Hoarding Disorder

Hoarding Disorder

Hoarding disorder is recognised in individuals who develop an irresistible urge to hoard various items that exceed necessary and practical purposes, whereby their hoarding behaviour can severely impinge upon various aspects of their daily functioning – including the lives of their loved ones

What sets hoarding apart from collecting items?

It is important to differentiate between the behaviours of individuals who enjoy collecting SPECIFIC items for interest sake, and the behaviours common to hoarders who experience an overbearing sense of urgency to accumulate RANDOM items in excess and feel an overwhelming level of distress when faced with parting with them. While many people enjoy collecting particular items as a form of interest (like stamps, models, shells, or other keepsake items), and similarly, many individuals like to snap up a bargain when the opportunity arises rather than paying top dollar – these behaviours are significantly different to the symptoms of hoarding disorder.

Individuals with hoarding disorder engage in various compulsive behaviours leading them to accumulate various items that are commonly considered to others as having little to no monetary, sentimental, or useful value, whereby the storage of these items hinder the practicality and functioning of their everyday living and working spaces. Comparatively, individuals who collect particular items for enjoyment, typically allocate a limited (and organised) space, budget and timeframe for their hobby that they usually associate with pride and fulfilment.

What are the symptoms of hoarding disorder?

Some of the common symptoms of individuals with hoarding disorder include:

  • Difficulty discarding items that others would usually throw out (eg: food past its use by date, recycling rubbish, plastic bags, items that are no longer useable or are broken).
  • Difficulty organising possessions, resulting in chaotic, cluttered and impractical living spaces.
  • Feeling ashamed, embarrassed and overwhelmed about quantity of possessions – often resulting in the individual attempting to hide these from others and/or displaying overly possessive behaviour of their items – often resulting in relationship difficulties, social isolation, hazardous living environments, and even legal disputes.
  • Experiencing high levels of distress resulting from indecision about where to put their items and when to discard them.
  • Impaired functioning in routine school, work, or social life.
  • The hoarding behaviour is not associated with another physical complication (such as brain injury or stroke) or various other psychiatric disorders.
  • Symptoms of hoarding disorder may present in a series of other mental health complications such as Obsessive Compulsive Personality Disorder (OCPD), Obsessive Compulsive Disorder (OCD), Attention Deficit Hyperactivity Disorder (ADHD), Psychosis, Anxiety or Depression, however, hoarding disorder has its own subset of clinical diagnostic criteria.
  • Individual demonstrates compulsive buying behaviour due to their inability to resist a “bargain” even if the individual has no need or storage space for it.

What are some of the distorted beliefs associated with HD?

  • Throwing away an item will be wasteful or irresponsible
  • Fear of making the wrong decision about throwing out an item that may have some use for them in the future
  • Fear that they will forget where they placed an object and that they will not be able to find it, causing them to ensure various items in one area remain visible.

Why does it happen?

Hoarding behaviour is typically rooted in an individual’s inability to part with the items they accumulate due to their distorted beliefs that the items hold some sentimental value, or invoke past memories, or will have some useful value to them or others in the future. There is not one singular and definitive cause that explains hoarding disorder, although there are various factors that can contribute to its onset and these will vary largely on each individuals’ life experiences and genetic predisposition. Some of the common risk factors include:

  • Prior exposure to behaviours of family member(s) with hoarding disorder or family history of hoarding
  • Genetic predisposition to hoarding behaviours
  • Traumatic life event such as the death of a loved one or experiencing some other significant loss

How common is hoarding disorder?

Hoarding disorder is thought to affect around 2-5% of the population and can develop in both men and women of all ages, although the first symptoms are usually recognised in early teenage years – averaging age 13.

How is it treated?

Often individuals with hoarding disorder display little insight into the consequences of their behaviour which is why many individuals are reluctant seek treatment in the first place. This is why it is most commonly the family members who will intervene and actively seek out the psychological treatment for their loved one. It is very important that family members develop a rich understanding of the disorder before attempting to intervene themselves as this may only make matters worse.

There are various medications that have been shown to be helpful during treatment to reduce the individual’s distress during the initial stages of intervention, however such medications may only be effective when used in conjunction with psychotherapeutic approaches as medications do not resolve the underlying issues that are causing the hoarding behaviour. This is why the more effective form of treatment for hoarding disorder is Cognitive Behavioural Therapy (CBT) with the ongoing support and guidance from a psychologist, as it works on addressing the individuals underlying distorted beliefs that are causing their behaviour.

During CBT, the psychologist assists the individual to firstly identify their irrational and hardwired distorted beliefs, and from here, teaches them how replace their negative thought patterns with more realistic cognitions, as they acquire various alternative coping skills along the way. Family members are usually required to partake in the individual’s therapeutic treatment program so that they can understand how best to help them.