Hoarding Disorder -Symptoms and Causes

What is hoarding disorder?

Hoarding disorder is a mental health condition where people face difficulty in throwing away or parting their possessions. People believe that they have to save things and giving them away can lead to distress.

They tend to collect and keep all the things, and gradually the collected things would pile up, regardless of their value. People with hoarding disorder can live in cramped living conditions with a narrow pathway winding through stacks of clutter. All places in the house, like countertops, desks, staircase, sink and stoves, can be filled with all the collected stuff.

The things in the house cannot be used for their intended purpose. For example, when things are piled up on the stove and sink in the kitchen, you would not be able to cook. When all the space in the house is filled with things, it can accumulate and become as clutter. This can affect the quality of life and cause stress in people. It can also lead to shame in an individual’s social, family and work life.

Hoarding disorder ranges from mild to severe cases. In mild cases, hoarding disorder will not significantly impact their lives. In other cases, the disorder can have a major impact and lead to problems in the daily functioning of life.

People affected with hoarding disorder will not consider them having the problem. So, getting them treated can be challenging. However, treatment can help change their behaviour which can help them live a happy and healthy life.

Symptoms of hoarding disorder

The symptoms of hoarding disorder usually set in during teenage or early adulthood. During these years, people tend to collect everything, and gradually, they will not be able to get rid of all the things which accumulate as clutter.

As they grow older, it becomes more difficult for them to get rid of the collected items. By middle age, it can become overwhelming, and the symptoms also become very severe. As a result, they will not be able to dispose of and treating them can become more challenging.

Hoarding disorder develops over time, and it becomes a private behavior. The affected person can also avoid family and friends. Some of the common symptoms of hoarding disorder include

• Difficulty in throwing away the collected things, despite their importance and value.
• Feeling a need to save all the items and thinking of throwing them away can lead to stress.
• Accumulation of clutter, where the usage of the place becomes limited.
• Problems with planning and organising.
• Piles or stacks of disorganised items like clothes, paperwork, books and sentimental items.
• Build up trash or food items, which can become unsanitary.
• Conflict with others when they tend to throw away the accumulated things.
• Avoiding social activities and relationship issues.
• Losing important things in clutter.
• Rooms cannot be used for their intended purpose as they will be filled with trash.

People with hoarding disorder tend to save all the collected for the below-listed reasons.

• They think that the collected items can be of use one day.
• The collected things are unique.
• The things that can make them feel safe and comforted.
• They cannot waste anything.

People with hoarding disorder will have issues in cognitive functioning.

• Perfectionism
• Distractibility
• Disorganisation
• Procrastination
• Indecisiveness

Hoarding disorder is different from collecting things like stamps and coins. People who collect things will look for a specific collection, organise them and know their value. They also throw out the things which they don’t need. On the other hand, people with hoarding disorder collect all the things as they feel safe and comfortable around the clutter.

Causes of hoarding disorder

The cause of hoarding disorder is still not known. It can be caused due to various reasons like genetics, stress and brain functions. It can also be caused due to other disorders and mental health conditions like  

• Obsessive-compulsive personality disorder (OCPD)
• Obsessive-compulsive disorder (OCD)
• Depression
• Attention-deficit/hyperactivity disorder.

Risk factors that can cause hoarding disorder are

• Traumatic life events
• Impulsive buying habits
• Prader-Willi syndrome
• Substance use disorder
• Alcohol use disorder
• Loneliness and social issues
• Brain or head injury.

Diagnosis of hoarding disorder

People with hoarding disorder will also have other mental health conditions like depression, relationship problems and anxiety. So, it is advised to reach a mental health professional.

The professional will have a mental health exam that includes a list of questions. This will test the emotional stability and well-being, and the treatment will be given accordingly.

There will also be questions about the person’s beliefs and behaviours. The mental health care professional will talk to the affected person’s friends and family to understand them better. They will also ask for a picture of the person’s living area. The medical history will also be asked to check for other mental health conditions that cause the hoarding disorder.

Treatment of  hoarding disorder

The treatment for hoarding disorder can be difficult and challenging. The treatment will also depend on the severity of the disorder. Some people will not have an impact on their daily life, so treating them can be easy. However, others may have a major impact on their life, and treating them can be challenging.

People with severe hoarding disorder can develop new life skills. This will help them gain confidence, and treatment can also be easy. When things are taken away from them, they tend to collect more items, which can worsen the disorder.

Hoarding disorder can be treated with cognitive behavioural therapy. The therapy can aim at

• To identify thoughts that challenge the beliefs of collecting things.
• Learn techniques to resist the thought of collecting things.
• Learn to organise things.
• Decide to keep the only required things and throw away the unwanted ones.
• Improves coping and decision-making skills.
• Remove clutter during in-home visits by a professional. And while removing to handle the anxiety.
• Techniques to increase the desire for change.
• Group and family therapy to help with loneliness and isolation.
• Reduce unhealthy habits.

Treatment also involves help from friends and family to remove the clutter. People may sometimes require medication and anti-depressants after removing things from their houses to treat the anxiety. The most used medication is serotonin reuptake inhibitors (SSRIs).

Prevention of  hoarding disorder

Hoarding disorder cannot be prevented, and more research is required to know the causes of the disorder. It is also important to identify whether any underlying health condition is causing the disorder. If it is treated, hoarding disorder can be treated.

Hoarding disorder can only be noticed when clutter gets piled up in the home. Early diagnosis can also play an important role in preventing hoarding disorder.

When to consult a doctor?

Friends and family can contact a healthcare professional for people affected with hoarding disorder. As it will be challenging to take the affected individual to a mental healthcare professional.

Conclusion

Hoarding disorder can be treated with proper treatment. However, with cognitive behavioural therapy, the symptoms can improve, whereas they can remain the same for others. It can affect their quality of life.

People affected with hoarding disorder will not have a proper functional place as it will be piled up with trash and other things. They will have difficulty performing other activities like cooking, cleaning, bathing and sleeping. This can lead to unsafe and unhealthy living conditions.

This can lead to major consequences like fire hazards, conflicts in personal relationships, isolation and loneliness. This can impact their mental health and make it more difficult to treat the disorder.

Early diagnosis and treatment can help reduce the severity of the disorder. The family members can also get affected by the disorder. So it is important to get professional help and get treated. Mental health professionals will also be able to plan your treatment.