Why hoard

Antidepressant medicines called selective serotonin reuptake inhibitors SSRIs have also been shown to help some people with hoarding disorders. CBT is a type of therapy that aims to help you manage your problems by changing how you think cognitive and act behaviour. It encourages you to talk about how you think about yourself, the world and other people, and how what you do affects your thoughts and feelings.

Regular sessions of CBT over a long period of time are usually necessary and will almost always need to include some home-based sessions, working directly on the clutter. This requires motivation, commitment and patience, as it can take many months to achieve the treatment goal. The goal is to improve the person's decision-making and organisational skills, help them overcome urges to save and, ultimately, clear the clutter, room by room.

The therapist won't throw anything away but will help guide and encourage the person to do so. The therapist can also help the person develop decision-making strategies, while identifying and challenging underlying beliefs that contribute to the hoarding problem.

The person gradually becomes better at throwing things away, learning that nothing terrible happens when they do and becomes better at organising items they insist on keeping. At the end of treatment, the person may not have cleared all their clutter, but they will have gained a better understanding of their problem. They will have a plan to help them continue to build on their successes and avoid slipping back into their old ways.

Page last reviewed: 12 June Next review due: 12 June Home Mental health Mental health conditions Back to Mental health conditions. Hoarding disorder. Hoarding is considered a significant problem if: the amount of clutter interferes with everyday living — for example, the person is unable to use their kitchen or bathroom and cannot access rooms the clutter is causing significant distress or negatively affecting the quality of life of the person or their family — for example, they become upset if someone tries to clear the clutter and their relationship suffers Hoarding disorders are challenging to treat because many people who hoard frequently do not see it as a problem, or have little awareness of how it's affecting their life or the lives of others.

If not tackled, it's a problem that will probably never go away. Why someone may hoard The reasons why someone begins hoarding are not fully understood. Mental health problems associated with hoarding include: severe depression psychotic disorders, such as schizophrenia obsessive compulsive disorder OCD In some cases, hoarding is a condition in itself and often associated with self-neglect.

These people are more likely to: live alone be unmarried have had a deprived childhood, with either a lack of material objects or a poor relationship with other members of their family have a family history of hoarding have grown up in a cluttered home and never learned to prioritise and sort items Many people who hoard have strongly held beliefs related to acquiring and discarding things, such as: "I may need this someday" or "If I buy this, it will make me happy".

What's the difference between hoarding and collecting? Signs of a hoarding disorder Someone who has a hoarding disorder may typically: keep or collect items that may have little or no monetary value, such as junk mail and carrier bags, or items they intend to reuse or repair find it hard to categorise or organise items have difficulties making decisions struggle to manage everyday tasks, such as cooking, cleaning and paying bills become extremely attached to items, refusing to let anyone touch or borrow them have poor relationships with family or friends Hoarding can start as early as the teenage years and gets more noticeable with age.

Items people may hoard Some people with a hoarding disorder will hoard a range of items, while others may just hoard certain types of objects. Items that are often hoarded include: newspapers and magazines books clothes leaflets and letters, including junk mail bills and receipts containers, including plastic bags and cardboard boxes household supplies Some people also hoard animals, which they may not be able to look after properly.

Why hoarding disorders are a problem A hoarding disorder can be a problem for several reasons. For example, it can: make cleaning very difficult, leading to unhygienic conditions and encouraging rodent or insect infestations be a fire risk and block exits in the event of a fire cause trips and falls fall over or collapse on people, if kept in large piles The hoarding could also be a sign of an underlying condition, such as OCD , other types of anxiety , depression and dementia.

Some individuals with hoarding disorder may recognize and acknowledge that they have a problem with accumulating possessions; others may not see a problem.

Excessive acquisition occurs in the vast majority of cases and—although not a core diagnostic feature—should be carefully monitored. In addition to the core features of difficulty discarding and clutter, many people with hoarding disorder also have associated problems such as indecisiveness, perfectionism, procrastination, disorganization and distractibility.

These associated features can contribute greatly to their problems with functioning and the overall severity. Animal hoarding may form a special type of hoardindisordder and involves an individual acquiring large numbers dozens or even hundreds of animals. The animals may be kept in an inappropriate space, potentially creating unhealthy, unsafe conditions for the animals. People who hoard animals typically show limited insight regarding the problem.

The cause of hoarding disorder is unknown. Due to its recent classification, the neurobiology of hoarding disorder in humans is a newly burgeoning field; making it somewhat premature to draw firm conclusions. Hoarding is more common among individuals with a family member who also has a problem with hoarding. A stressful life event, such as the death of a loved one, can worsen symptoms of hoarding.

Hoarding disorder has a symptom profile, neural correlates, and associated features that differ from OCD and other disorders. A number of information processing deficits have been associated with hoarding; including planning, problem-solving, visuospatial learning and memory, sustained attention, working memory, and organization.

Hoarding behaviors appear relatively early in life and then follow a chronic course. Most studies report onset between 15 and 19 years of age. Early recognition, diagnosis, and treatment are crucial to improving outcomes. Treatment can help people with hoarding disorder to decrease their saving, acquisition, and clutter, and live safer, more enjoyable lives.

Randomized controlled trials have established cognitive behavioral therapy CBT for hoarding disorder as an effective treatment. During CBT, individuals gradually learn to discard unnecessary items with less distress—diminishing their exaggerated perceived need or desire to save these possessions.

They also learn to improve skills such as organization, decision-making, and relaxation. Despite the effectiveness of CBT for hoarding disorder, a substantial number of hoarding disorder cases remain clinically impaired by their hoarding symptoms after treatment.

Regarding medication treatment, studies of hoarding disorder psychopharmacology have been small and open-label, which limit the conclusions that can be drawn from this literature. To date, there are no controlled trials to support efficacy. Despite this, there is some evidence of benefit from paroxetine, venlafaxine extended-release, amphetamine salts, methylphenidate, methylphenidate extended-release, and atomoxetine.

There are no data on comparative efficacy between these drugs. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Hoarding disorder is a persistent difficulty discarding or parting with possessions because of a perceived need to save them. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Hoarding disorder.

Arlington, Va. Accessed Feb. Help with hoarding disorder. American Psychiatric Association. Mataix-Cols D. Hoarding disorder. New England Journal of Medicine.

Mataix-Cols D, et al. Hoarding disorder in adults: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis. Treatment of hoarding disorder in adults.

Phillips KA, et al. Merck Manual Professional Version. Brakoulias V, et al. A meta-analysis of the response of pathological hoarding to pharmacotherapy. Psychiatry Research.