Hoarding disorder: The basics

It was a rather heartbreaking yet undeniably fascinating story in Saturday's Press: An elderly Coeur d’Alene resident’s extreme hoarding went undetected for decades. So deep were the piles upon piles of unneeded paper, jars, broken appliances (and occasional gems) that a mint-condition Volkswagen Bug was hidden underneath.

Imagine enough stuff piled so deep it hid a car. No one knew it was there. No one knew things had gotten that bad.

Mess and clutter are common in human living, but what makes someone so reticent to chuck anything that virtually no floor, counter, or wall space is left visible? Food rotting, threadbare socks stinking, bed buried so completely with junk only the tub is left for slumber?

As you might imagine, hoarding is a genuine psychiatric disorder. Here are some of the basics gleaned from the Mayo Clinic, American Psychiatric Association, and Anxiety & Depression Association of America:

· Hoarding is the persistent inability to let go of just about any possession or store it elsewhere, from a flyer to a plastic fork, or clothes that don’t fit. Doing so leads to extreme anxiety, so everything just piles up. Hoarders often start out mild upon reaching their teens and tend to get worse as they get older.

· Difficulty or inability to organize

· Severe indecisiveness, in general and about what to keep “in case” it’s wanted later. Or is associated with a memory. And everything is.

· Distress; feeling overwhelmed and embarrassed about possessions and hoarding

· Feeling safer when surrounded by everything they’ve saved

· Suspicion over others touching items in the hoard

· Functional impairments, including lack of living space, health hazards, relationship problems, and financial difficulties. Think hiding spots for bugs, moldy food and trash, endless obstacles to trip and fall over. Family members’ discomfort, frustration and embarrassment. Not being able to find what’s needed, such as bills, homework, and records.

· A subtype is animal hoarding – people cohabitating with dozens or hundreds of animals and a psychological inability to find new homes for them.

· Obsessive thoughts and compulsive actions: Real fear of running out of items, of needing them later. Continually checking trash for items. Impulse buying unneeded things.

That last one is a big hint. Yes, one form of OCD is hoarding, although not all hoarders are obsessive-compulsive in other ways, and most who suffer from obsessive-compulsive disorder aren’t hoarders. But hoarding does involve aspects of obsession and compulsion.

What’s the difference between collectors and hoarders? If you know someone so into collecting that they devote an entire room, or even two, to action figures or model trains (well, those tracks do take up a lot of space!) and are always on the prowl for more, that’s not hoarding. Collectors tend to keep their collections organized, limited in space, and derive great joy from them. Collectors don’t clutter hallways, bathrooms, and floors with their collections.

With hoarders the organization, quantity, and quality of what they hoard sets it apart, overwhelming living and personal spaces and including items most people throw away. No one collects half-used mayonnaise jars or keeps (and doesn’t wear) old underwear. While they feel a strong need for the hoard, they don’t generally feel happy about it.

Causes of hoarding disorder are unknown, but common risk factors or triggers include an indecisive personality, family history, and traumatic events such as death, divorce, eviction or losing possessions in a fire.

Many people with hoarding disorder also have other mental health conditions such as severe anxiety, depression, AD/HD and OCD. Treatment generally consists of professional behavioral therapy. Hoarding can be cured, especially when treatment includes active family members.

An interesting article about treatment is in the May/June 2011 issue of the journal Social Work Today. See: socialworktoday.com/archive/051711p14.shtml

Sholeh Patrick is a columnist for the Hagadone News Network who feels so much lighter with less “stuff.” Email sholeh@cdapress.com.