As an officially recognized condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), ‘hoarding disorder’ is more than just collecting a few trinkets. With increased emotional attachment to things, impaired decision-making, associated mental health difficulties, and social stigma, it can be difficult to find a starting point for recovery. Here are some ways to help your loved one deal with hoarding disorder.
What is hoarding disorder?
This condition is characterized by an accumulation of possessions, a strong attachment to seemingly endless ‘clutter,’ and difficulty parting with items. It’s not a lifestyle but rather a result of genetics, an underlying mental condition, or emotional stress.
The media often provides us with comical, exaggerated examples of this condition that lack complexity and exclude the everyday challenges that the individual and their loved ones face. This portrayal only serves to propagate stigma, which makes it even more difficult to initiate recovery due to embarrassment or shame.
Hoarding can affect health and well-being, cause tension in relationships, and significantly reduce quality of life. Thankfully, there are many ways in which people living with this diagnosis can thrive, and further research is being done to find the best possible solution for this condition.
What triggers hoarding disorder?
Hoarding disorder can have many triggers, including factors such as attachment issues, genetics, impaired neurocognitive functioning, and stress, among others. A single cause has not yet been established, with research indicating a multitude of aspects specific to the affected individual as catalysts. Using hoarding as emotional regulation is a common practice among those who live with the diagnosis. It can be difficult to understand that those with hoarding disorder can have an extreme emotional connection to their things — it can actually be a pillar of their mental stability. Hoarding practices often intensify when someone is going through a tough time. Isolation and loneliness, which are major effects of hoarding disorder, can also cause people to stay stuck in their cycle and continue to hoard.
How can you help someone with a hoarding disorder?
Providing help with hoarding disorder can be difficult. Although tempting, it is not as easy as just telling someone to “throw stuff away.” In fact, professionals condemn this approach, as it is dismissive and can make the person feel dehumanized, which can, in turn, hinder them from getting the help they need. Here are some proven, respectful ways to get your loved one through their hard days and help them thrive in the long term.
1. Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a standard treatment for both common and complex mental disorders. It involves modifying behavior, creating healthy new habits, and ingraining desired behavior patterns gradually. It is clinically proven to encourage self-worth, implement positive routines, and remodel behavior. This therapy can be conducted by a licensed therapist, with research proving CBT to be effective as a standalone treatment or supplementary to other methods.
2. Group support
Group therapy is becoming increasingly popular, and using it to treat hoarding disorder is no exception. Recent research has pointed toward this type of therapy for enhancing a positive outlook through human connection. Networking with those who experience the same symptoms can increase confidence in sufferers and promote overall recovery.
Loneliness is one of the key detriments of hoarding, as those with hoarding disorder are likely to experience embarrassment, shame, and, in some cases, an inferiority complex, preventing them from accessing help. A support group for people with the same experiences is often inspiring; it can provide new opportunities to open up, and talking with others might mean they gain more skills that aid them in recovery. Talking about your worries openly is not a bad thing — it might make your loved one feel more comfortable approaching you and asking for help.
Hoarding disorder medication is available as a prescription from a psychiatrist or general practitioner and is generally the same medication used to target depressive or anxiety disorders. This includes medications such as selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Although more research into medication as the primary treatment for hoarding disorder is needed, some results prove that medication could be an effective solution, with more than half of treated individuals responding well to pharmacological treatment. It is always advised to consult a healthcare professional for the go-ahead regarding medication.
4. Informal support
Novel approaches are especially important in recovery. Continuing with therapy techniques at home, sticking to routines, managing stress, and addressing triggers are all ways to propel the process of recovery. In addition, family and peer support is noted as one of the most valuable support systems. Sure, it can be hard to understand why they won’t “just clean up” or “throw things away,” but at the end of the day, your support can be part of the reason why your loved one commits to recovery. Addressing hoarding is often a sensitive topic of conversation; be empathetic to their struggle and do your best to encourage them gently through their journey to recovery.
Does hoarding get worse with time, and is it age related?
There is considerable variability, but recent studies have shown that hoarding tends to intensify with age. It can be easy for someone to get into a cycle of reluctance to get help, which can result in avoidance, leading to the worsening of the condition over time. Studies have shown that older individuals with hoarding disorder can also suffer more health detriments, such as malnutrition, increased risk of illness, and self-neglect. Also posing a safety risk, severe clutter is likely to result in a fall or tripping over. It can eventually go as far as resulting in a public health issue, with contamination risks and pest and fire hazards arising.
Is it possible to overcome hoarding disorder?
Thankfully, living with hoarding disorder does not have to be a life sentence.
A person can recover from hoarding disorder with adequate treatment. But, like any ailment, the road to recovery can be long, difficult, and mentally taxing. There is no quick fix or specific timeline for recovery.
Those supporting their loved ones are also encouraged to seek help if their own mental health is affected, as it can be a confronting process being a support person and can often induce feelings of helplessness amidst the clutter. Although it is important to try and stay strong for the person you love, looking after yourself is equally important.
At the end of the day, committing to the recovery journey and adhering to treatment is crucial. While it’s challenging, individualized therapies can be invaluable in your loved one’s quality of life and your relationship with them.
Is it possible to help someone with a hoarding disorder?
Sufferers can sometimes be reluctant to take the first step due to stigma and shame. Depending on a variety of factors, if committed to treatment and the response to the chosen treatment is positive, recovery is possible. Though there might be some trial and error, it is definitely worth exploring recovery options to see which is most effective for your loved one’s individual circumstances.
What is the best treatment for hoarding disorder?
At this stage, cognitive behavioral therapy tends to be the go-to treatment for hoarding disorder, but every individual is different. Some people respond better to medication, group support, or a combination of all of the above.
What makes hoarding worse?
Emotional distress, life stressors, and personal triggers may make hoarding worse. Lack of social support and loneliness can also have an impact on the level of hoarding. Hoarding also tends to intensify with age.
Hoarding disorder was formerly a subtype of obsessive-compulsive disorder (OCD) but is now classified as a separate entity.
A combination of aspects influences this condition, such as genetic factors, neurocognitive functioning, personality traits, and trauma.
Therapy, group support, medication, and informal support systems can all aid in recovery.
Research is ongoing into further effective treatments.
- The American Psychiatric Association. Expert Q&A: Hoarding Disorder.
- Current Psychiatry Reports. Recent Advances in Research on Hoarding.
- Journal of Obsessive-Compulsive and Related Disorders. Quality of life in patients with hoarding disorder.
- Current Neuropharmacology Reports. The Etiology of Hoarding Disorder: A Review.
- International Journal of Geriatric Psychiatry. Age at onset and clinical features of late life compulsive hoarding.