What Is Hoarding Disorder?

According to the Mayo Clinic, hoarding is defined as “a persistent difficulty discarding or parting with possessions because of a perceived need to save them.” And while this is an adequate definition, it often leads people, such as friends and loved ones, to believe that treating the condition is as simple as getting rid of extraneous possessions the hoarder may have accumulated. However, hoarding is typically the symptom of a larger mental health condition, and it’s typically tied to anxiety disorders such as obsessive-compulsive disorder (OCD).

There is no known cause for compulsive hoarding, although studies have shown that there may be links between hoarding and depression, anxiety disorders, social isolation, stress, or chemical dependency. The actual cause is unknown, and until the fifth edition of the DSM (Diagnostic and Statistic Manual of Mental Disorders) was released in 2013, it wasn’t even a defined condition, but rather a listed symptom of other mental health conditions, such as OCD. It’s still unknown as to whether compulsive hoarding is a mental disability or a symptom of obsessive-compulsive disorder, but we do know that it has a relatively high prevalence rate. Currently, estimates state that two to five percent of adults are compulsive hoarders, with most of these instances manifesting in childhood and then worsening as the subject ages.

Due to the link with depression, anxiety, and attention deficit hyperactivity disorder (ADHD) there is some reason to believe that compulsive hoarding can be triggered by traumatic events such as a death in the family, loss of job, divorce, or abuse. The occurrence rate in healthy individuals is markedly lower than those with co-occurring psychological disorders.

Hoarding Therapy
What is Hoarding Therapy?

While most hoarders are secretive and prefer to keep to themselves, the conditions in which they live in are reason to exercise extreme caution. Often the hoarders live in unsanitary conditions that are prime environments for disease, accidents, house fires, mold, and pest infestations. Many hoarders suffer from chronic respiratory dysfunction or cardiac issues due to large amounts of ammonia (from human or pet urine or feces), mold, dust and other allergens. In addition, the increasing weight from the possessions that a hoarder keeps can cause structural damage, or even complete collapse of otherwise healthy structures.

Methods Used in Therapy for Hoarding?

Hoarding is a difficult problem to treat. While most friends and loved ones make an attempt to help, this is often characterized by a gentle or forceful coaxing of the loved one to release unneeded or unwanted possessions. While this may bring temporary relief, it certainly isn’t a permanent solution, as the hoarder will continue to accumulate possessions until the problem resurfaces. In addition, this often makes the problem worse by increasing anxiety levels in an individual who may already be dealing with an underlying mental condition.

Compulsive hoarding has various types of treatment. While both medicine and psychological therapy are key aspects to helping compulsive hoarders, the addition of cognitive behavioral therapy (or behavior modification therapy) in addition to on-going counseling sessions to treat the underlying cause of the behavior are often the best course of action.

The treatment program is often long, and fairly slow moving, as hoarders are typically quite anxious by nature. Moving slowly and altering behavior at a speed that they are comfortable with is often the most effective way to combat compulsive hoarding.

Therapists typically work to address the problem by earning the trust of the patient, and then slowly working to make them realize how hoarding is harmful, before ultimately working out a step-by-step program to modify the behavior at its core. The complications when treating compulsive hoarders are often magnified by the hoarder not believing that the behavior itself is a problem. Addressing the issue and then slowly working to address the behavior, as opposed to just getting rid of extraneous possessions, helps to keep it from re-occurring once the patient is finally ready to discard items.

Why Hire a Therapist?

Hoarding is a compulsion that most affected individuals don’t necessarily see as a problem. The act of cleaning a hoarder’s house or forcing them to remove certain objects often causes undue stress and ultimately becomes counter productive. Once hoarded items are gone, the behavior or underlying psychological condition can remain unaddressed, making ongoing therapy sessions more important.

Hoarders are often unaware that they have a problem, until loved ones discover what kind of conditions they are living in. Once this happens, it’s best to contact a mental health professional – with experience in compulsive hoarding – for help. Only he or she can properly help your loved one with any underlying psychological conditions as well as chip away at the root behavior, instead of just addressing the visible symptoms. Remember, getting rid of the extraneous items doesn’t relieve the problem.

What to Look for When Finding a Therapist.

When looking for a therapist, finding one with experience in hoarding is ideal, but since this is a rather new condition, a therapist with experience in obsessive-compulsive behavior, or anxiety disorders, is often more than qualified to handle most hoarding cases.