Compulsive hoarding

Compulsive Hoarding is a behavioral pattern characterized by excessive acquisition of and an inability or unwillingness to discard large quantities of objects that cover the living areas of the home and cause significant distress or impairment. Compulsive hoarding behavior has been associated with health risks, impaired functioning, economic burden, and adverse effects on friends and family members. When severe, it can significantly interfere with a person's daily activities, such as cooking, cleaning, showering, and sleeping.

Definition

Compulsive hoarding, also known as hoarding disorder, is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a persistent difficulty discarding or parting with possessions, regardless of their actual value. This difficulty is due to a perceived need to save the items and to distress associated with discarding them.

Symptoms

The main symptom of hoarding disorder is the persistent difficulty discarding or parting with possessions because of a perceived need to save them. A person with hoarding disorder experiences distress at the thought of getting rid of the items. Excessive accumulation of items, regardless of actual value, occurs. Symptoms may include:

• Living spaces so cluttered that they cannot be used for their intended purpose
• Significant distress or problems functioning
• Keeping stacks of newspapers, magazines, or junk mail
• Letting food or trash build up to unusually excessive, unsanitary levels
• Severe anxiety when attempting to discard items
• Great difficulty categorizing or organizing possessions
• Indecision about what to keep or where to put things
• Distress, such as feeling overwhelmed or embarrassed by possessions
• Suspicion of other people touching items
• Obsessive thoughts and actions: fear of running out of an item or of needing it in the future; checking the trash for accidentally discarded objects

Causes

The exact cause of hoarding disorder is unknown. However, it is believed to be a complex disorder that results from a combination of genetic, brain abnormalities, and stressful life events. Factors that can increase the risk of developing or triggering compulsive hoarding include:

• Family history
• Social isolation
• Traumatic events
• Difficulty processing information
• Problems with planning and organizing

Treatment

Treatment of hoarding disorder can be challenging because many people with hoarding disorder do not recognize the harmful impact of their behavior. Treatment options include:

• Cognitive-behavioral therapy (CBT), which is the most common treatment for hoarding disorder. CBT helps individuals to identify and challenge their thoughts and beliefs about keeping items and to learn to discard them.
• Medication, such as selective serotonin reuptake inhibitors (SSRIs), may help some individuals.
• Support groups may also be beneficial.

Complications

Compulsive hoarding can lead to a variety of complications, including:

• Unsanitary conditions that pose a health risk
• Increased risk of falls
• Fire hazards
• Family conflicts
• Isolation
• Financial problems

Prevention

There is no sure way to prevent hoarding disorder. However, getting treatment at the first sign of a problem may help prevent hoarding from becoming severe.