Compulsive Hoarding Syndrome

Many people like to keep their favorite things around to make them feel at home. Some even enjoy collecting different trinkets and memorabilia based on their interests. But when people keep stuff in excess just to keep it, compulsive hoarding syndrome might be the reason. It’s estimated that up to 1.2 million people suffer from compulsive hoarding in the United States.^[1]

Definition of Compulsive Hoarding Syndrome

Compulsive hoarding syndrome, also called compulsive hoarding and hoarding, is an anxiety disorder characterized by the compulsion to excessively collect of items and difficulty discarding things that appear to most people to have little or no value to the point where clutter makes it difficult to navigate through one’s home.^[1,2] Commonly hoarded items include newspapers, magazines, paper and plastic bags, cardboard boxes, photographs, household supplies, food and clothing and even animals.^[3]

Types of Compulsive Hoarding Syndrome

The following are forms of hoarding.^[4]

Obsessive compulsive disorder (OCD) hoarding. In some cases, hoarding behavior is driven entirely by OCD symptoms. For instance, objects can’t be touched because they are contaminated and thus they accumulate on the floor or wherever they are dropped.

Hoarding in older adults. While limited research has been done on hoarding in older adults with, it is well known that late life hoarding is a serious psychiatric and community problem.

Signs & Symptoms of Compulsive Hoarding Syndrome

Hoarding affects emotions, thoughts and behavior. Signs and symptoms of hoarding may include the following:^[5]

Cluttered living spaces
Inability to discard items
Keeping stacks of newspapers, magazines or junk mail
Moving items from one pile to another, without discarding anything
Acquiring unneeded or seemingly useless items, including trash or napkins from a restaurant
Difficulty managing daily activities, including procrastination and trouble making decisions
Difficulty organizing items
Shame or embarrassment
Excessive attachment to possessions, including discomfort letting others touch or borrow possessions
Limited or no social interactions

Causes of Compulsive Hoarding Syndrome

While it’s not known exactly what causes hoarding, it is far more likely to affect those with a family history of hoarding. Compulsive hoarding is thought to result from problems in one or more of the following areas:^[6]

Information processing. People with compulsive hoarding often have difficulty:

Categorizing their possessions (i.e., deciding what’s valuable and what’s not)
Making decisions about what to do with possessions
Remembering where things are

Beliefs about possessions. People with compulsive hoarding often:

Feel a strong sense of emotional attachment toward their possessions
Feel a need to stay in control of their possessions and are protective of them
Worry about forgetting things so they use their possessions as visual reminders

Emotional distress about discarding. People with compulsive hoarding often:

Feel very anxious or upset when they have to make a decision about discarding things
Feel distressed when they see something they want and think they can’t feel better until they acquire that object
Control their uncomfortable feelings by avoiding making the decision or putting it off until later

Effects of Compulsive Hoarding Syndrome

Hoarding usually has deleterious effects—emotional, physical, social, financial, and even legal—for a hoarder and family members. Hoarding can cause a variety of complications, including the following:^[3,7]

Unsanitary conditions that pose a risk to health
Increased risk of falls
An inability to perform daily tasks, such as bathing or cooking
Poor work performance
Family conflicts (separation or divorce, eviction, and even loss of child custody)
Serious financial problems
Loneliness and social isolation
A fire hazard

Treatments for Compulsive Hoarding Syndrome

There is no cure for compulsive hoarding, but the following treatments may help manage symptoms:^[6]

Medications

Antidepressant medications, which increase the level of serotonin activity in the brain, have been shown to help some people with compulsive hoarding. However, people with compulsive hoarding do not appear to respond as well to medications as do people with other kinds of obsessive-compulsive symptoms.

Cognitive-behavioral therapy

Though it’s not known how effective cognitive-behavioral therapy is with hoarders, the available evidence suggests that cognitive-behavioral therapy is effective for many people with compulsive hoarding, maybe more so than medications. The therapy focuses on helping hoarders learn how to make decisions and think clearly about their possessions.

References

University of California Department of Psychiatry. What is compulsive hoarding? Retrieved February 6, 2013, from http://psychiatry.ucsd.edu/OCD_hoarding.html.
Mayo Clinic. Hoarding. Retrieved February 6, 2013, from http://www.mayoclinic.com/health/hoarding/DS00966.
Anxiety and Depression Association of America. Hoarding: The Basics. Retrieved February 6, 2013, from http://www.adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/hoarding-basics.
International OCD Foundation. Types of Hoarding. Retrieved February 6, 2013, from http://www.ocfoundation.org/hoarding/types.aspx.
Mayo Clinic. Hoarding symptoms. Retrieved February 6, 2013, from http://www.mayoclinic.com/health/hoarding/DS00966/DSECTION=symptoms.
Hartford Hospital. Compulsive Hoarding. Retrieved February 6, 2013, from http://www.harthosp.org/InstituteOfLiving/AnxietyDisordersCenter/CompulsiveHoarding/default.aspx.
Mayo Clinic. Hoarding complications. Retrieved February 6, 2013, from http://www.mayoclinic.com/health/hoarding/DS00966/DSECTION=complications.

By C. J. Newton, MA, Therapists.com Editor