What is hoarding disorder?
The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American
Psychiatric Association, provides criteria and definitions for various mental health disorders,
including hoarding disorder. The DSM-5, which was the latest version available as of my last
knowledge update in September 2021, contains the following diagnostic criteria for hoarding
disorder:
Hoarding Disorder (DSM-5 300.3)
A. Persistent difficulty discarding or parting with possessions, regardless of their actual value.
B. This difficulty is due to a perceived need to save the items and to distress associated with
discarding them.
C. The difficulty discarding possessions results in the accumulation of possessions that congest
and clutter active living areas and substantially compromises their intended use. If living areas
are uncluttered, it is only because of the interventions of third parties (e.g., family members,
cleaners, authorities).
D. The hoarding causes clinically significant distress or impairment in social, occupational, or
other important areas of functioning (including maintaining a safe environment for self and
others).
E. The hoarding is not attributable to another medical condition (e.g., brain injury,
cerebrovascular disease, Prader-Willi syndrome).
F. The hoarding is not better explained by the symptoms of another mental disorder (e.g.,
obsessions in obsessive-compulsive disorder, decreased energy in major depressive disorder,
delusions in schizophrenia or another psychotic disorder, cognitive deficits in major
neurocognitive disorder, restricted interests in autism spectrum disorder).
Please note that the criteria mentioned above are for the diagnosis of hoarding disorder
according to the DSM-5. If you or someone you know is struggling with hoarding tendencies or
behaviors, it is essential to consult with a qualified mental health professional for a proper
evaluation, diagnosis, and guidance on treatment and management. The DSM-5 is a diagnostic
tool used by mental health professionals to aid in the diagnosis of mental health conditions.
What is the connection between Hoarding Disorder and OCD?
Hoarding disorder (HD) and obsessive-compulsive disorder (OCD) are related in that they are
both categorized as obsessive-compulsive and related disorders in the Diagnostic and
Statistical Manual of Mental Disorders (DSM-5), which is a classification system used by mental health professionals. However, while there are similarities between hoarding disorder and OCD,
they are distinct conditions with some key differences:
Obsessive-Compulsive Nature:
OCD: In OCD, individuals experience intrusive and distressing thoughts
(obsessions) and engage in repetitive behaviors (compulsions) to alleviate the
anxiety caused by these thoughts. The compulsions are usually aimed at
reducing the perceived threat, such as washing hands excessively due to a fear
of contamination.
HD: In hoarding disorder, individuals have a persistent difficulty discarding
possessions, which leads to the accumulation of items and clutter. The driving
force behind hoarding is not the presence of intrusive obsessions, as in OCD, but
rather the need to save items and the distress associated with discarding them.Nature of Compulsions:
OCD: Compulsions in OCD are typically ritualistic and are performed in response
to obsessions to reduce anxiety. They are aimed at preventing harm or reducing
perceived risks. Common compulsions include checking, washing, counting, or
repeating behaviors.
HD: In hoarding, the behaviors are not ritualistic in response to obsessions.
Instead, the primary compulsion is the acquisition and saving of items, often
driven by an intense attachment to possessions and a perceived need to retain
them.Themes and Content:
OCD: Obsessions in OCD can vary widely and encompass a broad range of
themes, including contamination, harm, symmetry, and intrusive thoughts. The
specific obsession determines the nature of the compulsion.
HD: Hoarding typically revolves around the acquisition and retention of objects,
and the primary theme is related to the fear of discarding items and the distress
associated with letting go. The clutter and disorganization of living spaces are
often the most visible manifestations of hoarding.Treatment Approaches:
OCD: Treatment for OCD often involves cognitive-behavioral therapy (CBT),
particularly exposure and response prevention (ERP), which aims to reduce the
anxiety associated with obsessions and compulsions. Medication, such as
selective serotonin reuptake inhibitors (SSRIs), can also be a part of the
treatment plan.
HD: Hoarding disorder is typically treated with a combination of CBT, focused on
the issues related to hoarding, and medication, such as SSRIs or mood
stabilizers. Treatment for hoarding often includes addressing the emotional and
psychological factors behind the hoarding behavior.
While hoarding disorder and obsessive-compulsive disorder share some common features and
are both characterized by repetitive behaviors, they are separate conditions with distinct
diagnostic criteria and treatment approaches. It's important for individuals who may be
struggling with these disorders to receive a thorough evaluation and appropriate treatment from
mental health professionals who specialize in these areas.
What are the common mistakes made by family members of individuals who hoard?
Family members of individuals who hoard may face a challenging and complex situation. It's
important for family members to provide support and assistance in a way that promotes the well-
being of their loved one while avoiding common mistakes that can potentially exacerbate the
problem. Some common mistakes that family members of hoarders make include:
Lack of Understanding: Not taking the time to educate themselves about hoarding
disorder and its underlying causes. Without understanding the nature of the condition,
family members may respond in unhelpful or judgmental ways.Critical or Judgmental Attitudes: Expressing frustration, anger, or criticism toward the
hoarder. This can intensify feelings of shame and isolation for the individual with
hoarding disorder.Forcing Cleanup: Attempting to forcibly clean or declutter the hoarder's space without
their consent can lead to resistance, anxiety, and a breakdown of trust. It may also be
counterproductive if not done in a way that addresses the root causes of the hoarding
behavior.Threats or Ultimatums: Issuing ultimatums or threats, such as eviction, can create
additional stress and may not lead to positive outcomes. Hoarders often require patience
and support rather than pressure.Ignoring Mental Health Needs: Focusing solely on the physical clutter while neglecting
the emotional and mental health needs of the hoarder. Hoarding is often linked to
underlying psychological issues that require attention.Enabling: Enabling hoarding by providing financial support or living arrangements that
allow the hoarding behavior to continue. This can prolong the problem and may have
financial and legal consequences.Inaction: Ignoring the hoarding behavior and its impact on the hoarder's well-being and
the safety of others. Inaction can lead to a worsening of the living conditions and further
social isolation.Isolating the Hoarder: Limiting social interactions and relationships for the hoarder.
Social isolation can exacerbate the problem, as a lack of support networks can
contribute to hoarding behaviors.Not Seeking Professional Help: Failing to seek professional assistance, such as
therapy, counseling, or interventions by mental health experts who specialize in hoarding
disorder. Professional guidance is often crucial for effective treatment.Neglecting Self-Care: Family members may neglect their own well-being while trying to
support the hoarder. It's essential for caregivers to maintain their own physical and
emotional health and seek support for themselves.Expecting Quick Fixes: Expecting hoarding behavior to change rapidly or easily.
Hoarding is a complex and persistent issue that typically requires long-term efforts and
treatment.
In dealing with a family member who hoards, it's advisable to approach the situation with
empathy, patience, and a willingness to work together to find solutions. Seeking the guidance of
mental health professionals who specialize in hoarding disorder can be highly beneficial for both
the hoarder and their family members. Family therapy or support groups can also provide a safe
and understanding environment for loved ones to share their experiences and receive guidance
on how to help effectively.
What is the difference between hoarding and collecting?
Hoarding and collecting are two distinct behaviors related to acquiring and keeping objects, but
they differ significantly in their motivations, the types of items involved, and the impact on a
person's life.
Here are the key differences between hoarding and collecting:
1. Motivation:
Hoarding: Hoarding is often driven by a psychological disorder known as
hoarding disorder. People who hoard accumulate items compulsively, often due
to an intense fear of discarding things, attachment to possessions, or a belief that
the items will be needed in the future. Hoarding is typically associated with
anxiety and an inability to let go of possessions, even when they have no
practical value.
Collecting: Collecting, on the other hand, is a hobby or interest where individuals
intentionally seek out specific items for pleasure or personal satisfaction.
Collectors choose their items based on personal interest, aesthetics, historical
significance, or investment potential. Collecting is not driven by compulsion or
anxiety but by enjoyment.
2. Types of Items:
Hoarding: Hoarders accumulate a wide range of items, often including trash, old
newspapers, broken objects, and other seemingly worthless or nonfunctional
things. The items collected by hoarders may not have any inherent value or
purpose.
Collecting: Collectors focus on a specific type of item or category, such as
stamps, coins, comic books, antiques, art, or even rare automobiles. These items
typically have inherent value and are carefully curated to build a meaningful
collection.
3. Organization:
Hoarding: Hoarded items are usually disorganized, cluttered, and can obstruct
living spaces. Hoarders often have difficulty categorizing, sorting, or disposing of
their possessions, leading to chaotic living conditions.
Collecting: Collectors tend to be organized and take care of their items. They
may catalog, display, and preserve their collections in a neat and structured
manner, often showcasing their passion for their chosen items.
4. Emotional Attachment:
Hoarding: Hoarders often have strong emotional attachments to their
possessions, making it extremely challenging for them to part with even the most
trivial items.
Collecting: Collectors may also have attachments to their items, but the
attachment is typically based on the joy of ownership and the appreciation of the
items' qualities rather than an irrational fear of loss.
5. Impact on Daily Life:
Hoarding: Hoarding can have a negative impact on a person's daily life, including
their physical and mental health, relationships, and living conditions. Hoarding
often leads to social isolation and distress.
Collecting: Collecting is a hobby that enhances a person's life by providing
enjoyment, satisfaction, and opportunities for social interaction with like-minded
enthusiasts. It generally does not have a negative impact on daily functioning.
It's important to note that hoarding disorder is a recognized mental health condition, and those
who suffer from it may require professional help to address their compulsive hoarding
behaviors. Collecting, on the other hand, is generally a harmless and enjoyable pastime.
How is hoarding related to compulsive buying?
Compulsive acquiring and hoarding are related behaviors often associated with
obsessive-compulsive and related disorders. While they are distinct, they share some common characteristics and can sometimes co-occur.
Here are the key connections between compulsive acquiring and hoarding:
Acquisition of Items: Both compulsive acquiring and hoarding involve the acquisition of
items, but the reasons and motivations behind the acquisitions differ:
In compulsive acquiring, individuals purchase or acquire items impulsively, driven
by intense urges, emotional distress, or a need to alleviate negative emotions.
The act of acquiring brings temporary relief or satisfaction.
In hoarding, individuals accumulate items compulsively, often driven by an
intense fear of discarding things, emotional attachment to possessions, or a
belief that the items will be needed in the future. Hoarders have difficulty letting
go of items, even when they have no practical value.
Emotional Distress: Both compulsive acquiring and hoarding are associated with
emotional distress:
Compulsive acquiring can lead to feelings of guilt, shame, and regret after a
shopping spree or excessive acquisition, especially when it results in financial
problems.
Hoarding is often characterized by feelings of anxiety, distress, and discomfort
when faced with the prospect of discarding possessions, even when those items
are of little or no value.
Obsessive-Compulsive Traits: Compulsive acquiring and hoarding are considered part
of the spectrum of obsessive-compulsive and related disorders. Individuals with these
behaviors may share certain traits such as perfectionism, difficulty making decisions,
and difficulty organizing and managing possessions.
Co-Occurrence: It is not uncommon for individuals to experience both compulsive
acquiring and hoarding tendencies. In some cases, compulsive acquiring behaviors can
contribute to the buildup of possessions seen in hoarding.
Treatment Approaches: The treatment approaches for both compulsive acquiring and
hoarding often involve cognitive-behavioral therapy (CBT), which aims to address the
underlying thought patterns and behaviors associated with these conditions. In the case
of hoarding, specific interventions like exposure therapy may be used to help individuals
reduce distress associated with discarding items.
It's important to note that while compulsive acquiring and hoarding are related, they are not the
same. Compulsive acquisition tends to focus on the acquisition phase, whereas hoarding
centers on the retention of items. It's possible for someone to have one behavior without the
other, but they often share common underlying emotional and psychological processes.
Treatment for either condition should be tailored to the individual's specific needs and can be
facilitated by mental health professionals experienced in dealing with obsessive-compulsive and
related disorders.
If you recognize that you have hoarding tendencies, what should you do?
If you recognize that you have hoarding tendencies and are concerned about it, it's important to
take proactive steps to address this issue. Hoarding tendencies can be challenging to
overcome, but with the right approach and support, you can make progress. Here are some
steps you can take:
Self-awareness: The first step is acknowledging that you have hoarding tendencies.
Self-awareness is essential for initiating change. Understanding the impact of hoarding
on your life and the lives of those around you is crucial.Seek professional help: At Kairos, we have a practitioner with lived experience, who
specializes in hoarding disorder. They can provide a proper diagnosis, evaluation, and
therapy to help you address the underlying causes and behaviors associated with
hoarding. Check out Elena’s profile here.Support system: Engage with friends and family who are supportive and understanding.
Share your concerns with them and ask for their assistance in addressing your hoarding
tendencies. A support system can provide encouragement, help you make decisions
about your possessions, and assist in the decluttering process.Educate yourself: Learn more about hoarding disorder, its causes, and treatment
options. Understanding the condition can help you and your loved ones better manage it.Decluttering: Gradual and systematic decluttering is an important step in managing
hoarding tendencies. Start small, perhaps with a single area or category of items, and
work your way through your possessions. It can be helpful to create a plan, set
achievable goals, and enlist the help of a professional organizer or therapist experienced
in hoarding issues.Cognitive-behavioral therapy (CBT): CBT is often used in the treatment of hoarding
disorder. It can help you identify and challenge unhelpful thought patterns and behaviors
associated with hoarding. Your therapist will work with you to develop coping strategies
and improve decision-making skills.Medication: In some cases, medication may be prescribed by a mental health
professional to address underlying anxiety, depression, or other mental health issues
that can be associated with hoarding disorder.Support groups: Consider joining a support group for individuals with hoarding
tendencies or hoarding disorder. Connecting with others who share similar experiences
can provide a sense of community and understanding.Practice maintenance: After decluttering, it's important to establish new habits and
routines to prevent re-accumulation of possessions. Regularly assess your belongings,
make decisions about new acquisitions, and avoid bringing unnecessary items into your
living space.Be patient: Overcoming hoarding tendencies is a process that takes time and effort. Set
realistic goals, and be patient with yourself as you work towards managing your hoarding
behaviors.
Remember that seeking help is a sign of strength, and you don't have to go through this
journey alone. Professional guidance and the support of friends and family can make a
significant difference in managing hoarding tendencies and improving your quality of
life.
Reach out to Kairos Wellness Collective today if you would like support with Hoarding
Tendencies.