Hoarding Disorder

Hoarding disorder is a type of anxiety disorder characterized by a continuous difficulty in throwing or parting with one’s belongings because of an assumed need to save them for later use, regardless of the fact that most of the stuff being piled-up is useless. Consequently, it gives rise to excessive accumulation of unwanted stuff and cramped living conditions.

Overview

Hoarding disorder usually starts during 11 to 15 years of age, and it is likely to get worse with age, due to the disorder, homes often get filled to the capacity, with only narrow pathways through piles of clutter. It ranges from mild to severe. In some cases, hoarding may not have a big impact on your life, while in other cases it has a serious influence over your functioning abilities on a daily basis.

The overall prognosis for hoarding disorder is good. Many people who receive treatment for hoarding disorder learn to manage their belongings, by learning new behaviors the affected individuals tend to feel less anxious. Treatment can decrease their need to save items. Reducing these symptoms leads to a better quality of life.

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Symptoms of Hoarding Disorder:

Those having hoarding disorder might exhibit the following:

  • Lack of ability to throw away their belongings
  • Extreme anxiety while trying to throw the items
  • Much difficulty while categorizing or organizing belongings
  • Indecisiveness about what to save or where to place the stuff
  • Feeling overwhelmed, distressed or embarrassed by the excessive belongings
  • Distrust for other people touching the stuff
  • Obsessive actions and thoughts
  • Fear of running out of an item or of needing it for later use
  • Looking into the trash for the objects thrown away accidentally
  • Functional difficulties, due to loss of living space, social isolation, family or marital conflicts, financial problems, health risks.

Risk factors of Hoarding Disorder:

  • Personality type: Many people who have hoarding disorder have a specific temperament that includes inconclusiveness/indecisiveness.
  • Family history: There is a strong link between having a family member who has hoarding disorder and having the disorder yourself i.e. a close relative having hoarding disorder brings you at risk for developing the disorder.
  • Stressful life events: Some people get hoarding disorder after experiencing a traumatic or stressful life event that they had difficulties dealing with, such as the death of a loved one, eviction, divorce, or losing belongings in a fire or a natural disaster.

Causes of Hoarding Disorder

It is still not clear that what causes hoarding disorder. Genetics, disturbance in brain chemicals, and stressful life events are seen as possible causes. People usually hoard as they believe that an item will be valuable or useful in the future. Or they feel it has sensational value, is irreplaceable and unique, or big a loss to throw away. They might also consider an item a reminder of a good memory, assuming that without it they would not be able to remember an important event or person. Or because they cannot decide where something belongs, it is better just to keep it anyway.

Hoarding is a disorder that might be present on its own or as a symptom of another disorder. Those most often associated with hoarding disorder are following:

  • Obsessive-compulsive disorder (OCD),
  • Obsessive-compulsive personality disorder (OCPD),
  • Attention-deficit/hyperactivity disorder (ADHD),
  • Depression

Difference between Hoarding and Collecting

Hoarding is not like the habit of collecting. Generally, those having a habit of the collection have a sense of pride about their belongings and they experience happiness in showing and discussing them. They usually keep their stuff well organized, feel pleasure when adding more stuff to their collection, and budget their money and time.

On the other hand, those who hoard usually experience shame about their chattels and feel disturbed when others see them. They have a mess, often at the expense of their livable space, they feel ashamed and unhappy after attaining further items, and they are mostly in debt.

Complications of Hoarding Disorder:

Hoarding disorder can cause a variety of complications, involving:

  • Increased risk of falls due to loss of space
  • Injury or being struck by falling or shifting items
  • Family fights
  • Loneliness and social isolation
  • Unhygienic conditions that pose a health risk
  • A fire risk
  • Poor work performance
  • Legal issues, such as eviction

Diagnosis of Hoarding Disorder:

Diagnostic criteria for hoarding disorder consists of the following:

  • Patients have continuous difficulty in discarding or throwing away the possessions, irrespective of their actual value.
  • The difficulty in discarding the stuff is due to the assumed need to save the stuff and to the stress related to discarding them.
  • The accumulated possessions obstruct and mess with active living areas (i.e. not basements or storage areas) and significantly compromise the proper use of these areas.
  • Hoarding causes a significant disturbance or damages one social, occupational, or other areas of life.

Treatment of Hoarding Disorder:

Treatment for hoarding disorder involves both pharmacological and psychological interventions

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Medications

There are currently no medicines approved by the FDA (Food and Drug Administration) for the treatment of hoarding disorder. Usually, medicines are used to treat other symptoms such as depression and anxiety that often occur along with hoarding disorder. The medicines used most commonly are a type of anti-depressant known as SSRIs (selective serotonin reuptake inhibitors). Research continues on the most effective ways to use medicines for the treatment of hoarding disorder.

Psychological treatment:

Cognitive Behavioral Therapy that is used to treat the specific symptoms of hoarding might also be useful. For instance, this type of therapy focuses on assisting the patients to discard useless items, avoiding buying new stuff (if excessive buying is a problem), and improving their decision-making skills.