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Hoarding Disorder

About the Disease

Hoarding disorder is a persistent difficulty discarding or parting with possessions because of a perceived need to save them. A person with hoarding disorder experiences distress at the thought of getting rid of the items. Excessive accumulation of items, regardless of actual value, occurs. Hoarding often creates such cramped living conditions that homes may be filled to capacity, with only narrow pathways winding through stacks of clutter. Some people also collect animals, keeping dozens or hundreds of pets in unsanitary conditions because they can't care for them properly. Hoarding ranges from mild to severe. In some cases, hoarding may not have much impact on your life, while in other cases it seriously affects your functioning on a daily basis. People with hoarding disorder often don't see it as a problem, making treatment challenging. But intensive treatment can help people with hoarding disorder understand their compulsions and live safer, more enjoyable lives.

In the homes of people who have hoarding disorder, the countertops, sinks, stoves, desks, stairways and virtually all other surfaces are usually stacked with stuff. And when there's no more room inside, the clutter may spread to the garage, vehicles and yard. Clutter and difficulty discarding things are usually the first signs and symptoms of hoarding disorder, which often surfaces during the teenage years. As the person grows older, he or she typically starts acquiring things for which there is no need or space. By middle age, symptoms are often severe and may be harder to treat.Hoarding disorder affects emotions, thoughts and behavior. Signs and symptoms may include:

  • Persistent inability to part with any possession, regardless of its value
  • Excessive attachment to possessions, including discomfort letting others touch or borrow them or distress at the idea of letting an item go
  • Cluttered living spaces, making areas of the home unusable for the intended purpose, such as not being able to cook in the kitchen or use the bathroom to bathe
  • Keeping stacks of newspapers, magazines or junk mail
  • Letting food or trash build up to unusually excessive, unsanitary levels
  • Acquiring unneeded or seemingly useless items, such as trash or napkins from a restaurant
  • Difficulty managing daily activities because of procrastination and trouble making decisions
  • Moving items from one pile to another, without discarding anything
  • Difficulty organizing items, sometimes losing important items in the clutter
  • Shame or embarrassment
  • Limited or no social interactions

People with hoarding disorder typically save items because:

  • They believe these items will be needed or have value in the future
  • The items have important emotional significance — serving as a reminder of happier times or representing beloved people or pets
  • They feel safer when surrounded by the things they save
  • Hoarding disorder is different from collecting.

People who have collections, such as stamps or model cars, deliberately search out specific items, categorize them and carefully display their collections. Although collections can be large, they aren't usually cluttered and they don't cause the distress and impairments that are part of hoarding disorder.

Hoarding animals

People who hoard animals may collect dozens or even hundreds of pets. Animals may be confined inside or outside. Because of the large numbers, these animals often aren't cared for properly. The health and safety of the person and the animals are at risk due to unsanitary conditions.

If you or a loved one has symptoms of hoarding disorder, talk with a doctor or mental health provider as soon as possible. Some communities have agencies that help with hoarding problems. Check with your local or county government for resources in your area. As hard as it might be, you may also need to contact local authorities, such as police, fire, public health, child protective services or animal welfare agencies, especially when health or safety is in question.

It's not clear what causes hoarding disorder. Genetics, brain chemistry and stressful life events are being studied as possible causes.

Hoarding disorder can affect anyone, regardless of age, sex or economic status. It's not clear, though, how common hoarding disorder is. That's partly because some people never seek treatment. Risk factors include:

  • Age - Hoarding usually starts around ages 11 to 15, and it tends to get worse with age. Younger children may start saving items, such as broken toys, pencil nubs, outdated school papers and broken appliances. Hoarding is more common in older adults than in younger adults.
  • Personality - Many people who have hoarding disorder have a temperament that includes indecisiveness.
  • Family history - There is a strong association between having a family member who has hoarding disorder and having the disorder yourself.
  • Stressful life events - Some people develop hoarding disorder after experiencing a stressful life event that they had difficulty coping with, such as the death of a loved one, divorce, eviction or losing possessions in a fire.
  • Social isolation - People with hoarding disorder are typically socially withdrawn and isolated. In many cases, the hoarding leads to social isolation. But, on the other hand, some people may turn to the comfort of hoarding because they're lonely.

Hoarding disorder can cause a variety of complications, including:

  • Unsanitary conditions that pose a risk to health Increased risk of falls Injury or being trapped by shifting or falling items
  • A fire hazard An inability to perform daily tasks, such as bathing or cooking
  • Poor work performance
  • Family conflicts
  • Loneliness and social isolation
  • Financial problems Legal issues, including eviction

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