What Is Hoarding? What is compulsive hoarding? A person collects and keeps a lot of items, even things that appear useless or of little value to most people. These items clutter living spaces and keep the person from using their rooms as they were intended. These items cause distress or problems in day-to-day activities. What are the signs of compulsive hoarding? Difficulty getting rid of items. A large amount of clutter in the office, at home, in the car, or in other spaces (i.e., storage units) that makes it difficult to use furniture or appliances or move around easily. Losing important items like money or bills in the clutter. Feeling overwhelmed by the volume of possessions that have taken over the house or workspace. Being unable to stop taking free items, such as advertising flyers or sugar packets from restaurants. Buying things because they are a bargain or to stock up. Not inviting family or friends into the home due to shame or embarrassment. Refusing to let people in to the home to make repairs. What are the effects of hoarding? Severe clutter threatens the health and safety of those living in or near the home, causing health problems, structural damage, fire, and even death. Expensive and emotionally devastating evictions or other court actions may lead to hospitalizations or homelessness. Conflict arises with family members and friends who are frustrated and concerned about the state of the home and the hoarding behaviors. What makes getting rid of clutter difficult for hoarders? Difficulty organizing possessions. Unusually strong positive feelings (joy, delight) when getting new items. Strong negative feelings (guilt, fear, anger) when considering getting rid of items. Strong beliefs that items are valuable or useful, even when other people do not want them. Feeling responsible for objects and sometimes thinking of inanimate objects as having feelings. Denial of a problem even when the clutter or acquiring clearly interferes with a person’s life. Who struggles with hoarding behavior? Hoarding behaviors can begin as early as the teenage years, although the average age of a person seeking treatment for hoarding is about 50. Hoarders often endure a lifelong struggle with hoarding. They tend to live alone and may have a family member with the problem. It seems likely that serious hoarding problems are present in at least one in 50 people, but they may be present in as many as one in 20. What kinds of things do people hoard? Most often, people hoard common possessions, such as paper (e.g., mail, newspapers), books, clothing and containers (e.g., boxes, paper and plastic bags). Some people hoard garbage or rotten food. More rarely, people hoard animals or human waste products. Often the items collected are valuable but far in excess of what can reasonably be used. How is hoarding different from collecting? In hoarding, people seldom seek to display their possessions, which are usually kept in disarray. In collecting, people usually proudly display their collections and keep them well organized Can compulsive hoarding be treated? Yes, compulsive hoarding can be treated. Unfortunately, it has not responded well to the usual treatments that work for OCD. Strategies to treat hoarding include: Challenging the hoarder’s thoughts and beliefs about the need to keep items and about collecting new things. Going out without buying or picking up new items. Getting rid of and recycling clutter. First, by practicing the removal of clutter with the help of a clinician or coach and then independently removing clutter. Finding and joining a support group or teaming up with a coach to sort and reduce clutter. Understanding that relapses can occur. Developing a plan to prevent future clutter. Are there medicines that can help reduce hoarding? Medicines alone do not appear to reduce hoarding behavior. However, they may help reduce the symptoms. Medicines can be used to treat conditions that may make hoarding worse, like depression and anxiety. Credit: Maria Mancebo, Ph.D., Butler Hospital, Providence, Rhode Island