Hoarding disorder - NHS

A hoarding disorder is where someone acquires an excessive number of items and stores them in a chaotic manner, usually resulting in unmanageable amounts of ... Skiptomaincontent Home Mentalhealth Mentalhealthconditions Backto Mentalhealthconditions Hoardingdisorder Ahoardingdisorderiswheresomeoneacquiresanexcessivenumberofitems andstorestheminachaoticmanner,usuallyresultinginunmanageableamountsofclutter.Theitemscanbeoflittleornomonetaryvalue.Hoardingisconsideredasignificantproblemif:theamountofclutterinterfereswitheverydayliving–forexample,thepersonis unabletousetheirkitchenorbathroomandcannotaccessroomstheclutteriscausingsignificantdistressornegativelyaffecting thequalityoflifeofthepersonortheirfamily– forexample,theybecomeupsetifsomeonetriestocleartheclutterand theirrelationshipsuffersHoardingdisordersarechallengingtotreatbecausemanypeoplewhohoardfrequentlydonotseeitasaproblem,orhavelittleawarenessofhowit'saffectingtheirlifeorthelivesofothers.Somemayrealisetheyhaveaproblembutarereluctanttoseekhelpbecausetheyfeelextremelyashamed,humiliatedorguiltyaboutit.It'sreallyimportanttoencourageapersonwhoishoardingtoseekhelp,astheirdifficultiesdiscardingobjectscannotonly causelonelinessandmentalhealthproblemsbutalsoposeahealthandsafetyrisk.Ifnottackled,it'saproblemthatwillprobablynevergoaway. Whysomeonemay hoardThereasonswhysomeonebeginshoardingarenotfullyunderstood.Itcanbeasymptomofanothercondition.Forexample,someonewithmobilityproblemsmaybephysicallyunabletoclearthehugeamountsofcluttertheyhaveacquired,andpeoplewithlearningdisabilitiesorpeopledevelopingdementiamaybeunabletocategoriseanddisposeofitems.Mentalhealth problemsassociatedwithhoardinginclude:severe depressionpsychoticdisorders,suchas schizophreniaobsessivecompulsivedisorder(OCD)Insomecases,hoardingisaconditioninitselfandoftenassociatedwithself-neglect.Thesepeoplearemorelikelyto:livealonebeunmarriedhavehadadeprivedchildhood,witheitheralackofmaterialobjectsorapoorrelationshipwithothermembersoftheirfamilyhaveafamilyhistoryofhoardinghavegrownupinaclutteredhomeandneverlearnedtoprioritiseandsortitemsManypeoplewhohoardhavestronglyheldbeliefsrelatedtoacquiringanddiscardingthings,suchas:"Imayneedthissomeday"or"IfIbuythis,itwillmakemehappy".Othersmaybestrugglingtocopewithastressfullifeevent,suchasthedeathofalovedone.Attemptstodiscardthingsoftenbringupverystrongemotionsthatcanfeeloverwhelming,sothepersonhoardingoftentendstoputofforavoidmakingdecisionsaboutwhatcanbethrownout.Often,manyofthethingskeptareoflittleornomonetaryvalueandmaybewhatmostpeoplewouldconsiderrubbish.Thepersonmaykeeptheitemsforreasonsthatarenotobvioustootherpeople,suchasforsentimentalreasons,orfeelingtheobjectsappearbeautifuloruseful.Mostpeoplewithahoardingdisorderhaveaverystrongemotionalattachmenttotheobjects. What's thedifferencebetweenhoardingandcollecting?Manypeoplecollectitemssuchasbooksorstamps,andthisisnotconsideredaproblem.Thedifferencebetweena "hoard" anda "collection" ishowtheseitemsareorganised.Acollectionisusuallywellordered,andtheitemsareeasilyaccessible.Ahoardisusuallyverydisorganised,takesupalotofroomandtheitemsarelargelyinaccessible.Forexample,someonewhocollectsnewspaperreviewsmaycutoutthereviewstheywantandorganisetheminacatalogueorscrapbook.Someonewhohoardsmaykeeplargestacksofnewspapersthatcluttertheirentirehouseandmeanit'snotactuallypossibletoreadanyofthereviewstheywantedtokeep. Signs ofa hoardingdisorderSomeonewhohasahoardingdisordermaytypically:keeporcollectitemsthatmayhavelittleornomonetaryvalue,suchasjunkmailandcarrierbags,oritemstheyintendtoreuseorrepairfindithardtocategoriseororganiseitemshavedifficultymakingdecisionsstruggletomanageeverydaytasks,suchascooking,cleaningandpayingbillsbecomeextremelyattachedtoitems,refusingtoletanyonetouchorborrowthemhavepoorrelationshipswithfamilyorfriendsHoardingcanstartasearlyastheteenageyearsandgetsmorenoticeablewithage.Formany,hoardingbecomesmoreproblematicinolderage,buttheproblemisusuallywellestablishedbythistime. Items peoplemay hoardSome peoplewitha hoardingdisorder willhoardarangeofitems,whileothersmayjusthoardcertaintypesofobjects.Itemsthatareoftenhoardedinclude:newspapersand magazinesbooksclothesleafletsandletters,includingjunkmailbillsandreceiptscontainers,includingplasticbagsandcardboardboxeshouseholdsuppliesSomepeoplealsohoardanimals,whichthey maynotbeabletolookafterproperly.Morerecently,hoardingofdatahasbecomemorecommon.Thisiswhere someonestoreshugeamountsofelectronicdataandemailsthatthey'reextremelyreluctanttodelete. WhyhoardingdisordersareaproblemAhoardingdisordercanbeaproblemforseveralreasons.Itcan takeovertheperson'slife,makingitverydifficultforthemtogetaroundtheirhouse.Itcancausetheirworkperformance,personalhygieneandrelationshipstosuffer.Thepersonhoardingisusuallyreluctantorunabletohavevisitorsorevenallowtradesmenintocarryoutessentialrepairs,whichcancauseisolationandloneliness.Thecluttercan pose ahealthrisktothepersonandanyonewholivesinorvisitstheirhouse.Forexample,itcan:makecleaningverydifficult,leadingto unhygienicconditionsandencouragingrodentorinsectinfestationsbe afirerisk andblockexitsintheeventofafirecausetripsand fallsfalloverorcollapseonpeople,ifkeptinlargepilesThehoarding couldalso beasignofanunderlyingcondition,suchasOCD,othertypesofanxiety,depressionanddementia. WhatyoucandoifyoususpectsomeoneishoardingIfyouthinkafamilymemberorsomeoneyouknowhasahoardingdisorder,trytopersuadethemtocomewithyoutoseeaGP.Thismaynotbeeasy,assomeonewhohoardsmightnotthinktheyneedhelp.Trytobesensitiveabouttheissueandemphasiseyourconcernsfortheirhealthandwellbeing.Reassurethemthatnobodyisgoingtogointotheirhomeandthroweverythingout.You'rejustgoingtohaveachatwiththedoctorabouttheirhoardingtoseewhatcanbedoneandwhatsupport isavailabletoempowerthemtobegintheprocessofdecluttering.YourGPmaybeabletoreferyoutoyourlocalcommunitymentalhealthteam,whichmighthaveatherapistwho'sfamiliarwithissuessuchasOCDandhoarding.Ifyouhavedifficultiesaccessingtherapy,thecharity OCD-UKmaybeabletohelp.It'sgenerallynotagoodideato getextrastoragespaceorcallinthecouncilorenvironmentalhealthtocleartherubbishaway.Thiswon'tsolvetheproblemandtheclutteroftenquickly buildsupagain. HowhoardingdisordersaretreatedIt'snoteasytotreat ahoardingdisorder,evenwhenthe personispreparedtoseekhelp,but itcanbeovercome.Themaintreatmentiscognitivebehaviouraltherapy (CBT).Thetherapistwillhelpthepersontounderstandwhatmakesitdifficulttothrowthingsawayandthereasonswhytheclutterhasbuiltup.Thiswillbecombinedwithpracticaltasksandaplantoworkon.It'simportantthepersontakesresponsibilityforclearingtheclutterfromtheirhome.Thetherapistwillsupportandencouragethis.Antidepressantmedicinescalledselectiveserotoninreuptakeinhibitors(SSRIs) havealsobeenshowntohelpsomepeoplewith hoardingdisorders.Ifapersoniswillingtoseekhelpthentheymayfeelmorecomfortablecontactingatherapistthemselves.TheycanreferthemselvesdirectlytoanNHSpsychologicaltherapiesservice(IAPT)withoutareferralfromaGP.FindanNHSpsychologicaltherapiesservice(IAPT)Cognitivebehaviouraltherapy(CBT)CBT isatypeoftherapythataimstohelpyoumanageyourproblemsbychanginghowyouthink (cognitive)andact(behaviour).Itencouragesyoutotalkabouthowyouthinkaboutyourself,theworldandotherpeople,andhowwhatyoudoaffectsyourthoughtsandfeelings.RegularsessionsofCBToveralongperiodoftimeareusuallynecessaryandwillalmostalwaysneedtoincludesomehome-basedsessions,workingdirectlyontheclutter.Thisrequiresmotivation,commitmentandpatience,asitcantakemanymonthstoachievethetreatmentgoal.Thegoalisto improvetheperson'sdecision-makingandorganisationalskills,helpthemovercomeurgestosaveand,ultimately,cleartheclutter,roombyroom. Thetherapistwon'tthrowanythingawaybutwillhelpguideandencouragethepersontodoso.Thetherapistcanalsohelpthepersondevelopdecision-makingstrategies,whileidentifyingandchallengingunderlyingbeliefsthatcontributetothehoardingproblem.The persongradually becomesbetteratthrowingthingsaway,learningthat nothingterriblehappenswhentheydoandbecomesbetteratorganisingitemstheyinsistonkeeping.Attheendoftreatment,thepersonmaynothaveclearedalltheirclutter,butthey willhavegainedabetterunderstandingoftheirproblem.Theywillhave aplantohelpthemcontinuetobuildontheirsuccessesandavoidslippingbackintotheiroldways. Pagelastreviewed:1June2022 Nextreviewdue:1June2025