According to the DSM-5, a person with hoarding disorder: A) has severe difficulty parting with possessions regardless of actual value; B) thinks saving items is necessary and feels distress at the thought of discarding them; C) accumulates possessions to the degree that they clutter living areas and limit functionality (such as by blocking the stove or filling the tub); D) has significant distress or impairment in social, occupational, or other areas; E) does not have a brain injury or other disease or disorder that better explains the behavior.
Collectors are almost always precise and particular about the organization, categorization, and display of their chosen items (like dolls or antique toasters). The items may fill or even clutter areas of the house, but don’t usually impede normal activities. People who have hoarding disorder may insist otherwise, but their accumulations of items are almost always disorganized and impediments to normal household functions. Collectors derive pleasure or joy from the items they accumulate and display. People who have hoarding disorder have an anxiety disorder that causes fear at the notion of discarding items. [3] X Research source
People who have hoarding disorder, for instance, tend to rarely leave home, often out of embarrassment and/or fear that someone will come and take their possessions. They often therefore face difficulty finding and keeping jobs, and may face evictions or other legal action due to unsafe living conditions. People living with someone who has hoarding disorder may be affected by the accumulation of items throughout the house, but other family and friends are also negatively impacted. They often find opportunities for interaction with the person who has hoarding disorder significantly reduced, and may feel shame or embarrassment by association with the person who has hoarding disorder.
Individuals who have both OCD and hoarding disorder may need related yet separate treatment regimens to deal with each. Behavioral therapy and possibly medication will likely be involved, but there is no “one size fits all” treatment for these conditions, either individually or in tandem. [6] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source
Hoarding disorder will typically be diagnosed by a psychiatrist or other mental health professional. He or she may utilize tools like the Hoarding Rating Scale or Hoarding Assessment Battery, both of which utilize observations and questions to help determine if the condition exists. [8] X Research source If and when hoarding disorder is diagnosed, the mental health professional, the patient’s primary care physician, and any specialists or other professionals involved will ideally work together to develop a coordinated treatment approach. Don’t be afraid to demand communication and coordination in care for yourself or a loved one with hoarding disorder.
CBT can help a person who has hoarding disorder identify the causes of his or her condition, which might include a traumatic childhood incident or a family history (diagnosed or not) of the illness. From there, the therapist and patient can work on developing organization and categorization skills, improving coping, decision-making, and relaxation skills, and slowly taking steps toward reducing the accumulation of items. CBT takes time to make progress in treating hoarding disorder, potentially months or even years. But, regardless of what TV shows on the subject may indicate, there is no lasting “quick fix” for hoarding.
A person with hoarding disorder may be prescribed an antidepressant medication in the SSRI class. Common examples in this category include Paxil and Prozac. SSRI medications may help alleviate some of the anxiety about not having what you need when you need it, which is one of the core elements of the condition.
Ask questions of a person who has hoarding disorder in order to better understand him or her, not to judge. Ask “Why do you feel like you need all of these?”, not “What in the world could you ever need all this junk for?”
Once you get to the point where you can begin de-cluttering, focus on one room at a time, or one category of hoarded item at a time. Start with less essential areas of the house or item categories. Celebrate achievements, however small.
As awareness of hoarding disorder grows, so too do support group options. There is a good chance that there is a meeting somewhere in your area. If not, online support groups can also be very helpful. Physicians, mental health professionals, social workers, and local nonprofit or government agencies that deal with hoarding disorder can often provide guidance on support groups available to you or the person who has hoarding disorder in your life.
While they make for good TV, interventions usually provide only a short-term fix for hoarding disorder. If underlying causes and perspectives are not addressed, whatever clutter is cleared after a person is put “on the spot” is likely to return quickly. Sadly, people have died due to hoarding disorder, by contracting illnesses from rodent infestations or even by being buried under fallen piles of clutter. Some people who have hoarding disorder live in homes so cluttered that they cannot access sinks, toilets, windows, or even doors. If you genuinely fear for the health and safety of a person who has hoarding disorder, call the proper authorities — the fire department, police, social services, child services, animal control (for pet hoarding), etc. [16] X Trustworthy Source Cleveland Clinic Educational website from one of the world’s leading hospitals Go to source
