What is hoarding disorder?

Hoarding disorder is estimated to affect up to 6% of the general population. It’s categorized as an obsessive-compulsive-related disorder, and it causes people to amass an excessive accumulation of unneeded objects. People with hoarding disorder have difficulty disposing of or donating items, and the resulting clutter often creates unsafe or unusable living spaces. 

Anyone can be affected by hoarding disorder. But those with a family history of hoarding or other mental health conditions, like anxiety or depression, might be at greater risk. In addition, experiencing stressful life events, like the loss of a loved one, may worsen hoarding symptoms.

Like other challenging behaviors, hoarding can range in severity. However, it’s important to know that it’s not the same as collecting or having a disorganized home. Hoarding disorder is a mental health condition that often requires professional help. Understanding more about it can empower you to seek the support you need to manage your mental health.

At what point is hoarding a mental health condition?

Maybe you consider yourself a collector. You love the thrill of finding rare or highly sought-after items to add to your collection. Or perhaps you’re someone who struggles to stay on top of household chores. So your living space tends to feel a little chaotic. Both of these scenarios can result in a large accumulation of objects or clutter, which may or may not negatively impact some aspect of your life. But this isn’t the same as living with a mental health condition like hoarding disorder.

People with hoarding disorder have an uncontrolled compulsion to accumulate unnecessary or unusable items and intense difficulty discarding or parting with them. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the text professionals use to diagnose mental health conditions, outlines the diagnostic criteria for hoarding disorder as follows:

• A chronic inability to part with or dispose of possessions, even if they have no real value (i.e. junk mail, sugar packets from restaurants, old clothes, trash, etc.)
• Feeling intense distress at the thought of getting rid of hoarded items
• Hoarding that causes an accumulation of clutter that creates living areas that are unsafe or inaccessible
• Clutter that causes emotional distress and an interruption in social, occupational, or other important forms of functioning (including creating an unsafe living environment for others)
• Hoarding behaviors that aren’t caused by another medical or mental health condition 

Hoarding is a chronic mental health condition that, without support, tends to get worse with age. Left untreated, it can lead to all sorts of unwanted consequences, such as:

• Difficulty moving around the home safely
• Damage to the physical structure of the home due to rodent or insect infestations, inability to make repairs, etc.
• Problems maintaining personal hygiene or sanitary living conditions
• Compromised professional or academic performance
• Strained relationships with loved ones
• Loneliness and isolation due to shame or embarrassment

In addition to these concerns, hoarding can sometimes point to the presence of other mental health conditions. Conditions like anxiety, depression, or dementia aren’t caused by hoarding disorder alone. But they frequently co-occur. 

Signs and symptoms of hoarding disorder

Hoarding can manifest in many ways, and recognizing the symptoms is an important step in asking for help. However, people with hoarding disorder can have different levels of insight into their behavior. For example, some may be acutely aware of their hoarding and the challenges it creates, even if they’re unable to control it. But others might have limited or no insight into their hoarding.

If you’re unsure whether you need help for hoarding, one of the best things you can do for yourself is seek a professional evaluation. In the meantime, it can help to familiarize yourself with some common signs. 

You might have hoarding disorder if:

• Your home, garage, or car are overflowing with excessive clutter, making spaces unusable or unsafe.
• You struggle to discard or part with items, regardless of their actual value.
• You feel intense anxiety or emotional distress when someone asks you to throw or give something away.
• You feel embarrassed or ashamed by the clutter in your home, and it keeps you from entertaining visitors.
• You’ve fallen, tripped, or injured yourself in some other way due to the clutter in your home.
• You often struggle to concentrate or focus because of the clutter. 
• Daily tasks like cooking, cleaning, or bathing are difficult or impossible due to clutter.
• You have more of certain useful objects (like bottles of water) than you could ever use in a typical timeframe (i.e. a year).

What is the root cause behind hoarding?

Experts aren’t completely sure of the root cause behind hoarding disorder, and people will engage in hoarding for different reasons. However, a person may be more likely to develop a problem with hoarding if:

• They experience uncomfortable emotions and use hoarding as a way to cope with or avoid them.
• They have difficulty with impulse control, so they’re more likely to purchase things they don’t actually need.
• They have perfectionistic tendencies, and this makes it harder for them to stay organized because they worry about making mistakes in the process.
• They grew up in a home where their basic needs weren’t met, so they use hoarding as a way to feel safe from scarcity.
• They have experienced trauma — like abuse, neglect, or bullying — and use hoarding as a way to self-soothe.
• They have family members who also have hoarding disorder.
• They have challenges with executive functioning skills, like planning, problem solving, organization, paying attention, or memorizing. 

Overcome hoarding tendencies with professional support

If you’re dealing with hoarding, you can learn to manage your behavior with help from a mental health professional. This process typically starts with an evaluation and a series of conversations about your history, symptoms, and concerns. From there, your provider will provide a formal diagnosis and make some treatment recommendations.  

Your hoarding disorder treatment experience will be based on your unique needs and preferences. But it’s likely to include a form of talk therapy called cognitive behavioral therapy (CBT). It’s considered the most effective form of care for hoarding disorder. 

CBT can help you change how you think and feel about your possessions. In doing so, CBT can help decrease the distress you might feel when you think about getting rid of accumulated items. CBT can also help you develop alternative strategies for coping with uncomfortable emotions and learn skills that can help you stay organized and reduce the clutter in your home. 

Currently, no medications are approved to treat hoarding disorder on its own. However, medications are sometimes used to treat co-occurring conditions, like anxiety or depression. You can talk to your provider about whether this is the right option for you.

Find care with Rula

People with hoarding disorder accumulate large numbers of objects they don’t need. Often, this makes their homes unsafe or hard to navigate, and they might feel embarrassed about how they’re living. But remember, hoarding disorder is a clinical mental health condition. If clutter is negatively impacting your well-being or your ability to function in any way, you deserve to ask for help. 

At Rula, we’re committed to making it easier to access affordable mental healthcare via convenient virtual appointments. No matter the challenges you’re facing, you can use our therapist-matching program to select an in-network therapist in just a few minutes. And thanks to our extensive network of over 10,000 providers, you won’t ever have to wait weeks or months for an appointment. With Rula, you can start the process today and meet with a therapist via live video as soon as tomorrow.

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