When hoarding disorder first gained popularity on television, many of us watched with wide eyes, curious about how something as simple as collecting items could spiral so far out of control. You may have also been surprised by the intense struggle that some people had with getting rid of seemingly meaningless junk. So where does hoarding disorder come from and why is it so difficult to manage?

Hoarding Disorder

In 2013, hoarding disorder was included in the DSM-5 as its own disorder separate from obsessive compulsive disorder (OCD). It impacts 1/50 people and can range from mild to severe, depending on the impact on daily living. Hoarding disorder typically begins between ages 15-19 and gets progressively worse with age. By the time it reaches the attention of others, it is usually out of hand and much more difficulty to treat. It is characterized by:

Compulsive accumulation of items
Difficulty discarding or parting with possessions regardless of their value
Increased distress at the thought of or from the act of getting rid of items
Interference in being able to function in living spaces

Collecting or Hoarding?

Many of us enjoy collecting items that we are interested in or find value from. We enjoy finding that perfect treasure to add to our collection. But how do we know when we crossed the line from collecting to hoarding?

Commonly Acquired Items

Just as each of us is unique, so are our acquiring tendencies. We are drawn to different items based on our life experiences and interests. We may acquire items from one, multiple, or all the following categories:

Papers

Newspapers
Magazines
Books
Junk Mail
Bills

Storage Containers

Storage Containers
Plastic Containers
Plastic bags
Cardboard boxes

Sentimental Items

A deceased loved one
Special occasions
Childhood keepsakes

Clothes

New, used, and/or inherited

Garbage

Food
Packages
Broken items

Digital Files

Photos/videos, documents, hard drives, texts, index of physically hoarded items

Animals

Dozens or hundreds of pets
Difficulty noticing the harm they are causing
Lack of food and shelter, unsanitary environment, lack of medical care, unsafe breeding

Contributing Factors

Similarly to any mental health disorder, there are many factors that might increase the chances of developing a hoarding disorder. Some of these include:

Genetics

Intergenerational
It may also be influenced by learned behaviour
Brain functioning - dopamine rush

A strong positive sensation when acquiring new things that leads to repeatedly seeking this sensation
Contributes to reduced impulse control

Personality traits

Perfectionism – worrying about making a mistake can lead to difficulty making decisions around discarding items

Childhood Experiences

Trauma
Lack of warmth and support
Basic needs were not met
Things being thrown out or taken away
Poverty

Not owning things
Worries about money

Unhealthy attachment to possessions

Can often be greater than the attachment to people
Stressful Life Events
Used as a coping mechanism for grief, loss, and PTSD
Helps fill the emotional void and distract from the pain

Negative Impact on Lifestyle

There can be a range of negative consequences on your life, depending on the severity of hoarding symptoms and clutter.

Home environment - excessive amounts of clutter can lead to narrow pathways, covered surfaces, and large heaping piles that may make it difficult to find things and an inability to prepare meals, bathe, or sleep comfortably. The clutter may also spread to other areas such as the garage, vehicles, office spaces, or other storage areas.
Mental health – hoarding disorder is associated with powerful beliefs that reinforce the need to acquire items. You may believe that the items are unique/special, that they will be needed in the future, that discarding them would be wasting or harming the environment, or that you may forget important memories if the item is thrown away. Your level of insight into the severity of your hoarding behaviours may be impacted, despite the negative consequences.
Emotional wellbeing – you may experience intense emotions during the acquiring and discarding processes. You may feel a strong positive feeling when acquiring due to the strong emotional connection to the item or the sense of safety it brings you. Alternatively, intense anxiety and overwhelm might occur when you attempt to discard items due to fears of making a mistake. Shame is also common, particularly when the severity of the situation is realized or others become aware of it.
Interpersonal relationships – stigma and negative comments from others may prevent you from allowing family, friends, or repair people into your home. This can lead to social isolation and conflict in relationships, especially if your loved ones have tried to reduce or remove the clutter from your home. For these reasons, you may find it difficult to connect with others which has led to you to being single.
Physical health and safety – extreme clutter can lead to unsanitary living conditions, including rotten food, pests, animal urine and feces, dust, and mold. Additionally, there may be increased risk of fire, falls, or being trapped by falling items that can lead to serious injury or death.
Legal – due to the significant risk of injury to yourselves, those who live close by, and pets, legal intervention may be required in more serious cases. Services that may be involved include the health department, fire and rescue services, social services, courts, and animal welfare. This could lead to forced removal of items from your home, eviction, or charges.

I (or a Loved One) May Have Hoarding Disorder - Now What?

If this information strikes close to home, it may be time to speak to your family physician to get properly assessed for hoarding disorder. Even without a diagnosis, you can take these steps to start getting your acquiring habits and clutter under control.

Speak to your family physician about a proper assessment
Practice self-compassion and acceptance about the complexity of your symptoms
Increase your awareness about your beliefs, feelings, and habits, and their impact on your life, relationships, and wellbeing
Start with small gradual steps – develop a time sensitive schedule that prioritizes high-impact areas and focuses on sorting items into keep, donate, recycle, and discard piles
Develop simple rules to help with the decision making process
Maintain motivation by starting with the easiest areas, finding ways to track your progress, and celebrating your wins
Prepare for the possibility of relapse by putting safeguards in place
Establish a strong support system
Begin working through the difficult feelings and strong attachment to items through journalling and other self-care strategies
If needed, seek professional help from a therapist to help address the underlying issues contributing to your hoarding tendencies

Additional Resources

Clutterers Anonymous. Clutterers Anonymous℠ - 12-Step Program for Help with Clutter
International OCD Foundation. Home - Hoarding (iocdf.org)
Helpline 1-800-HOARDERS

If you or someone you know is struggling with hoarding disorder, know you are not alone. With the proper steps and support, you can be successful in increasing your awareness around your tendencies, developing healthier coping strategies, and living a safer and more satisfying life. Take the first step!

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