WHAT IS HOARDING DISORDER?

others may view as worthless and have persistent difficulty getting rid of or parting with possessions, leading to clutter

that disrupts their ability to use their living or work spaces.

Hoarding is not the same as collecting; collectors look for specific items, such as model cars or stamps, and may

organize or display them.  People with hoarding disorder often save random items and store them haphazardly.

In most cases, people save items that they feel they may need in the future, are valuable, or have sentimental value;

some may also feel safer surrounded by the things they save.

Hoarding disorder occurs in an estimated 2%-5% of the population and often leads to substantial distress and

disability.

CONSEQUENCES

Hoarding disorder can impair social, occupational, and other important areas of functioning.  Potential consequences

of serious hoarding include health and safety concerns, such as fire hazards, tripping hazards, and health code

violations.  It can also lead to family strain and conflicts, isolation and loneliness, unwillingness to have anyone else

enter the home, and an inability to perform daily tasks such as cooking and bathing in the home.

DIAGNOSING HOARDING DISORDER

Individuals with hoarding disorder have difficulty discarding items because of strong perceived need to save items

and/or distress associated with discarding. The symptoms result in the accumulation of a large number of

possessions that congest and clutter living areas of the home or workplace to the extent that their intended use is no

longer possible or substantially impaired. The hoarding causes clinically significant distress or impairment in social,

occupational, or other important areas of functions (including maintaining a safe environment for self and others). 

The clinician must determine that the hoarding is not due to another medical condition or better accounted for by the

symptoms of another mental disorder.

An assessment for hoarding may include questions such as

Do you have trouble discarding (or recycling, selling, giving away) things that most other people would get rid

of?

Because of the clutter or number of possessions, how difficult is it to use the rooms and surfaces in your home?

To what extent do you buy items or acquire free things that you do not need or have enough space for?

To what extent do your hoarding, saving, acquisition, and clutter affect your daily functioning?

How much do these symptoms interfere with school, work, or your social or family life?

How much distress do these symptoms cause you?

Mental health professionals may also ask permission to speak with friends and family to help make a diagnosis.

The level of insight varies across people with hoarding disorder.  Some individuals may recognize and acknowledge

that they have a problem with accumulating possessions; others may not see a problem. 

In addition to the core features of difficulty discarding, excessive saving, and clutter, many people with hoarding

disorder also have associated problems such as indecisiveness, perfectionism, procrastination, disorganization, and

distractibility.  These associated features can contribute greatly to their functional impairment and overall severity.

Animal hoarding, which appears to be distinct from hoarding disorder, involves an individual acquiring large numbers

(dozens or even hundreds) of animals. The animals may be kept in an inappropriate space, potentially creating

unhealthy, unsafe conditions for the animals.

Hoarding was previously considered a subtype or symptom dimension of obsessive compulsive disorder (OCD) or

obsessive compulsive personality disorder, but recent research has indicated that it is more appropriately classified

as a distinct condition.  Hoarding disorder will be included in the latest edition of the APA’s Diagnostic and Statistical

Manual of Mental Disorders (DSM-5), due out in May 2013.   

CAUSES, RISK FACTORS, and COURSE

It is not known what causes hoarding disorder, but researchers have identified a number of risk factors.  Hoarding is

more common among individuals with a family member who is also a hoarder.  Genetic research has begun to

identify gene variants that may convey risk for hoarding.  Brain injuries have also been found to cause secondary or

acquired hoarding symptoms in some patients.

Hoarding disorder is also associated with distinct abnormalities of brain function and neuropsychological

performance, distinct from those seen in people with OCD or other disorders.

Many people with hoarding disorder also experience other psychological disorders, including depression, anxiety

disorders, attention deficit/hyperactivity disorder, or alcohol use disorder.  A stressful life event, such as the death of a

loved one, can also trigger or worsen symptoms of hoarding.

Symptoms of hoarding, such as difficulty discarding items, usually start during the teen years.  The average age at

onset of fist symptoms is 13.  Hoarding disorder tends to be chronic, often becoming more severe over decades, as

more and more clutter accumulates, causing more and more dysfunction.  Hence, early recognition, diagnosis, and

treatment are crucial to improving outcomes. 

TREATMENT

Treatment can help people with hoarding disorder decrease their saving, acquisition, and clutter, and live safer, more

enjoyable lives.   There are two main types of treatment that help people with hoarding disorder: cognitive-behavioral

therapy (CBT) and medication.

During CBT, individuals gradually learn to discard unnecessary possessions with less distress, diminishing their

exaggerated perceived need or desire to save for these possessions.  They also learn to improve skills such as

organization, decision-making, and relaxation.  For many people, certain anti-depressant medications may be helpful

and may produce more rapid improvement.

If you or someone you know is experiencing symptoms of hoarding disorder, contact your doctor or mental health

professional.

In some communities public health agencies can help address problems of hoarding and getting help for individuals

affected. In some instances, it may be necessary for public health or animal welfare agencies to intervene.

Hoarding is the act of collecting excessive quantities of unneeded items. It is generally classified as compulsive behavior and can have serious effects, both for the hoarder and for those around him.

Physical effects of hoarding can include health problems as well as injuries from accidents. Psychological effects include increased compulsive behavior and, for those living with the hoarder, anxiety and depression. The most common social effect is isolation.The physical effects of hoarding are usually the most obvious. Hoarders are often compelled to keep unsanitary or dangerous objects. This can include keeping foodstuffs until they decay, causing mold and other bacteria to grow and spread throughout the house. The sheer quantity of items in a hoarder's house often makes cleaning virtually impossible, so dust and particulates accumulate. All of these factors can cause or contribute to health disorders, such as respiratory infections and asthma.

Rodents and insects can easily become a problem in a hoarder's house as well. These pests often carry diseases that can be spread as they run through the home. Small children and pets, in particular, may be at risk of a bite from an infected rodent or insect. Fires also are a serious risk, as hoarders often collect highly flammable objects and also because the collections often impede the ability to escape from the house if a fire does start.

Effects of hoarding  When someone hoards it is often a symptom of a mental health issue. There are a number of reasons hoarding may begin. It not only affects the emotional state of the person who is hoarding it also impacts loved ones emotionally. Obviously, hoarding impacts the physical environment as well. 

Over time, the effects of hoarding can wreak havoc both emotionally and physically.  Regarding the physical effects - a person’s health as well as the house itself may be susceptible. An accumulation of items ranging from trash and old household items, to mold, food, animal waste, and virtually anything else can potentially be the cause of occupants contracting a variety of communicable diseases, viruses and, various other health-related problems.

The physical aspects of the hoarder’s house itself can be at risk as well. One thing to consider is that when there is a hoarding issue there very well may be a problem with rodents such as mice, insects, and other pests. These animals carry disease and pose a huge risk. Odors that result from some of the items or waste materials not disposed of may require a professional odor removal process. In addition, the home may contain various biohazards resulting from the hoarded items which would require professional sanitization of the house.

Moving about the house can be a major concern.  There can be so much clutter that a path needs to be built through so occupants can go from one room to the next. However, this can become more dangerous as new clutter or existing clutter falls in the path; the occupant or occupants could slip or fall. Should a fire or other emergency occur, vacating the house could be impossible.

The structural integrity of the house can be jeopardized due to the sheer weight of the clutter. Floors could collapse. If liquids are among the clutter and/or there are clogged pipes, this can cause a lot of pressure to be put on the floorboards and cause decay.

When a hoarder lives with other people, they too are affected by the above factors. In addition, they may be forced out of their living space or confined to a very small area. Their ability to take care of themselves can be impaired; they may not be able to get to the sink or stove, the plumbing may not be functioning, and/or they may be exposed to unhealthy air.

Bio Clean, Incorporated of Washington has extensive experience helping people who are dealing with hoarding. We know what the issues are; we know how to work in this unique environment. Our staff is ready to help and we want to work with you to organize your life. Give us a call at 888-412-6300 and we’ll come out and talk with you at your convenience.