Causes Compulsive Hoarding or Hoarding Disorder?

One cannot exactly say what actually causes compulsive behavior in a person. Genetics, brain chemistry and stressful life events are being studied as possible causes for Compulsive Hoarding or Hoarding Disorder.

Compulsive Hoarding or Hoarding Disorder can be a symptom of another condition. For example, someone who has difficulty in movement will certainly be unable to clear the huge amounts of clutter they have acquired. People who have difficulty in learning or people with dementia may not be able to categorize and dispose of items. Mental health problems associated with hoarding include:

  • Psychotic disorders, like schizophrenia
  • Obsessive compulsive disorder (OCD)
  • Clinical depression or major depressive disorder.

Compulsive Hoarding or Hoarding Disorder can also be caused by itself in few cases without any other associated mental conditions with some incidence of neglect, either self-inflicted or not. The cases of neglect that lead to Compulsive Hoarding or Hoarding Disorder include the following:

  • The person has had a deprived childhood, lacking some good things in life or good relationships with other family members.
  • The person is unmarried.
  • The person lives alone.
  • Have a family history of hoarding.
  • The individual grew-up in a cluttered home and was not taught to prioritize and organize things.

Most people with Compulsive Hoarding or Hoarding Disorder always have similar reasons for keeping those items. Many people who hoard have strongly held beliefs related to acquiring and throwing things away. They always feel that they may need it someday or that the mere thought of seeing the items around makes them happy, while others may still be affected by a grave loss, such as the death of a loved one. Any attempt to get rid of things often leads to emotional imbalance and this makes the person always feel reluctant to throw the hoarded items away.

What are the Signs and Symptoms of Compulsive Hoarding or Hoarding Disorder?

Stacked and untidy cooking areas, stoves, sinks, desks, stairways and almost all other surfaces, usually characterize the homes of people with a Compulsive Hoarding or Hoarding Disorder. In addition, when there is no more space inside, they may extend the cutter to the garage, vehicles and yard.

The first signs and symptoms of Compulsive Hoarding or Hoarding Disorder are clutters and difficulty parting with items, which often surfaces from the teenage years and continues as the person grows older. By middle age, symptoms become severe and may be harder to treat.

Compulsive Hoarding or Hoarding Disorder affects emotions, thoughts and behavior. Various symptoms experienced may include:

  • Strong difficulty to part with the possessions, regardless of its value.
  • Excessive emotional attachment to possessions, they are not comfortable with others touching or borrowing them and they feel pain at the idea of letting an item go.
  • Cluttered living spaces, making most areas of the home unusable, such as inability to cook in the kitchen or have a bath in the bathroom.
  • Keeping stacks of newspapers, magazines or junk mail.
  • Allowing excess store of food in the kitchen or letting the trash build up to unusually excessive, unsanitary levels.
  • Limited or no social interactions.
  • Acquiring items that are often not needed, such as newspapers or shopping bags.
  • Difficulty adequately performing daily activities because of procrastination and trouble making decisions.
  • Constantly rummaging through the pile of items, without throwing anything away.
  • Difficulty organizing items and often losing important items in the clutter.
  • Often feel shame or embarrassment with them in the presence of a visitor and not doing anything about it.

People with Compulsive Hoarding or Hoarding Disorder typically save items because:

  • They believe these items will be useful in the future.
  • They are emotionally attached to the items, as they often remind them of happier times or they represent beloved people or pets.
  • The items they save provide a kind of safety to them.

Hoarding of Animals in Compulsive Hoarding or Hoarding Disorder

Surprisingly, people with Compulsive Hoarding or Hoarding Disorder also do hoard animals. They can gather so many kinds of animals and keep them in their homes and may not take proper care of them because they are too many. This can lead to serious health problems on both the hoarder and the animals.

What are the Items People with Compulsive Hoarding or Hoarding Disorder may Hoard?

Almost everyone do hoard from time to time. Those with Compulsive Hoarding or Hoarding Disorder can hoard almost anything; while others without hoarding disorder hoard a few things they feel they may need some day. The examples of items people usually hoard are:

  • New and old books.
  • Old or new clothes both for when you will need to wear it and also clothing accessories.
  • Music cd, leaflets, letter and junk mails.
  • Groceries and food items.
  • Receipts and invoices.
  • Containers.
  • Old and broken electronics.
  • Animals.
  • Newspapers and magazines.
  • Old pots and pans.
  • Old and new cutleries saved for future use.
  • Shopping bags, etc.

When to See a Doctor for Compulsive Hoarding or Hoarding Disorder?

The first thing to do whenever a person discovers they have Compulsive Hoarding or Hoarding Disorder is to see a psychologist or psychiatrist immediately. You may also see an agency in your community who takes care of issues of Compulsive Hoarding or Hoarding Disorder. This kind of agency is not available in all communities, so you should find out from your local authority if there is such available service.

What are the Risk Factors for Compulsive Hoarding or Hoarding Disorder?

Anyone can be affected with Compulsive Hoarding or Hoarding Disorder, no matter the gender, age or social status. The various cases and situations that can cause a person to have Compulsive Hoarding or Hoarding Disorder or engage in any form of hoarding include:

  • The age of a person: The age of a person can determine their level of Compulsive Hoarding or Hoarding Disorder, also, the kind of things they will hoard. Compulsive Hoarding or Hoarding Disorder starts gradually from ages 11 to 15 years. The older people get, the more things they hoard. Children hoard things like spoilt and old toys, old notebooks and papers.
  • The family history of a patient: If there is a trace of a family member who was affected with Compulsive Hoarding or Hoarding Disorder, there is a possibility of offspring to hoard.
  • The nature of the person: The personality of a person, such as when a person is indecisive in nature, such a person while most likely exhibit some Compulsive Hoarding or Hoarding Disorder, simply because he or she do not know what to do with it.
  • Socially insecurity: When a person shows some sign of social insecurity and they most often have to isolate themselves from the society, they tend to get more comfort and joy in keeping inanimate objects they can control, and are attached to. This makes them hoard even more items if they are not aware of it and leads to Compulsive Hoarding or Hoarding Disorder.
  • Loss of a loved one or something they cherish: Some evidences have shown that most people who hoard some items keep them because of some emotional attachment they have for them, which usually reminds them of a loved one they lost or of a particular event they do not want to forget and this can lead to Compulsive Hoarding or Hoarding Disorder.

What are the Complications of Compulsive Hoarding or Hoarding Disorder?

Many complications are caused by Compulsive Hoarding or Hoarding Disorder. It can cause a various problems for the hoarder and other people around them. These problems will most often occur in homes filled with hoarded items.

  • It can lead to constant falls around the house when someone suddenly bumps into them.
  • The home will become very untidy and dirty which can cause some health problems to the inhabitants.
  • Compulsive Hoarding or Hoarding Disorder causes serious fire outbreaks, thereby destroying those items and other properties and which may also lead to death.
  • The items can injure someone when they suddenly fall from place and on the person around it, most especially children.
  • They can hinder people from doing some certain things in the house as they may block entrances and so forth.
  • Hoarding items can cause the hoarder to become lonely.
  • Hoarding items can cause some conflicts in the family, especially if those items are kept occupying another persons' place or if other people do not feel comfortable with them around.
  • When a partner hoards items in the house and the other persons' go against it, they may decide to send the person away, and this can lead to legal issues.

What Tests are conducted to Diagnose Compulsive Hoarding or Hoarding Disorder?

When a sign of Compulsive Hoarding or Hoarding Disorder is discovered in a person, it is important that they consult a mental health provider, who will diagnose them, by asking various questions that will help to determine their level of Compulsive Hoarding or Hoarding Disorder and their emotional and mental health conditions.

Most people with Compulsive Hoarding or Hoarding Disorder are often affected by psychological problems like Obsessive-Compulsive Disorder (OCD), depression and anxiety.

There are certain criteria that are used by various mental health providers to test or diagnose affected people. These criteria are contained in the Diagnostic and Manual Statistical Manual Mental Disorders (DSM-5), by American Psychiatric Association (APA). The criteria for diagnosing Compulsive Hoarding or Hoarding Disorder by DSM-5 include:

  • The person finds it difficult to throw away, or part with objects, no matter their value or importance.
  • The person usually experiences some difficulty performing as required at work and other social gatherings.
  • The person feels bad throwing away items.
  • That the person does not hoard as a symptom of any particular mental health condition.
  • If the items crowds up the house and other living areas as well, making the home unsafe and inhabitable.

What is the Treatment for Compulsive Hoarding or Hoarding Disorder?

People whose possessions offer great comfort and satisfaction to them do not usually want to admit that they have Compulsive Hoarding or Hoarding Disorder. This makes it difficult for people to seek for any kind of treatment for Compulsive Hoarding or Hoarding Disorder. Admitting to yourself that you have Compulsive Hoarding or Hoarding Disorder is the first step to treatment. After testing, the physician will prescribe treatment, which the person will strictly follow. There are two types of treatment usually prescribed for Compulsive Hoarding or Hoarding Disorder. They are:

  • Psychotherapy, and
  • Medications

Psychotherapy for Treating Compulsive Hoarding or Hoarding Disorder

Psychotherapy is also known as talk therapy. The treatment is usually done using the Cognitive behavioral Therapy (CBT), combined with some practical tasks the patient will perform and the plan of action to work things out.

Cognitive Behavioral Therapy or CBT is designed to help an individual with any mental disorders, by helping them change the way the think and the way they behave. It will help them open up and talk about how they feel and how they relate with people around.

This therapy can last for a very long period, which is usually broken into sessions including home-based sessions and having to work on the cluttered items. To achieve success in this therapy, there is need for the patient to adhere strictly to instructions, be patient and committed, as the program may run for many months.

Cognitive Behavior Therapy (CBT) for Treating Compulsive Hoarding or Hoarding Disorder

The following are the complete objectives and of cognitive behavior therapy (CBT) for Compulsive Hoarding or Hoarding Disorder:

  • CBT helps the person improve their decision making by allowing them throw the items themselves.
  • CBT helps them over the overly urge to save anything.
  • CBT helps the person become more organized.
  • Cognitive behavior therapy will also help to tackle other things that cause the patient to behave the way they do.
  • Gradually, the patient gets used to throwing things and does not feel bad at it anymore.
  • The therapy is also intended to help the person clear the clutter, and once they are cleared, the person will now come to understand their problem all along.
  • The person will learn and practice how to relax.
  • Even after treatment, there will be continued plan to ensure that the success attained so far is sustained and that the person does not go back to his or her former lifestyle.

Medications for Treating Compulsive Hoarding or Hoarding Disorder

Medications including antidepressants such as Serotonin Reuptake Inhibitors (SSRIs) are usually prescribed for handling the problem of Compulsive Hoarding or Hoarding Disorder. But, psychotherapy is the primary and the best treatment for Compulsive Hoarding or Hoarding Disorder.

What is the Prognosis and Recovery Period for Compulsive Hoarding or Hoarding Disorder?

People say that is usually very hard to attain complete recovery from Compulsive Hoarding or Hoarding Disorder, nevertheless, with willingness to change and great commitment to the treatment course, a lot of success can be achieved. The length of time it takes a person with Compulsive Hoarding or Hoarding Disorder to recover is often dependent on the persons' willingness to change. The patient needs to adhere strictly to session meetings and schedule and also follow the therapists' instructions and carry out all tasks given. Within 1 to 2 years, there will be positive results. Practicing regular yoga, mindful meditation combined with CBT should help in faster recovery.

What are the Lifestyle Changes Recommended for Compulsive Hoarding or Hoarding Disorder?

To recover properly from Compulsive Hoarding or Hoarding Disorder, a patient needs to change their lifestyle which is a hindrance to their treatment. Some of the changes they need to implement are:

  • Always maintain a good personal hygiene.
  • Adhere strictly to the treatment course and follow all instructions.
  • Always tell yourself that you deserve to live a better life.
  • Maintain a good diet and nutrition.
  • Talk to other people who have overcome this problem and make notes on how they have succeeded.
  • Be focused and determined to overcome Compulsive Hoarding or Hoarding Disorder. Take one step at a time.
  • If you are an animal hoarder do the right thing and take proper care of all your pets. Provide proper food and nutrition for them. If you have too many pets and you are not able to handle them give them to others who are interested. They deserve a better health and life just like you do.
  • Accept any kind of assistance from professionals and other local organizers.

What Can Yoga Offer for Compulsive Hoarding or Hoarding Disorder?

Compulsive Hoarding or Hoarding Disorder is a mental condition and yoga can help both your body and mind to function at their best. Yoga can help you get rid of Compulsive Hoarding or Hoarding Disorder. Yoga poses helps release negativity and tension from your body:

Carryout some yoga postures regularly such as dhanurasana or the bow pose, paschimottanasana or the two-legged forward bend, hastapadasana or the standing forward bend, adhomukha shwanasana or the downward facing dog pose, matsyasana or the fish pose, janu shirsana or the one-legged forward bend, shirshasana or the headstand, setubandhasana or the bridge pose, marjariasana or the cat pose, shavasana or the corpse pose.

You can also learn and practice mindful meditations as well for Compulsive Hoarding or Hoarding Disorder. Mindful meditation is a type of meditation that brings us closer to our human nature. Mindful meditations help you become aware of yourself from moment to moment. It helps you stop and break the compulsive behavior of Compulsive Hoarding or Hoarding Disorder.

How to Prevent Compulsive Hoarding or Hoarding Disorder?

Since most Compulsive Hoarding or Hoarding Disorder cases showed no trace of the particular course and most people are often unconsciously affected, the only prevention available is to seek immediate treatment at the slightest sign of it, also, take repercussions to stop you from immersing into the habit.

Also Read:

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: May 3, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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