Hoarding disorder

About a hoarding disorder

A hoarding disorder is considered to be a significant problem if:

• the amount of clutter interferes with everyday living – for example, the person is unable to use their kitchen or bathroom and cannot access rooms
• the clutter is causing significant distress
• it is negatively affecting the person's quality of life  or their family's – for example, they become upset if someone tries to clear the clutter and their relationships with others suffer

Why someone may hoard

The reasons why someone begins hoarding aren't fully understood.

It can be a symptom of another condition. For example, someone with mobility problems may be physically unable to clear the huge amounts of clutter they have acquired.

People with learning disabilities or people developing dementia may be unable to categorise and dispose of items.

Mental health problems associated with hoarding include:

• severe depression
• psychotic disorders, such as schizophrenia
• obsessive compulsive disorder (OCD)

In some cases, hoarding is a condition in itself and often associated with self-neglect. These people are more likely to:

• live alone
• be unmarried
• have had a deprived childhood, with either a lack of material objects or a poor relationship with other members of their family
• have a family history of hoarding
• have grown up in a cluttered home and never learned to prioritise and sort items

Most people with a hoarding disorder have a very strong emotional attachment to the objects.

Difference between hoarding and collecting

Many people collect items such as books or stamps and this isn’t considered a problem. The difference between a ’hoard’ and a ’collection’ is how these items are organised.

A collection is usually well-ordered and the items are easily accessible. A hoard is usually very disorganised, takes up a lot of room and the items are largely inaccessible.

Signs of a hoarding disorder

Someone who has a hoarding disorder may typically:

• keep or collect items that may have little or no monetary value, such as junk mail and carrier bags, or items they plan to reuse or repair (see below) 
• find it hard to categorise or organise items
• have difficulties making decisions
• struggle to manage everyday tasks, such as cooking, cleaning and paying bills
• become extremely attached to items, refusing to let anyone touch or borrow them
• have poor relationships with family or friends

Hoarding can start as early as the teenage years and gets more noticeable with age. Many people seem to start problematic hoarding in older age.

Items people may hoard

Some people with a hoarding disorder will hoard a range of items. Others with the condition may just hoard certain types of objects.

Items that are often hoarded include:

• newspapers and magazines
• books
• clothes
• leaflets and letters, including junk mail
• bills and receipts
• containers, including plastic bags and cardboard boxes
• household supplies

Some people also hoard animals, which they may not be able to look after properly.

More recently, hoarding of data has become more common. This is where someone stores huge amounts of electronic data and emails that they're extremely reluctant to delete.

Why hoarding disorders are a problem

A hoarding disorder can be a problem for several reasons. It can take over the person's life, making it very difficult for them to get around their house. It can cause their work performance, personal hygiene and relationships to suffer.

The person hoarding is usually reluctant or unable to have visitors, or even allowing tradesmen in to carry out essential repairs, which can cause isolation and loneliness.

The clutter can pose a health risk to the person and anyone who lives in or visits their house. For example, it can:

• make cleaning very difficult, leading to unhygienic conditions and encouraging rodent or insect infestations
• be a fire risk and block exits if there's a fire
• cause trips and falls
• fall over or collapse on people, if kept in large piles

The hoarding could also be a sign of an underlying condition, such as OCD, other types of anxiety, depression and conditions, such as dementia.

What you can do if you think someone is hoarding

If you think a family member or someone you know has a hoarding disorder, try to persuade them to come with you to see their GP.

Reassure them that nobody is going to go into their home and throw everything out.

Your GP may be able to refer you to your local community mental health team for help and support, see more useful links below.

It's generally not a good idea to get extra storage space or call in the council or environmental health to clear the rubbish away. This won't solve the problem and the clutter often quickly builds up again.

How a hoarding disorder is treated

The main treatment for treating a hoarding disorder is cognitive behavioural therapy (CBT).

A therapist will help the person to understand what makes it difficult to throw things away and the reasons why the clutter has built up.

Antidepressant medicines have also been shown to help some people with hoarding disorders.

More useful links

• How to use your health services
• OCD UK – Belfast support group
• OCD Action – Northern Ireland