Can hoarding be a symptom of OCD?

These days, most people’s knowledge of hoarding comes from reality TV. However, these depictions rarely tell the full story of what drives someone to stockpile their homes with often unusable objects. 

Although hoarding can be a symptom of obsessive-compulsive disorder (OCD), it could also indicate the presence of a condition called hoarding disorder. A mental health provider may diagnose someone with hoarding disorder when their compulsive hoarding behaviors stand alone and aren’t related to another diagnosis (like OCD).

As you might expect, the line between these two experiences can get a little blurry. If hoarding can be caused by both OCD and hoarding disorder, how do mental health professionals understand the difference? 

The first step is to identify the reason someone is hoarding. People living with hoarding disorder collect objects because they feel a sometimes unexplained need to save items. They also experience significant distress when they have to part with those items. But in the case of OCD-related hoarding, a person’s hoarding is a response to anxious, obsessive thoughts. Like other forms of OCD, the behavior causes distress and interrupts a person’s ability to function. 

Fortunately, while it can be incredibly difficult to live with, OCD in all forms can be managed with the right support. 

What is OCD-related hoarding?

OCD causes repeated, distressing, and unwanted thoughts called obsessions. These intrusive thoughts prompt ritualistic behaviors called compulsions that are intended to resolve discomfort. 

When a person’s hoarding is a response to obsessions, it’s labeled as a symptom of OCD. OCD-related hoarding causes people to accumulate objects as a way of relieving distressing thoughts. 

People living with compulsive hoarding (caused either by OCD or hoarding disorder) have a hard time discarding objects, even when they have little to no value, like a scrap of paper. While they’re typically aware that this behavior is problematic, the constant accumulation of clutter can have a significant impact on their living space and quality of life. 

Left untreated, hoarding can cause safety and hygiene concerns and make it difficult to safely move around one’s home. It can even lead to eviction in severe cases. In addition to creating potentially hazardous living conditions, hoarding can also take a toll on relationships. People living in hoarding environments may feel shame or embarrassment about the condition of their homes. They may not want friends or family to see how they’re living. This can lead to a sense of loneliness or isolation, making it more difficult to ask for help.

What are the signs of compulsive hoarding?

Everyone affected by OCD will have their own unique experience of the condition. But if you have hoarding behaviors caused by OCD, you will likely experience some version of the following symptoms:

• You have a hard time getting rid of items, even things like trash or other things that don’t have intrinsic value.
• Your home, car, or other living spaces are full of visible clutter, so much so that you may have a hard time moving around in those spaces.
• You frequently lose track of important items because the clutter makes it difficult to stay organized.
• You feel distressed and overwhelmed by the clutter in your living space, but you can’t seem to get it under control.
• You often buy large quantities of items you don’t need, just in case.
• You often take multiple free items, like coupons or straws from a restaurant, even when you don’t need them. 
• You’re embarrassed by the state of your home, so you don’t invite guests to visit.
• You don’t allow anyone into your home to make repairs or do inspections.

People who hoard as a result of OCD aren’t just avid collectors. They build up large amounts of possessions as a response to obsessive thoughts. They might be upset by their hoarding and the clutter it creates. But they just can’t seem to get their compulsive behavior under control. 

Here are two examples of how hoarding-related OCD might manifest:

• Obsession: If I throw away a memento from my youth, I won’t be complete. It’s like throwing away a part of my story and identity, and the thought of doing so makes me incredibly anxious.

• Compulsion: I keep anything that even remotely reminds me of important life experiences. This includes things like childhood toys and report cards, as well as items that are broken or unusable.

• Obsession: I really like this cup, so I need 12 of them. If I don’t have 12, then it’s not right.

• Compulsion: I purchase 12 of the same cup even though I only need and have space for 1 cup.

In the second example, the person might also experience numbers-based obsessions, which is another common presentation of OCD. One thing to remember about OCD and the different presentations is that there is often a lot of overlap, so many people experience multiple OCD “subtypes” at once.

What causes OCD-related hoarding?

More research is needed to better understand the cause of hoarding. But there are some known factors, including:

• Being highly sensitive to anxiety
• Experiencing trauma
• Having a relative who also struggles with hoarding

In addition, researchers have uncovered some factors that may make you more likely to have OCD. Having risk factors for both hoarding behavior and OCD may make you more likely to develop OCD-related hoarding. 

Some risk factors for OCD include:

• Genetic factors: Having a first-degree relative (like a sibling or parent) who also lives with OCD
• Brain differences: Having structural and functional differences to certain areas of the brain
• Environment: Navigating a major life transition or living in a high-stress environment
• Personal experiences: Living with post-traumatic stress disorder (PTSD) 

Most effective treatment options for compulsive hoarding

Several support options have been proven effective in helping people manage their OCD symptoms. These include:

• Cognitive-behavioral therapy (CBT): This type of therapy helps people identify, challenge, and replace unhelpful or irrational thoughts. With this process, CBT helps people shift their emotional responses to triggers and change their hoarding behaviors.
• Exposure and response prevention (ERP): This form of therapy involves a slow, gradual exposure to triggers within the safety and supervision of your therapist’s office (or via teletherapy). In the case of OCD-related hoarding, this might mean throwing away one small object and processing the experience with help from your therapist.
• Group support: Group therapy, when facilitated by a trained provider, may help people struggling with hoarding behavior feel less isolated and alone. Family involvement may also be helpful.
• Medication: Medication for OCD is typically not recommended as a standalone treatment, although it can help you manage your symptoms if you’re also in therapy. Your provider may also recommend that you take medication to treat co-occurring mental health conditions, like depression or anxiety.

Find care with Rula

OCD is a serious mental health condition that can take a significant toll on your mental health, relationships, and ability to function in daily life. But fortunately, with the right support, it’s possible to manage your symptoms. 

With Rula, you get access to our diverse network of therapists and psychiatric providers with diverse expertise. When you’re ready, you can use our therapist-matching program to connect with a provider who takes your insurance in just a few clicks. And throughout your experience with Rula, our team will be there to answer questions and offer guidance at every step of the way.

Get started with Rula today