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Hoarding Disorder: What it is and How to Help

2014-08-18



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Believe it or not, mental disorders such as anorexia nervosa and obsessive compulsive disorder (OCD) only represent about 1% (respectively) of the U.S. population, while hoarding disorder may affect up to 5% of the U.S. population! Of course, this doesn’t mean that any one illness is more “important” than the other, but hoarding disorder is now more prevalent than previously thought. It wasn’t until recently that the disorder gained widespread awareness, when popular TV shows such as A&E’s Hoarders and TLC’s Hoarding: Buried Alive shed some light on the mental illness. Before the early 1990′s, there was very little research on hoarding. It wasn’t until May 2013 that hoarding disorder was officially recognized as its own entity.

How is hoarding disorder diagnosed?

Mental health professionals (and insurance companies) refer to the Diagnostic and Statistical Manual of Mental Disorders (the latest edition, DSM-5) to diagnose and treat psychiatric disorders. The DSM-5 diagnostic criteria for hoarding disorder include:

  • Having difficulty throwing out or parting with things, regardless of actual value.
  • Feeling the need to save items, and feeling upset by the thought of discarding them.
  • Possessions crowding and cluttering living areas, making the space unusable.
  • Significant distress or problems functioning at work, socially, or in other important areas.
  • Hoarding is not due to another medical condition, such as a brain injury, or another mental disorder symptom, such as decreased energy from major depression.

What kind of items do people hoard?

Generally, people with hoarding disorder hold onto common possessions, such as newspapers, mail, books, clothing, containers, and boxes. The items collected are sometimes valuable, but they always exceed in what can be reasonably used. In some cases, people hoard garbage or rotten food. In rare instances, people may hoard animals or human waste products.

Interesting facts about hoarding disorder.

  • Andy Warhol was a hoarder, and his four-story Upper East Side town house was so jammed with clutter that the only two rooms with paths through them were the kitchen and bedroom. When he died in 1967, he left behind over 600 cardboard boxes that he called “time capsules.”
  • Hoarding has been identified as a direct contributor for up to 6% of all deaths by house fire.
  • In a study where subjects with hoarding disorder had to choose whether to keep or discard their personal possessions, scans displayed an overactive anterior cingulate cortex, which is a part of the brain that controls decision-making. Interestingly enough, that part of the brain was underactive when they were asked to make a decision about other people’s possessions.

How can you help yourself (or someone else) deal with hoarding disorder?

1. Seek professional help.

The Anxiety and Depression Association of America has a qualified therapist finder which includes those who specialize in hoarding disorder. Cognitive Behavioral Therapy (CBT) seems to be the most effective method thus far, so make sure that you seek a professional who utilizes this form of therapy.

2. Don’t expect change overnight.

Once the hoarder is ready for your help, you can start to begin the cleaning process. It’s not your job to understand the reasons behind a person’s hoarding, so try to avoid getting frustrated, even if you think certain items should be thrown out. Each individual with hoarding disorder is going to move at his or her own pace, so any effort the hoarder makes to throw something away should be celebrated as a victory. If you’re allergic to dust or mold, ask your doctor about preventative measures that you can take before going inside of the hoarder’s home.

Once the hoarder has made some progress and is ready to make some bigger changes, try a company such as 1-800-GOT-JUNK?. The full-service company has been around for over 20 years, and has lots of experience with hoarders in particular. In fact, you might remember seeing them on A&E’s Hoarders. They don’t just throw out everything they come across–they do their best to donate or recycle any clean, lightly used items. To date, 1-800-GOT-JUNK? has prevented over 2 billion pounds of material from being sent to landfills.

Keep in mind: you’re probably going to need to make multiple trips, but that’s okay. Coming off as judgmental is rarely (if ever) effective in any given situation. Try to remain as calm and supportive as you can.

3. Learn more about hoarding disorder.

Psychiatry.org, OCFoundation.org, and ADAA.org offer helpful information about hoarding disorder.

You can also read books such as:

Sources:
http://www.medscape.com/viewarticle/803884_7
http://www.ocfoundation.org/hoarding/
http://www.dsm5.org/
http://www.psmag.com/navigation/health-and-behavior/hoarding-science-55196/
http://www.webmd.com/mental-health/features/harmless-pack-rat-or-compulsive-hoarder
http://www.mayoclinic.org/diseases-conditions/hoarding-disorder/basics/definition/con-20031337
http://www.sutterhealth.org/eap/employees/resources/anorexia.html
http://www.nimh.nih.gov/news/science-news/2012/brain-hubs-boil-when-hoarders-face-pitching-their-own-stuff.shtml