Hoarding Disorder

Hoarding Disorder

Most of us have keepsakes we don’t want to throw out, like old letters, pictures, and memorabilia close to our hearts. Some of us even keep things in our bags for future use. We believe these things are important to us and we hold them close to our hearts. Just like hoarders, we place our feelings on these items. So when does this habit become a hoarding disorder? What makes hoarding conditions so unhealthy? In 2009, a show called Hoarders aired. This show took a look at the lives of people with obsessions over their things, allowing them to take over their lives. People found this show interesting yet couldn’t stop watching it. It was fascinating to see how differently hoarders lived. Some people on the show hoarded things like trash, rotten food, broken appliances, and even animals. It may have been interesting, but the show always emphasized that this is not a healthy way to live. It’s important to remember that these are people who also need help.

 

What is Hoarding Disorder?

Hoarding Disorder involves acquiring and keeping things for themselves that are of little value for others. But for hoarders, these things are important and they grow an extreme attachment for them. Because of that, they have trouble parting with their things, regardless of their real value. It used to be a subtype of obsessive-compulsive disorder because hoarders obsess over their possessions. They fear losing them because they either think it’s too important to throw away or it might come in handy later. Hoarding behaviour can be harmful. It can cause health problems like animal hoarding because they can pass on diseases. Some cases have even led to deaths from fires with hoarded flammable items. It can also be disabling to a person. Hoarders can have problems with eating, sleeping, and dressing. Their houses look messy inside because of the things they’ve collected. Because of this, it becomes hard to walk around in them and chaotic to live in. You would find the items on their floor, sometimes even blocking your way. Items usually take up space where other things should be. Hoarding Disorder is not simply keeping your stuff because you value them. It might also be seen in people who splurge whenever they see a sale or unique items. It can also be in people who collect free stuff like, samples and flyers. If a person lives in a cluttered room and owns massive amounts of things they don’t need, it might be wise to look into this disorder.

 

Hoarding vs Collecting

Some of us have hobbies like collecting. Many people collect stamps, photos, figures, and other belongings, then put them on display. But this is not the same as hoarding. Collectors enjoy showing off their things. Their houses have their collections on display for all to see and might even brag about it. Their display cases and shelves are organized and clean. While they may spend a lot of money on their collection, they still make sure they budget it. So, they don’t usually risk going into debt for their hobby.

On the other hand, hoarders feel embarrassed about their messy rooms. They sacrifice their living space and finances to support their habits. There may even be guilt following a spending spree or simply because they know their living quality is not normal. This causes a big amount of stress, pushing them to seek help.

 

What are the signs & symptoms of Hoarding Disorder

It can be hard to tell the difference between hoarding and collecting. But it’s important to recognize hoarding disorder’s symptoms because it can become a problem it gets in the way of living comfortably and maintaining relationships. Hoarding disorder symptoms may include, but are not necessarily always the following:

  • Having a hard time getting rid of items
  • Having cluttered rooms, workspaces, car, and other spaces
  • Hard time moving around living spaces
  • Losing essential items in the clutter like phones or wallets
  • Experiencing anxiety attacks if items were discarded
  • Believing that items are more important than they are
  • Fearing the loss of possessions
  • Building emotional attachments to items
  • Always splurging, or getting free or discounted items
  • Feeling shame when people see their living space
  • Not letting people help fix their home

Knowing the symptoms can make a huge difference. Seeing them early can help things from getting worse. For example, if you see a friend keep items they don’t need, you need to be able to call them out and reason with them about the importance of organization. So if you or a person you care about act this way, you can figure out how to stop it from becoming a hoarding condition by reaching out for help from friends or a therapist if the symptoms are hard to control.

 

Causes of hoarding conditions

Hoarding conditions can be seen in teens to adults. Usually, people with hoarding disorder have it most of their lives. Because it can happen at any time in adulthood, it is important to know the possible causes. If these causes can be avoided, so can the problem. Even though avoiding them can’t completely prevent the disorder, it can help make things easier for the person. In psychology, we can look at it from a biopsychosocial point of view.

 

Biological

It’s possible that hoarding behaviour is associated with a part of the brain in charge of attention and decision-making. Studies have shown that these parts of the brain have less activity in hoarders compared to people in general. This makes it physically hard for them to think about the outcomes of their actions. There might even be a gene related to hoarding disorder. This means that people can be genetically susceptible to developing the disorder. In other words, if they have a parent or relative who is hoarders, it can make you more at risk of having it, too. Around 80% of people with a hoarding condition have at least one direct relative with hoarding behaviour as well.

 

Cognitive

What could go on in the heads of hoarders? What’s the point in keeping all this needless stuff? It may seem impractical to us but, hoarders believe that the things they keep are important. It can reach the point that they have anxiety attacks if things are thrown out. In the end, they can never throw out their things. Hoarders also have trouble organizing their things, even when it starts becoming hard to move around their house and find important things. They also find it hard to focus on their tasks. It takes extra effort to throw things out and sort through items. So it could be that they have a hard time doing simple chores even though many of them live alone. If you were to ask a hoarder to clean up their mess, they’ll likely respond by saying they don’t want to waste things or their things are exactly where they want them to be. They might even say they will try to in the future, but never follow through.

 

Social

Most of us keep memorabilia to help us remember important people and events. It can be a ticket from a first date, photos of a trip, or a receipt from an important purchase. But hoarders can believe that without these items, they might forget these people or events. This makes it hard to see if their actions are normal or not because their actions are a bit relatable. A good telltale sign is when it begins to affect their work and hygiene, and the number of items they keep.

 

Relationship with other disorders

 

Obsessive-compulsive Disorder (OCD)

Hoarding disorder used to be a subtype of OCD but, it was made into its own disorder. A compulsive behaviour commonly linked to hoarding is shopping. In other words, people buying needless things because they might need it in the future, even though it is likely they will not. In addition to OCD, hoarding disorder is also linked to high rates of obsessive-compulsive personality disorder (OCPD). But there are some differences between the two. Hoarding disorder doesn’t usually have intrusive thoughts or ritualistic behaviour like OCD does. Meanwhile, people with OCD also have better insight. They usually know they have a problem and want to get better. But hoarders usually believe their behaviour is okay. They don’t see another alternative for their habits.

 

Schizophrenia

This disorder is commonly linked to hoarding disorder. Schizophrenia can even present when hoarding disorder becomes more serious. They are similar because they both involve delusional belief systems. People with hoarding disorder believe that their things are important even though they don’t hold any real value. These beliefs can persist even when told otherwise, they live chaotic lives, and neglect their self-care, similar to schizophrenia.

 

Attention-Deficit/Hyperactivity Disorder (ADHD)

ADHD has also been shown to be related to hoarding disorder. People with ADHD don’t often plan out what they do. They impulsively buy what they want and procrastinate from doing their tasks. This is similar to hoarders who buy things they want even if they don’t need them and avoid doing small tasks. Hoarders with ADHD have been shown to have more severe symptoms. They have messier homes and a harder time throwing away their stuff.

 

How is Hoarding Disorder diagnosed?

There are no lab tests for diagnosing Hoarding Disorder. But Hoarding Disorder is in the DSM-5. Its main features are:

  • Getting and failing to throw away a lot of possessions that are of little to no value
  • Cluttered living spaces
  • Hoarding causes distress and impedes normal activities

These features are enough to seek professional help. But some hoarders don’t realize their hoarding condition is a problem. This makes it hard for them to find help even when their relationships and work are affected. Much of the time, they don’t look for help until they are in their 40s or 50s. These symptoms can start out mild and get worse over time. Some people only hoard during stressful times of their life. Either way, if you or anyone you know has these symptoms, you might want to see a professional.

 

Treatment for Hoarding Disorder

Because hoarders rarely think they have a problem, it’s hard to tell them to get help, let alone treat them. It’s also hard to treat because they usually have low motivation to get better. Some even avoid treatment altogether. But it is important to get them treated because of the poor quality of life that hoarding conditions can cause. They have cluttered houses that can be harmful to people living with or near them. It can pose health problems, structural damage, fires, and even death. Debt is common in hoarders too, which doesn’t help if they get evicted from their homes due to the clutter in their homes. Even if they aren’t evicted, many hoarders live with broken appliances and furniture. They would rather live with broken items than throw them out and ask someone to fix them. There are also cases of families and friends becoming frustrated and leaving due to the hoarder’s disorganized behaviour. Because of all of these consequences, treatment becomes essential if they can’t help themselves.

 

How can I help someone with a hoarding condition?

If you want to help someone you care about who has these symptoms, it won’t be an easy job. You can’t simply throw out their things and think the problem is solved. There is a cause for their hoarding that needs to be addressed. You’ll want to plan an intervention. The first goal in intervention is to have them see a therapist. If you don’t know where to start, you and other concerned persons can see a therapist first. This will give you a better idea of how to approach the hoarder. You, along with a few trusted friends or family, can arrange a confrontation first before having the hoarder see a therapist. Here, you can talk about how the clutter affects their lives and that they are willing to help them get better. It must be an open space, free of judgment. But you need to emphasize that the hoarder needs to see a therapist. This first encounter can be through the therapist’s office, at home, or even through tel consult. At the end of the day, the hoarder must be the one to decide to get better. You can’t force them to be move or to clean. If you forcefully throw away their things, you might trigger an anxiety attack and ruin your chances of helping them. But the intervention does not stop there. Friends and family are important sources of support during treatment. Without a source of support, the hoarder will likely go back to their old ways. Their reason for hoarding may be related to friends and family which needs to be addressed in therapy.

 

Self-care

If you think you might have a hoarding condition, you can talk to a therapist for help. Maybe your behaviour led to some negative changes in your life. It could be someone leaving the house, getting into an accident, or maybe it’s just hard living at home because of the clutter. But it’s not impossible to recover from hoarding disorder! Your first step after realizing you have a problem would be to find help. Whether it’s looking for a professional or a friend to help support you, having someone around can give an objective view of your behaviour. But even if you find treatment, you will need to commit to it. Your journey to getting better doesn’t stop with cleaning your house. You need to maintain it and practise the positive behaviours you can learn in therapy.

 

Cognitive Behavioral Therapy for Hoarding Disorder

This is one of the most common treatments for people with hoarding disorder. The main goal of CBT is to prevent more items from being added to the clutter. CBT helps understand the hoarder’s thoughts and actions. Together with the therapist, the client will think about the possible causes that led to their behaviour. Then, they can figure out better coping mechanisms than resorting to hoarding behaviour. The aim of this therapy is to:

  • Organize and clean up the cluttered living spaces
  • Better their decision-making skills in buying, keeping, and throwing away their things
  • Learn organizing skills for their belongings
  • Build resistance against their need to save things they don’t really need

One of the activities in this therapy is keeping a record of their behaviour when they get or buy something. Afterwards, they can go over it and see what patterns led to their hoarding behaviour. This will allow them to find the cause of their harmful beliefs and thoughts. Then, they can find a way to redirect these thoughts into better coping mechanisms. They will also be asked to change many of their behaviours. One example would be stopping their subscriptions to magazines and newspapers that just end up piled up in their homes. Their daily routines will have to be changed and include cleaning activities like, throwing out their trash, organizing their things, and washing the dishes. As part of behaviour therapy, they will also have relaxation skills training. Since throwing things out causes them anxiety, relaxation skills will help them be more comfortable with their new lifestyle.

 

How can a mental health professional help with hoarding conditions?

Mental health professionals can give therapy to people who need it. Therapy needs a licensed or certified professional because it is more than just talking and listening. Therapists can help you find what thoughts influence harmful behaviours. They may not give advice to you but, unlike talking to your friends, therapists can give you an objective viewpoint. Through therapy, you’ll be setting goals with the therapist and how to really reach them. It can be a long time before you see results. But it can be worth it with commitment and determination. Therapy is not the only treatment for hoarding disorder. Psychiatrists are set apart from psychologists and therapists because they can give medications the client needs. For this disorder, doctors can give SSRI antidepressants. But this might not work for you. SSRI drugs act on the brain by increasing the serotonin available. Serotonin helps control your moods and is linked to happy feelings. So when this chemical is more available in your body, your mood should improve. In the case of hoarders, it can help them cope with their negative feelings over losing their things. But medication with therapy produces better results. Psychiatrists might also have better insight into the biological factors that affect disorders.

 

Prognosis of Hoarding Disorder

Hoarders usually don’t realize they have a problem unless the symptoms and impact on their life are severe. Even when told their hoarding condition is problematic, they will still refuse to believe it. This is why the outlook for hoarders is negative. But they are not beyond help. Hoarding disorder has treatments and the hoarder can function better if they follow the goals they set in therapy. What’s important is knowing the symptoms when you see them and convincing people with these symptoms to look for professional help. But only do so when they are ready to talk about their problem with you. Treatment can be a long, tedious process but it can help better someone’s life in the long run.

 

Sources

https://www.anxietyaustralia.com.au/resources/compulsive-hoarding/
https://iocdf.org/wp-content/uploads/2014/10/Hoarding-Fact-Sheet.pdf
https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/hoarding-basics
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038586/
https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/hoarding-basics/staging-intervention