What Is Hoarding or Disorder?

Hoarding disorder, previously called compulsive hoarding, is a mental illness characterized by:

- persistent difficulty in throwing away or parting with possessions, not based on their actual value

- accumulation of possessions that congest and clutter active living areas of the home, and sometimes the entire house

- significant impairment of functioning in one or more home areas because of accumulated clutter

There may also be distress or anxiety from even the idea of getting rid of possessions.

Hoarding behavior can be difficult to recognize, even in yourself, because it often develops gradually over time. You might not even realize how much your belongings are affecting your life until you reach crisis point.

Symptoms

Signs and symptoms of hoarding disorder include:

- Acquiring an excessive number of items, often including items that are discarded or given to you for free.

- Keeping items that you don’t use, want or need.

- Difficulty organizing or prioritizing items.

- Frequently feeling a strong desire to save items and becoming upset or anxious at the thought of getting rid of them.

- Procrastinating or becoming stuck when it is time to get rid of items.

- Having difficulty leaving areas in your home open due to the accumulation of clutter.

- Feeling ashamed or embarrassed about the state of your home or feeling defensive or angry when others talk to you about it.

- Having difficulty with home organization and managing your time or financial affairs.

- Having tension, anxiety or other negative emotions when you try to declutter or discard anything.

- Spending most of your time trying to manage your belongings.

Treatment

Cognitive behavioral therapy (CBT), a form of psychotherapy that changes the way people think, feel and behave, is the mainstay of treatment for hoarding disorder. The goals of CBT are to help you:

- Understand your attitudes, beliefs and behaviors about your possessions.

- Develop and practice new organizational skills.

- Work through feelings of loss, guilt and shame related to discarding items.

- Identify your priorities.

- Set realistic goals.

- Solve problems effectively.

- Manage your time more effectively.

- Improve social skills.

- Practice self-care behaviors.

There are also different levels of treatment intensity (e.g. individual, group or clinic based). The best level of treatment intensity depends on the severity of your hoarding, whether or not you have other mental illnesses and whether or not you have support from family or friends.

There are limited data on the use of medications to treat hoarding disorder. However, some medications, typically used for treating depression, anxiety or obsessive-compulsive disorder, may be helpful in reducing hoarding symptoms in some people.