Whether you’re knowledge comes from a reality television show or you have more intimate life experience with it, chances are there is plenty you don’t know about compulsive hoarding. From mental health facts to the logistical details of dealing with a hoard, here are 10 Things You Need To Know About Hoarding.
1. Compulsive hoarding is a mental disorder.
Hoarding is a mental health disorder identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association and shared here by the International OCD Foundation as a reference tool for diagnosis.
The Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5, American Psychiatric Association, 2013) defines Hoarding Disorder (HD) as follows:
- Persistent difficulty discarding or parting with possessions, regardless of their actual value.
- This difficulty is due to a perceived need to save the items and to distress associated with discarding them.
- The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, authorities).
- The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment for self and others).
- The hoarding is not attributable to another medical condition (e.g., brain injury, cerebrovascular disease, Prader-Willi syndrome).
- The hoarding is not better explained by the symptoms of another mental disorder (e.g., obsessions in obsessive-compulsive disorder, decreased energy in major depressive disorder, delusions in schizophrenia or another psychotic disorder, cognitive deficits in major neurocognitive disorder, restricted interests in autism spectrum disorder).
2. Hoarding disorder is more common than you may realize.
The International OCD Foundation reports that:
Hoarding behaviors can begin as early as the teenage years, although the average age of a person seeking treatment for hoarding is about 50. Hoarders often endure a lifelong struggle with hoarding. They tend to live alone and may have a family member with the problem. It seems likely that serious hoarding problems are present in at least 1 in 50 people, but they may be present in as many as 1 in 20.
Psychiatry.org claims that as much as 2-6% of the population may struggle with hoarding disorder and that it may occur more frequently in males than in females. “It is also more common among older adults–three times as many adults 55 to 94 years are affected by hoarding disorder compared to adults 34 to 44 years old.” While age plays an obvious role, it is important to remember that hoarding can begin at a younger age. According to The Mayo Clinic, hoarding usually starts between the ages of 11 and 15 and progresses with age.
3. Hoarding is not the same as collecting.
Collectors search for and gather specific items that fit into a determined category. For example, an individual with a baseball card collection may always be on the lookout for specific cards that would complete or add to the value of the collection. A collector will most often store these items carefully or display them appropriately. A hoarder, on the other hand, likely accumulates items that have little to no value and that do not add to or complete any collection. They may insist that there is value where there is not and the items are often lost among the clutter and disorganization.
Collections rarely cause safety and health hazards that cluttered hoards do.
4. Those with hoarding disorder may experience other mental health disorders.
Psychiatry.org points out that “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.”
More serious mental health issues may also accompany a hoarding disorder diagnosis. International OCD Foundation is a valuable resource of hoarding disorder information for a good reason.
Compulsive hoarding was commonly considered to be a type of OCD. Some estimate that as many as 1 in 4 people with OCD also have compulsive hoarding. Recent research suggests that nearly 1 in 5 compulsive hoarders have non-hoarding OCD symptoms. Compulsive hoarding is also considered a feature of obsessive compulsive personality disorder (OCPD) and may develop along with other mental illnesses, such as dementia and schizophrenia.
In addition to strong correlations with Obsessive-compulsive disorder, Mayo reports that individuals with hoarding disorder may also have issues with anxiety, depressions, and ADHD.
5. Doctors don’t know what causes hoarding disorder.
It is certainly true that not every individual with anxiety, depression, ADHD, or OCD will also have a hoarding disorder. So what causes compulsive hoarding?
Some individuals may claim that an early life of poverty is to blame, but research has not supported this theory. It appears that while early trauma or loss can exacerbate hoarding tendencies, there is no obvious cause of compulsive hoarding disorder. According to Mayo, “Genetics, brain functioning and stressful life events are being studied as possible causes.”
6. There are different types of hoarding.
Hoarding of physical possessions is not the only type of hoarding. Animal hoarding is also a serious issue.
The ASPCA defines animal hoarding as “an inability to provide even minimal standards of nutrition, sanitation, shelter and veterinary care—often resulting in animal starvation, illness and death. In the majority of cases, animal hoarders believe they are helping their animals and deny this inability to provide minimum care.”
Animal hoarders often have dozens or even hundreds of animals in their home or on their property, but are not able to maintain proper care and humane conditions for them. If you have a legitmate concern about the welfare of animals in a hoarding situation, you should contact the proper authorities or your local animal shelter for resources and support.
7. Complications of hoarding disorder can be far reaching.
Persons dealing with hoarding disorder may believe that the issue is not an accumulation of items, but instead blame the clutter on any number of external issues like limited space or lack of help in organizing. Psychiatry.org sums up the potential consequences of hoarding disorder in this way.
Hoarding disorder can cause problems in relationships, social and work activities 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.
Left untreated, hoards can render homes unlivable. Government authorities may become involved if the condition of a property poses code violations and the department of human services may intervene if the health and safety of a hoarder or other residents of the home is in question.
In the most severe of hoarding situations, entire rooms of the hoarder’s home may be rendered unusable. When bathrooms and kitchens can no longer be safely used and the hoard prevents utilities from being functional or maintained, sanitation and personal health are at risk. These problems can create additional clutter and unsanitary conditions within the home.
8. Cleaning out a hoard will not solve the problem.
While well meaning family members or friends may believe that their physical labor and motivation will help bring a hoard under control, it is important to understand that this is not true. Help is likely to be unwelcome and your best intentions may be met with defensiveness and a multitude of excuses.
Pressure to get rid of items can cause extreme stress for a compulsive hoarder and the conflict between hoarder and helper can be intense. Until the individual is prepared to deal with the hoard and has professional support for the process, efforts to clean up may not be effective.
The IOCDF fact sheet explains that “Attempts to “clean out” the homes of people who hoard without treating the underlying problem usually fail. Families and community agencies may spend many hours and thousands of dollars clearing a home only to find that the problem recurs, often within just a few months. Hoarders whose homes are cleared without their consent often experience extreme distress and may become further attached to their possessions. This may lead to their refusal of future help.”
9. Hoarding disorder can be treated.
If cleaning out the persons hoard doesn’t solve the problem, then what can? That’s a complicated question and one size does not fit all. These options can all be useful in treating compulsive hoarding, but treatment plans will differ by individual and circumstance. Upon proper assessment of the condition, appropriate treatments can be proposed or utilized.
ADAA.org lays out a treatment format for adults that includes 26 therapy sessions that can be conducted individually or in group sessions. A family consultation, assistance from a coach, and clutter clean out with trained staff if appropriate in excessive situations are also part of the treatment plan.
Psychotherapy is the most common mode of treatment for hoarding disorder. Psychotherapy, also known as Cognitive Behavior Therapy or talk therapy, is useful for hoarders. Individuals meet with a trained professional for structured sessions in which they learn to identify the incorrect thinking that has led them to a place of unhealthy hoarding. Cognitive Behavior Therapy can also be a useful tool in dealing with depression, anxiety, and other mental health issues that may contribute to compulsive hoarding or that may occur as a result of cleaning out a hoard and increase chances of managing hoarding tendencies in the future.
The Mayo Clinic offers this advice in regard to medications for the treatment of compulsive hoarding.
“There are currently no medications approved by the Food and Drug Administration (FDA) to treat hoarding disorder. Typically, medications are used to treat other disorders such as anxiety and depression that often occur along with hoarding disorder. The medications most commonly used are a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs). Research continues on the most effective ways to use medications in the treatment of hoarding disorder.”
10. Hoard clean up can be extensive.
Treating the individual with hoarding disorder with respect while keeping health and safety at the forefront should always take priority. Reach out to your loved one with compassion and understand that change is not likely to happen the first time. It may very well take repeated efforts and many years to engage genuine change. When your loved one is ready, support him or her in finding a therapist that can guide you both through the process. When the time comes to start the physical clean up of a hoard, it can be daunting. Cleaning up can be a massive undertaking. Take these things into consideration before you begin.
- If human or animal waste is present, bio hazard precautions must be taken. Wear appropriate gear and dispose of waste appropriately.
- If the hoard is particularly large or has been accumulating for many years, the home’s structure may have been compromised. Proceed with caution and have an engineer examine the home if there is any question of safety.
- Dumpsters and trash containers fill up quickly. Schedule dumpsters accordingly and plan for the cost of each load of waste removed.
- Decide in advance if it is safe to salvage any items inside or if all items are to be disposed of.
- Schedule contractors or repairmen to make necessary repairs to the home and utilities to make future occupancy safe.
- Prepare for deep cleaning and disinfecting of the home as well as sanitizing any items to be saved and reused.
If you have a loved one struggling with hoarding disorder, we hope these resources will help you to support them and started on a treatment plan. If you are faced with the responsibility of cleaning up the hoard of a loved one and find the physical task to be more than you can handle, professional trash removal is also a great option.
Valet Trash Professionals understands that hoarding cleanup can be a stressful job. We have experience cleaning up extensive hoards and would be happy to speak with you about your specific clean out and removal needs. VTP can handle interior and exterior hoards.
Call or text us today at (479) 236-4981