Hoarding Disorder

a messy room full of stuff as an example of hoarding

An individual may be hoarding if he has had a long-term problem with getting rid of possessions, regardless of their actual value or usefulness. The individual consistently reports that the hoarded items are needed and he may suffer distress when asked to discard them.

The hoarding behavior creates an accumulation of possessions that interferes with normal and common or shared living areas. It tends to render these areas unusable for their intended purposes. If there are clear areas, it is probably because of family members, cleaners, or the authorities and is usually at the objections of the person hoarding.

The resulting clutter causes major interference or impairment in the individual’s ability to work, socialize, and live. It may also compromise the safety of themselves and others in their environment. Hoarding may interfere with house cleaning, cooking, and personal hygiene. It may result in poor sanitation, broken appliances, and the general disrepair of the dwelling. It can result in general and serious health issues and potential legal action.

About 80-90% of people who hoard have excessive acquisition (buying or getting items free). The individual accumulates things that are not needed and for which there is no available space. Commonly hoarded items include newspapers, magazines, old clothing, bags, books, and mail. Remember, what a person may hoard is limited only by their imagination.

Diagnosis of Hoarding

The onset of hoarding can occur as early as 11-15 years old. This can cause greater problems by age 20, which worsens through each decade. Hoarders often report traumatic life events preceding the onset of hoarding or as the cause of an exacerbation of hoarding behavior. The behavior tends to be familial. About 50% of individuals who hoard have a relative who also hoards.

The hoarding behavior must not be better explained by a medical condition like a brain injury, cerebrovascular disease, Prader-Willi syndrome or a mental health problem like obsessive-compulsive disorder, decreased energy in major depressive disorder, delusions in schizophrenia or another psychotic disorder, cognitive deficits in neurocognitive disorders, or significant restricted interest in autism spectrum disorder.

The person has good insight when they realize that hoarding is problematic. They have poor insight when they believe that there is mostly no problem. Finally, they suffer delusional beliefs if they are convinced there is absolutely no problem with the hoarding, despite evidence to the contrary.

Consult an Expert

About 75% of the time, there is also one or more other conditions present. Other conditions may include major depression, social anxiety disorder, generalized anxiety disorder, or OCD.

Please consult an expert if you suspect that someone you care about is hoarding in Greater Philadelphia, the Main Line, Montgomery County, PA, or the surrounding areas. Hoarding can be difficult to treat and it often gets worse without treatment.

With Kindness,
Harold

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