For most of us, watching an episode of Hoarders: Buried Alive is the closest we will ever get to actually witnessing the results of Hoarding Disorder. Hoarding Disorder goes beyond simply having a little bit too much clutter. Actually, it manifests in the form of massive and unsafe amounts of clutter as well as in the form of deeply-rooted emotional and mental issues.
Hoarding is a serious disorder that can cost an individual their health, home, and their peace of mind. While it is difficult to treat, there is hope for overcoming symptoms of Hoarding Disorder.
What Is Hoarding Disorder?
As it is laid out in the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Hoarding Disorder is the persistent inability or difficulty for an individual to get rid of their possessions. Hoarders often accumulate items that either do not serve a practical purpose or have some sort of sentimental value. The actual value of the items hoarded is not why they save the items.
Most often, cases of Hoarding Disorder result in extremely cluttered environments where access to the refrigerator, sink, bathtub, and even the toilet is blocked. In some cases, people hoard animals without having the ability to care for them.
Studies have found that:
- About 75% of hoarding cases involve extreme buying;
- 50% of individuals with Hoarding Disorder excessively collect free items;
- Additionally, only about 15% of these individuals acknowledge that their behavior is irrational and even harmful.
Symptoms of Hoarding Disorder
Symptoms of hoarding most predominantly and obviously manifest in a physical collection of extreme clutter. However, many symptoms have deeply-rooted psychological and emotional ties. They need just as much consideration as the physical hoarding. These symptoms include:
- Inability/difficulty discarding items;
- Severe anxiety or distress over discarding items;
- A limited amount of free living space in the home due to excessive clutter;
- Common living areas of the home (such as the counter-tops, bathrooms, and floors) earn the attributes of storage spaces;
- Feelings of loneliness;
- Being isolated;
- Feeling depressed;
- Withdrawing from social settings;
- Feeling afraid or embarrassed of having people visit the home;
- Being unable to decide where to store things;
According to the DSM-5, an individual must meet the following diagnostic criteria for Hoarding Disorder:
- Persistent difficult parting with items regardless of their value;
- Inability to discard of items has its roots in the perceived need to save them and avoid the distress associated with discarding them;
- Difficulties discarding items results in extremely cluttered living spaces. Also, one does not use the items for their initial purposes. De-cluttering of living areas is generally the result of a third-party intervention;
- Hoarding leads to significant distress or impairments to areas of functioning. This includes one’s occupation, social life, and the ability to maintain a safe environment;
- You cannot attribute the hoarding to a medical condition;
- Also, you cannot better explain the hoarding by another mental disorder (such as obsessive behaviors in those with Obsessive-Compulsive Disorder).
About 80-90% of those with Hoarding Disorder engage in excessive buying. But they might not realize that they have a serious mental health issue.
Causes of Hoarding Disorder
There is no singular root cause of Hoarding Disorder. Instead, Hoarding Disorder is likely the result of several interacting factors. Specialists noticed that about 50% of hoarding cases involve someone who grew up with a family member who was also a hoarder. There seems to be a degree of genetic predisposition with Hoarding Disorder.
Personality traits (namely, anxiety and extreme indecisiveness) also play a role in hoarding, as does the experiencing of a significant life trauma. For example, the sudden loss of a loved one might propel someone to begin excessively hoarding items due to their experience with grief. Also, those who are already socially withdrawn or inhibited tend to be more likely to hoard. Finally, there is also an age factor that comes into play. Hoarding tendencies generally start between ages 11 and 15 but do not fully manifest until midlife.
Other Issues Related to Hoarding Disorder
To expand a bit further upon personality traits of hoarders, there seem to be several common traits that are prevalent in those with Hoarding Disorder. These traits include the following:
Obsessive-compulsive Disorder (OCD) and Hoarding Disorder share some commonalities. In fact, about 18-40% of those with OCD present with hoarding as a symptom. However, only 5% have hoarding as a dominant symptom. Despite their similarities, most professionals in the field of psychology regard hoarding and OCD as two separate disorders.
Hoarding Disorder Treatment Options
There is hope for those with Hoarding Disorder, as treatment options are widely available. Also, their results are now parts of clinical success stories over the years. The three main treatments (which specialists can use in combination) for Hoarding Disorder are Cognitive Behavioral Therapy (CBT), antidepressants, and Exposure and Response Prevention (ERP).
- CBT is a psychological intervention in which a therapist works with a client to change their maladaptive or faulty thinking into reason-based and more positive thinking.
- Antidepressants also generate mixed results. But they seem to work better when combined with therapist-guided treatment.
- ERP is a form of CBT that targets obsessive behaviors. It is driven by the goal of getting the individual to cease the behaviors that they turned into rituals.
Hoarding Disorder in Popular Culture
As you also read in the introduction to this piece, Hoarders: Buried Alive is one of the most famous pop culture examples of hoarding. This reality show follows different individuals with Hoarding Disorder. More specifically, it stages interventions to help the person physically and emotionally de-clutter their lives.
One of the most notable cases of celebrity hoarders is that of Edith Bouvier Beale and her mother, Edith Ewing Bouvier. These relatives of Jackie Kennedy Onassis lived in seclusion, in a house that was found to be cluttered with animals and infested with fleas. Although Jackie and Aristotle Onassis attempted to intervene by having cleaning actions into the home, they were not able to find cure for their deep co-dependence.
Wrapping It All Up
Most hoarding cases can be effectively treated, as long as the individual is able to somehow recognize that there is a problem. Interventions and CBT or ERP seem to be the most effective methods for treating those with Hoarding Disorder.
If you or someone you love might have Hoarding Disorder, there are plenty of resources available to help. This article is meant to act as a guide for learning more about Hoarding Disorder. But it is important that you contact a licensed professional to discuss diagnosis and treatment options.