Hoarding Disorder: Help for Hoarders - HelpGuide.org (2023)

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Hoarding disorder goes beyond being a “pack rat” or having too much clutter. But there are ways to change your habits and regain control over your possessions, your home, and your life.

What is hoarding disorder?

Hoarding disorder is a chronic difficulty with discarding possessions—even those without any monetary value—accompanied by a dysfunctional attachment to often worthless or unusable items. It results in excessive accumulation of belongings, often making for a cramped, unmanageable, or unhealthy living space.

Many of us are prone to clutter or have trouble parting with old possessions, especially nostalgic mementos, knickknacks, or things we’re convinced will one day be useful. But if you have hoarding disorder, your home may be so cluttered with items that some living spaces are unusable. In extreme cases, items are piled floor-to-ceiling and cover virtually every surface, making it difficult to move through rooms, prepare food, go to bed, or use the bathroom.

As well as creating dangerous living conditions, this excessive need to accumulate possessions can have a detrimental impact on your health, relationships, and ability to function in daily life. You may feel ashamed or frustrated at your continued need to acquire items, embarrassed at how you live, or isolated from the family and friends you no longer feel able to invite into your home.

Whether your hoarding disorder is mild or severe, just thinking about parting with your possessions can be emotionally distressing. The beliefs you’ve attached to seemingly worthless items can make trying to discard them overwhelm you with feelings of anxiety, guilt, or sadness. Whatever your struggles, though, there are steps you can take to overcome hoarding symptoms, rid your life of the clutter, and develop new, healthier attitudes to maintain your recovery. The first step is to understand all you can about hoarding disorder and the hold it has over your life.

Dangers of hoarding

As the number of items filling your home grows, so too do the health hazards. Despite the mess, clutter, and disorganization, some people with hoarding disorder don’t always recognize a problem in their behavior. Rather, it may fall on friends or family members to point out the dangers and push for you to make a change.

• Piles of possessions can block doors, hallways, and stairways making it harder to navigate your home, especially if you’re an older adult with arthritis or mobility issues.
• The clutter can lead to an increased risk of falls or tripping.
• Crowded and cluttered stoves and heaters can become a fire hazard, with blocked exits increasing the dangers.
• As dust gathers, you may develop allergies or respiratory problems, such as COPD.
• Hoarding can restrict your ability to maintain basic hygiene standards, even lead to bug and rodent infestations. Animal hoarding can make these hygiene problems even worse.
• As the mess spreads outside your home, into the yard, garage, or patio, it can cause health problems for your neighbors and lead to conflict, eviction, or legal proceedings.
• If you live with a partner, hoarding can splinter your relationship, even lead to separation or divorce.
• Any children living in the home could be taken away by social services.
• Cramped living conditions can make it difficult to carry out plumbing, heating, or other repairs to your home.
• Shame about your living space can impact your social life, making it harder to invite friends or family to your home, and leave you feeling socially isolated.

Symptoms and causes of hoarding disorder

While it’s much more common than you may have imagined, not all hoarding behavior merits a diagnosis of hoarding disorder. In fact, up to 25 percent of us exhibit some hoarding symptoms, with about two percent of adults actually meeting the diagnostic requirements of hoarding disorder.

Hoarding disorder often runs in families and while it occurs most commonly in people over the age of 55, symptoms can surface in early adolescence. You may have experienced great distress as a child when your parents took items away or curtailed your impulse to collect. In other cases, hoarding disorder develops after a stressful life event such as divorce, the death of a loved one, or unemployment.

Many people with hoarding disorder value their possessions as part of themselves or part of their relationships with loved ones. Discarding them becomes emotionally painful, like ending a relationship or throwing away a part of your own identity.

Common symptoms of hoarding disorder include:

• Having persistent difficulty discarding possessions, even those without any actual use or value, such as old newspapers, clothes, receipts, junk mail, food containers, broken nails, or plastic bags, for example.
• Having a perceived need to save items and experiencing emotional pain or distress at having to discard them.
• Attributing emotion to inanimate objects, having a strong sentimental attachment to possessions, or otherwise overestimating the importance of items.
• Worrying about running out of specific things, such as household items, or believing that you’ll one day find a use for even junk objects.
• Indecision and disorganization; not knowing what to keep or where to put things.
• Accumulating possessions to the extent that your living areas become congested, made safe and habitable only by the intervention of family or friends.
• Hoarding impacts your daily functioning at work, in your personal relationships, or in your health and well-being.

Many people with hoarding disorder also have other co-occurring mental health issues, such as depression, an anxiety disorder, PTSD, ADHD, or most commonly, Obsessive-Compulsive Disorder (OCD). In some cases, treating the underlying condition can help improve the symptoms of hoarding disorder.

[Read: Anxiety Disorders and Anxiety Attacks]

Hoarding disorder vs. OCD

Estimates suggest that up to 20 percent of people with hoarding disorder also suffer with OCD. However, people with OCD tend not to accumulate so many possessions that their homes become unmanageable. Acquiring items for them involves mainly negative emotions; it’s done to satisfy the unwanted and intrusive thoughts that trigger anxiety.

Someone with hoarding disorder, on the other hand, experiences both positive and negative emotions. They derive pleasure from acquiring a new possession, but distress when faced with discarding the object.

Self-help for hoarding disorder: Deciding to make a change

The hardest thing for someone with hoarding disorder is often deciding to address the issue. You may not see your behavior as a problem and so struggle to find the motivation to change. Or you may see change as too overwhelming or scary a proposition. You might think there’s so much mess to clear up that you’ll never get it all done, so what’s the point in even trying?

Whether you’re struggling to get or stay motivated, it can help to start by making a pros and cons list for changing how you acquire and retain possessions.

• Some of the advantages of changing your behavior could include being able to entertain friends and family in your home again, preserving your relationship with the person you live with, improving your health, or regaining control over your finances, for example.
• The cons or disadvantages could include discarding something you later find a use for, feeling that you’ve been wasteful, or enduring anxiety as you pass up the opportunity to acquire something new.

You can also look to the future and list how your life will look if you continue your hoarding behavior and how it will look if you make a change. Keep your lists on your phone so you can regularly remind yourself what you’re working towards.

Self-help tip 1: Take steps to clear and organize your home

When you have hoarding disorder, it’s easy to feel overwhelmed at the prospect of decluttering your home and getting organized. However, there are simple ways to break tasks down into smaller, more manageable steps.

Start easy—and work your way up

We all have some items that we find much harder to discard than others. Old bills or plastic bags, for example, are probably easier to throw away than photographs, greeting cards, or gifts that conjure up lots of memories or emotions.

To make it easier on yourself, create a list of all the different items you’ve been hoarding and rank them from 1 (easiest to discard) to 10 (hardest to discard). Known as a “fear ladder,” your list may look something like this:

Rather than trying to tackle the highest ranked items, those you’re most fearful of throwing away, start with the easier items. Sorting through the first category should make you feel slightly anxious, but not so fearful that you’re unable to attempt it.

As you work through your possessions and build up your tolerance to discarding items, you can gradually move up the fear ladder.

Take it one step at a time

Starting on the first rung of your fear ladder:

Set small but specific goals. Instead of setting yourself the goal of cleaning an entire room, aim to declutter just one shelf, one drawer, or one pile at a time.

Establish a set time to work on your goals each day, even if it’s just for 10 or 15 minutes at a time. It’s easier to stay motivated when you break tasks into bite-size pieces and don’t try to do too much at once.

Turn off your phone and avoid other distractions. It’s easy to lose focus if you try to multitask, so stick to the task at hand for the short time you’ve allotted.

Assign each item to a specific category. You might decide on a “keep” pile, a “garbage” pile, and a “recycle” or “donate” pile. However you label your categories, though, it’s important to decide the outcome for each item, rather than assign things to any type of vague “decide later” category.

Adhere to the “OHIO” rule. Only Handle It Once means that each time you pick up an item, you decide which category it belongs in. You might think that if you come back to an item later you’ll feel better able to decide what to do with it—but that will only add to the chaos. So, OHIO and choose a category.

Go easy on yourself. If you find cleaning a whole shelf or an entire drawer too overwhelming, that doesn’t mean you’ll never make progress or that you’ve somehow failed. Instead, set yourself a smaller goal—half a shelf or a smaller pile, for example—and work towards that.

Be proud of your successes. Taking a moment to acknowledge even small accomplishments can help keep you motivated. Try rewarding yourself with a tasty treat or an episode of your favorite TV show.

Tip 2: Improve your decision making

Making the decision to part with an item is rarely easy, but people with hoarding disorder tend to struggle with indecision more than most. You may find it hard to resist the temptation to assign things to your “keep” pile just in case you ever need them in the future. It could be that you find it difficult to deal with uncertainty, you’re always expecting the worst to happen, or you’re prone to perfectionism.

Learning to challenge anxious thoughts can help you look at the world in a more balanced, realistic way and cope with the anxiety that often fuels indecision.

You can also ask the following questions as you sort through your possessions:

1. Have you used this object in the last year or do you have a specific plan to use it in the next few months?
2. Do you have enough space for the object?
3. Is the item usable?
4. Do you have time to use (or read) the item?
5. How many similar objects do you already have?
6. Does keeping the item help you achieve your goals?
7. If it’s important enough to keep, is there a way to store the item digitally instead (see below)?

Tip 3: Learn to cope with discomfort

As you sort through your possessions, it’s normal to feel anxious, stressed, or uncomfortable. Discarding an object may trigger difficult memories or emotions. The scale of the task ahead could suddenly seem overwhelming and cause you to feel like giving up. Or the stress could make you want to revert back to your old patterns of behavior and go shopping, for example.

Whatever discomfort you experience, instead of trying to ignore an unpleasant feeling or urge, stay with it until it passes. Known as urge surfing, this technique requires you to ride the “wave” of an uncomfortable emotion like a surfer. Rather than battle, judge, or try to ignore your discomfort, if you allow yourself to experience it, you’ll see just how quickly even an unpleasant feeling will crest, break, and fade away.

Adopt a mindfulness practice

A lot of hoarding tendencies stem from worrying about the past—accumulating items that bring back certain memories, judging your past actions negatively—or stressing about the future—ruminating on “what if’s” and saving things that you may one day have a use for. The practice of mindfulness, on the other hand, encourages you to spend time in the present.

[Listen: Mindful Breathing Meditation]

By focusing your attention on the present moment and accepting it without judgment, you’re less likely to get caught up in worries about the future or regrets over the past. Practicing mindfulness regularly can help you relieve stress, deal with symptoms of anxiety and depression, and better deal with adverse events.

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Tip 4: Identify what triggers you to acquire more

The first step to changing how you acquire things is to identify your personal triggers. What situations, places, or feelings make you want to acquire items? Perhaps you online shop for clothes after a stressful day at work, browse yard sales when you’re bored, buy books and magazines when you’re feeling lonely, or treat yourself with a new figurine or ornament to celebrate a holiday.

Keeping a diary can help you identify the patterns behind your shopping habits. Whenever you acquire more things—or feel the urge to do so—take a moment to figure out what’s triggering the urge.

Once you identify the triggers and patterns in your behavior, you can find healthier ways to deal with the urge to acquire more things.

Manage stress. Stress is one of the biggest triggers to “retail therapy.” Instead of opening your wallet, though, try exercising or practicing a relaxation technique such as meditation, deep breathing, or yoga.

[Read: Stress Management]

Distract yourself. When you feel the urge to shop, engage your attention elsewhere, by taking a walk, calling a friend, enjoying a bath, or watching a movie, for example. Once your attention has switched to something else, the urge often fades away.

Talk to someone. When you notice a craving, turn to a friend or family member you trust, someone who won’t judge you. Sharing what you’re going through is a great way to relieve stress, improve how you feel, and end the craving.

Accept the urge and ride it out. Use the urge surfing technique outlined above. The emotion that triggered the urge will often quickly pass if you allow yourself to simply feel it rather than act on it.

Delay. If you don’t feel you’re able to fight the urge to acquire something, try to delay it for just a short time. Walk away and try to hold off for one minute. If you succeed, try to hold off for five minutes. If you can keep stretching it out in this way, you’ll often find the urge passes naturally.

Stick to your shopping list. We all have to shop for groceries, toiletries, and other day-to-day items. Once you’re in the store, though, it’s easy to be tempted to buy other items you don’t need. If you shop weekly, take stock of the items you already have and prepare a list of things you will realistically use that week—and then stick to it. If online shopping isn’t a trigger for you, try ordering your groceries online so you’re less likely to make impulse purchases in-store.

Tip 5: Seek support

It can be tempting to try to hide your hoarding problem from friends and loved ones out of shame or embarrassment. But opening up to someone you trust can help you feel less alone—and an extra pair of hands can be invaluable in reducing the clutter in your home.

If you’ve had bad experiences in the past of others helping you clear up your home, it’s important to set boundaries. Be specific about what you want help with and for how long. While the final decision about whether to discard or keep something should always be yours, being open to other people’s ideas can help you make better decisions or find new solutions.

You can also seek support by:

Joining a support group. Talking regularly to others who are facing the same challenges can offer up lots of new coping tips. You can find in-person and online support groups by connecting to local senior centers, searching online, or accessing the resources in the Get more help section below.

Finding a “clutter buddy”. Working through your hoarding issues with someone who understands the problem firsthand is a great way to stay on track. Reach out to a friend or neighbor who may be in the same situation or pair up with someone from a support group. Set up regular times to talk, tackle decluttering tasks together, or offer each other support and encouragement.

[Read: Helping Someone with Hoarding Disorder]

Seeking professional help. Cognitive behavioral therapy (CBT) can help treat hoarding disorder by changing the way you think and act. Working with the right therapist can help with decision-making, how you tackle clutter, and resisting urges to acquire more things.

Authors: Lawrence Robinson and Melinda Smith, M.A.

• References

  Grisham, J. R., & Norberg, M. M. (2010). Compulsive hoarding: Current controversies and new directions. Dialogues in Clinical Neuroscience, 12(2), 233–240.
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181962/

  Nordsletten, A. E., Reichenberg, A., Hatch, S. L., Cruz, L. F. de la, Pertusa, A., Hotopf, M., & Mataix-Cols, D. (2013). Epidemiology of hoarding disorder. The British Journal of Psychiatry, 203(6), 445–452. https://doi.org/10.1192/bjp.bp.113.130195

  Dozier, M. E., & Ayers, C. R. (2017). The Etiology of Hoarding Disorder: A Review. Psychopathology, 50(5), 291–296. https://doi.org/10.1159/000479235

  Weiss, K. J., & Khan, A. (2015). Hoarding, Housing, and DSM-5. Journal of the American Academy of Psychiatry and the Law Online, 43(4), 492–498. http://jaapl.org/content/43/4/492

  Tolin, D. F. (2010). Is cognitive–behavioral therapy more effective than other therapies?: A meta-analytic review. Clinical Psychology Review, 30(6), 710–720. https://doi.org/10.1016/j.cpr.2010.05.003

  Obsessive-Compulsive and Related Disorders. (2013). In Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425787.x06_Obsessive_Compulsive_and_Related_Disorders

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Last updated: October 21, 2022