Hoarding was first brought to Americans’ attention in a big way by the sad case of the reclusive Collyer brothers of Harlem. After their death in 1947, their home was discovered to be crammed with over 100 tons of a huge variety of stuff, including tens of thousands of books, old food, family heirlooms, and eight cats. Langley Collyer was crushed by his own belongings when he inadvertently activated one of the booby traps he had set in the brownstone; his brother Homer, already in ill health, died soon after of starvation as Langley could no longer bring him meals.
Today, extreme hoarding behavior is featured on TV shows like “Hoarders” on A&E and “Hoarding: Buried Alive” on TLC. If you’ve watched these shows, you’ve probably felt fascinated by their depictions of people who, despite facing eviction and other serious consequences, just can’t seem to part with their enormous piles of papers, collectibles, and even trash. Usually, the fascination arises either because you couldn’t imagine living that way yourself, or because it’s all too easy to see how you or someone you love could spiral into a full-on clutter disaster given the right circumstances.
This type of hoarding is not uncommon; up to 5% of the world’s population displays clinical hoarding behavior, or twice the number who suffer from Obsessive Compulsive Disorder (OCD.) It’s also increasingly public, the subject of numerous books and blogs as well as television shows. Still, hoarding is often misunderstood.
In fact, experts who study the condition and work to help hoarders overcome their unhealthy patterns don’t always agree on how exactly to categorize or treat the disorder that causes people to become overwhelmed by their attachment to stuff.
What Does Hoarding Mean?
To hoard simply means to amass objects and store them away.
When switched for its synonyms “collect” or “accumulate,” it doesn’t typically carry the connotation of a behavior that’s strange or unsafe.
However, there is a difference between a person who hoards, for example, extra bottles of their favorite brand of ketchup to ensure they never run out, and a person who hoards empty condiment containers until they fill half the kitchen and becomes distressed at the mere suggestion of throwing them away. The latter scenario, called compulsive hoarding or hoarding disorder, is what makes for gripping (or exploitive, depending on your point of view) reality TV.
The degree of a person’s hoarding habit and whether it negatively impacts their daily life is what distinguishes problematic hoarding from normal collecting or “pack rat” behavior.
What Causes Hoarding?
There are multiple reasons why we accumulate clutter. But these tendencies, while not necessarily optimal, are normal and do not rise to the severity of compulsive hoarding. Almost everyone has bought clothing or equipment for an activity they imagine themselves doing in some unspecified future, aka aspirational clutter. And we can all probably relate to storing too many old birthday cards or childhood toys, aka sentimental clutter.
If you’re prone to keeping these sorts of objects even though you really don’t need them, you can probably stop hoarding before it starts by evaluating why you accumulate stuff and assessing whether or not your belongings are really serving you in your current life.
Hoarding disorder, on the other hand, cannot be prevented, though seeking professional help earlier rather than later may prevent the disorder from getting more severe over time. Although the language compulsive hoarders use to talk about their possessions - “But I might need it one day!” – is familiar to anyone who has ever been seduced by a great sale or feels guilty about disposing of a perfectly good gadget, the condition is not something that can be solved on a weekend with a good checklist and a trip to Goodwill. It also has a different set of potential causes.
Compulsive hoarding, research has found, runs in families, with half of hoarders reporting that a parent or sibling also hoards.
Hoarding behavior had benefits for humans in the distant past (and still does for many animals; think of a squirrel frantically amassing a stockpile of nuts.) These hoarding genes which helped our ancestors may have simply stuck around in some of us as we evolved.
Hoarding disorder may also be triggered by traumatic life events, after which victims turn to gathering objects as a way of coping.
Is Hoarding a Mental Illness?
Hoarding disorder is categorized in the latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) as a disorder related to OCD. (Though some doctors believe this classification could change in the future.) To quote the Association’s fact sheet on Obsessive Compulsive and Related Disorders, hoarding disorder is characterized by the persistent difficulty discarding or parting with possessions, regardless of the value others may attribute to these possessions.
Compulsive hoarding can go hand in hand with a shopping addiction, but not all hoarders pay for what they collect. Many acquire free items, including what others discard as trash.
When hoarding becomes a problem, a person’s living conditions can become unsanitary, dangerous, or just plain uncomfortable. Stacks of clutter can make it impossible to sit on the couch or lie on the bed, or block access to bathrooms or kitchens.
Pets suffer in hoarding situations, too. Hoarders may take in more animals than they can care for, leading to abusive conditions. They may also keep the bodies of deceased animals, creating an even more dangerous and unsanitary living situation for humans and animals in the home.
People who struggle with compulsive hoarding also frequently experience anxiety or depression. Some doctors believe that in the future, hoarding may be classed with these and attention deficit disorder, rather than OCD.
Hoarding tendencies often start young, but hoarding disorder is most often diagnosed in middle age.
Hoarders are often socially isolated, losing contact with friends and family or otherwise taking pains to hide the true state of their cluttered home from others. The isolation may come before the hoarding behavior develops, or it may result from the shame or logistical difficulties of living in an extremely cluttered home.
Risk factors for developing hoarding disorder are quite broad, and include having an indecisive personality, coming from a family with a history of hoarding, and experiencing particularly stressful life events.
This is not to say that any type of hoarding is a sign of mental illness or a serious problem. A person might collect thousands of books for enjoyment, refuse to throw away their high school wardrobe, or keep a large stock of batteries and candles in case of a power outage. But as long as their behavior doesn’t put themselves or others, or negatively interfere with their family or social life, work, health, or finances, then it probably does not require an immediate intervention.
Someone who owns too much stuff because they are simply reluctant to sort through their basement or closet will still, if necessary, be capable of cleaning out their space using clear guidelines on when to get rid of clutter or enlisting a more organized helper. A compulsive hoarder, on the other hand, won’t be able to get rid of items without experiencing serious emotional distress.
Treatment for Hoarding Disorder
To be diagnosed with hoarding disorder, according to the Mayo Clinic, a patient will need to undergo “a thorough psychological evaluation.” The doctor will ask about symptoms, behavior, and other health issues, and may ask to speak with the patient’s family or friends. Here is what the Mayo Clinic says is required for a patient to be diagnosed with hoarding disorder:
- You have difficulty throwing out or parting with your things, regardless of actual value.
- You feel a need to save these items, and the thought of discarding them upsets you.
- Because you don't discard any items, your possessions crowd and clutter your living areas and make the space unusable. If any living areas are uncluttered, it's because someone else cleaned them.
- Your hoarding causes you significant distress or problems functioning at work, socially or in other important areas, such as keeping yourself and others safe in your home.
- Your hoarding is not due to another medical condition, such as a brain injury, or another mental disorder symptom, such as decreased energy from major depression.
Because it is a chronic condition, hoarding disorder is often very difficult to treat. One common treatment option is psychotherapy, particularly Cognitive Behavioral Therapy, in which a patient learns to make decisions about objects and confront the emotions they feel about them. Prescription antidepressants are also sometimes used.
One treatment that has not proven effective is forcing a hoarder to get rid of their stash.
Some professionals prefer to concentrate on harm reduction, i.e. working with hoarders to find solutions for the most dangerous aspects of their condition, like preventing the spread of disease and reducing fire risks, without demanding that the individual stop the hoarding behavior itself.
Though compulsive hoarding has not been studied in-depth until relatively recently, it is now receiving much more attention and there are numerous resources out there to help hoarders and their families. If you or someone you know has a problem with hoarding, or if you’re interested in learning more about the disorder from International OCD Foundation or Anxiety and Depression Association of America