Everything You Need To Know About Hoarding Disorder

Contrary to what reality TV portrays, hoarding disorder is a serious—and often dangerous—mental health condition

June 17, 2023

Hoarding disorder is a mental health condition characterized by saving items that appear to have little or no worth, often accumulating magazines, mail, newspapers, and old clothing.

Between reality TV shows and common misconceptions about the condition, hoarding disorder is deeply misunderstood by many. People with hoarding disorder find themselves accumulating items to the point where the objects overrun their living spaces.

On top of emotional and mental health concerns, hoarding disorder can present a physical danger to the person struggling with the condition and the people they share their home with.

Living in unsafe conditions and having clutter accumulated throughout your home is a quality-of-life issue. Stress, shame, and anxiety are just some of the feelings that can accompany this serious mental health issue.

However, there is no need to feel ashamed. According to the American Psychiatric Association (APA), hoarding disorder affects approximately 2.6% of all adults, with similar symptoms and incidence occurring across countries, cultures, and genders.

The clutter that results can present safety and health concerns. It can create emotional distress in the person with the condition, as well as in family members and friends. Hoarding disorder often co-occurs with other mental health conditions.

It’s important to understand what hoarding disorder looks like so you can recognize if you or someone you know should seek help.

Keep Reading To Learn

  • How to recognize the signs of hoarding disorder
  • Which factors contribute to developing hoarding disorder
  • How to successfully manage hoarding disorder

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Dr. Jeff Szymanski talks about hoarding disorder and how to help someone who is struggling

The Signs and Symptoms of Hoarding Disorder

Saving excessive numbers of random objects is the first sign of hoarding disorder. Gradually, clutter may build up until there’s no living space. Since this happens over time, it may go unnoticed until someone points out how cluttered an area has become.

Symptoms of hoarding disorder can begin as young as the early teen years. As time goes by, symptoms tend to become more severe and harder to change.

People with the condition continue to accumulate things even when they run out of room or don’t need the items. Because people with hoarding disorder often store objects in their homes, it can be some time before others find out that someone is hoarding.

Many people with hoarding disorder may avoid letting other people enter their homes. This can lead to isolation, which further worsens many mental health issues.

Signs and symptoms of hoarding disorder include:

  • Excessive accumulation of items with limited or no space to store them
  • Difficulty parting with possessions of trivial value
  • Compulsion to save items or feeling upset if someone suggests throwing them out
  • Accumulating clutter until it’s difficult or impossible to move in living spaces
  • Indecisiveness, avoidance, procrastination, and disorganization

Accumulated items pose a tripping hazard. If there’s an emergency, first responders may not be able to access rooms in the home if there are too many items in the way. Clutter in the kitchen or bathroom may make it extremely difficult to cook or bathe.

Trying to live in overly cluttered rooms can create stress for members of a household.

It can also cause conflict: others may want to remove items that are important to the person who is hoarding things.

Collecting Items vs. Hoarding: What’s the Difference?

People with hoarding disorder may describe themselves as over-enthusiastic collectors. However, this isn’t true for several reasons.

Hoarding disorder involves difficulty parting with any possessions. If someone with the condition tries to discard items, they experience deep distress. Therefore, they begin to accumulate these things in their homes and other places.

Collectors, on the other hand, acquire items and organize them in an intentional way. Collectors often want to obtain specific objects that ultimately can be passed on to others or sold for monetary value. Although they may not use the objects, they’re able to display them for others to admire.

Hoarding disorder is typically impulsive, lacks organization, and rarely involves giving up items once obtained. While not all hoarding behavior is disruptive, many people with the disorder feel ashamed of the clutter in their homes and intentionally do not show it to others.

People over the age of 60 who have other mental health challenges are more likely to exhibit hoarding behavior. This is particularly true for those struggling with depression and anxiety.

What Is OCD?

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Though not the same, obsessive compulsive disorder and hoarding disorder share some similarities. Learn everything you need to know about OCD.

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What Causes Hoarding?

At this time, researchers haven’t pinpointed clear causes of hoarding disorder. However, genetics and brain functioning seem to play a role.

According to a 2009 article in the American Journal of Psychiatry, 50% of people with hoarding disorder know at least one relative with the condition. In fact, many people with hoarding disorder grew up in cluttered homes. Clutter may give them comfort.

Risk Factors

Hoarding disorder often begins between the ages of 11 and 15. However, hoarding behavior often happens in older adulthood rather than young adulthood.

Some of the risk factors of hoarding disorder include:

  • Personality: Many people with hoarding disorder show indecisiveness or perfectionism
  • Heredity: If you have a family member with hoarding disorder, you are more likely to develop it yourself
  • Stressful life events: Triggers such as the death of a loved one, an eviction, or divorce may trigger hoarding behavior

Conditions Associated With Hoarding Disorder

Many people with hoarding disorder have other mental health conditions. According to the APA, 75% of people with the condition also have a mood or anxiety disorder.

Other conditions that frequently occur alongside hoarding disorder include obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), dementia, and attention deficit hyperactivity disorder (ADHD).

Often, these coexisting conditions are the main reason people seek treatment before hoarding disorder is identified. People with hoarding disorder are also more likely to receive help when a concerned family member asks a mental health professional to intervene.

Individuals with hoarding disorder often resist seeking treatment because they feel shame about their condition. They may not realize the extent or seriousness of their issue.

Those with hoarding disorder deserve help to reduce feelings of distress and to create a healthier environment living environment for themselves and those around them.

Diagnosing Hoarding—Is it Time To Bring in a Health Care Provider?

If hoarding is affecting a healthy standard of living or making a home unsafe, it’s time to see a professional.

With the help of a mental health professional, individuals can receive an evaluation and treatment to overcome hoarding behavior and live a healthier life.

Prior to a diagnosis and treatment, a therapist meets with the individual to discuss their symptoms. A diagnosis of hoarding disorder involves a professional assessment based on criteria in The Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5).

In earlier versions of the DSM, hoarding behavior was listed as a symptom of OCD. In 2013, the APA reclassified hoarding as a distinct disorder.

An official hoarding disorder assessment may follow if these criteria are met:

  • Difficulty throwing away useless items
  • Accumulating items until they fill up the available living space
  • Becoming anxious, distressed, and depressed at the thought of giving up belongings
  • Exhibiting compulsive behavior to buy, steal, or scavenge possessions
  • Having delusional thoughts when it comes to evaluating hoarding habits
  • No history of a brain injury or other condition that may account for unusual behavior

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How Hoarding Disorder Is Treated

Fortunately, mental health specialists can effectively treat people with hoarding disorders.

Cognitive Behavior Therapy

According to the American Psychological Association, cognitive behavior therapy (CBT), is the most well-studied method for treating hoarding disorder. CBT focuses on dealing with the thoughts and emotions that lead to hoarding behavior.

With CBT, a person learns to identify thoughts and beliefs that trigger saving or accumulating items. Gradually, the individual learns to resist the urge to purchase or bring home additional objects.

People with the condition can learn coping skills that help them make better decisions. For example, someone may examine the importance of decluttering their home by focusing on safety and health concerns.

Motivational Interviewing

Motivational interviewing (MI) is another intervention for hoarding disorder.

According to the International OCD Foundation, motivational interviewing involves exploring any uncertainty a person may have about acknowledging and changing hoarding behavior.

With this type of treatment, a therapist helps the patient explore goals and values while reviewing their current circumstances.

Motivational interviewing taps into a person’s natural motivation to change. It encourages a person to place increasing importance on changing a specific behavior, and boosts the person’s confidence that they can actually make such changes.

Group Therapy and Family Therapy

Many treatment programs include group therapy and family therapy. Through these interventions, individuals with hoarding disorder and members of their support systems can learn the best ways to help you overcome hoarding behavior.

Harm Reduction for Hoarding Disorder

In recent years experts have recommended harm-reduction methods for treating hoarding disorder.

Harm reduction focuses on decreasing the effects of high-risk behavior. It does not require someone to stop their behavior before they receive care. It meets them where they are.

In this form of treatment, the person with hoarding disorder, their family members, and their therapist work together to address the issue.

According to the Oxford Handbook of Hoarding and Acquiring, family-focused harm reduction for hoarding includes enhancing the willingness of a patient and family to engage in treatment, assessing harm potential, creating a harm reduction team, and implementing and managing a harm reduction plan.


The Food and Drug Administration (FDA) has not yet approved any official medications for hoarding disorder.

Medications prescribed for those with hoarding disorder often treat co-occurring disorders, such as depression and anxiety. Researchers continue to look for effective medications for hoarding disorder, specifically.

Recognizing Hoarding Disorder Symptoms in Yourself

Hoarding disorder can have a dramatic impact on your life and the lives of those you love. If you live with other family members, it might cause significant stress and conflict.

The following strategies can help you stay on track in a treatment plan you develop along with a mental health professional.

1. Stick to the Program

Keep in mind that it’s normal to have setbacks. If your recovery doesn’t go as smoothly as you wish, don’t beat yourself up.

Trust that with time, practice, and support, you can get better.

2. Accept Help

Mental health professionals can help put you on the road to recovery. Consider including the support of loved ones to help you remain on that path.

If you have family members willing to help you organize and unclutter your living space, strongly consider accepting. Often, family and friends want you to get well and are willing to assist you to make that happen.

3. Socialize

Because of shame and stigma, people with hoarding disorder can become isolated. By taking small steps to connect with others, you can improve your outlook.

If you’re normally a solitary person, socializing may not be easy for you. You don’t have to go out with a large group of people if it makes you feel uncomfortable.

Instead, choose one friend or a couple of family members to have lunch with or watch a movie together. By choosing low-key activities, you can slowly get used to spending time with others.

You can also look for support groups online to find fellowship with others who experience hoarding disorder.

4. Practice Self-Care

If you recently uncovered your kitchen and bathroom, reintroduce yourself to self-care. Buying and preparing nutritious food, regularly taking showers, and enjoying your space can go a long way towards building up your resolve. Of course, you’ll also look and feel better.

As you become more confident, you may want to have a close friend or family member over for a cup of tea or a simple card game. This can help motivate you to keep your space uncluttered.

5. Consider the Welfare of Loved Ones

People with hoarding disorder may not recognize the impact that it has on their loved ones—whether it’s parents, children, or pets. The condition can be stressful for you and those that you care about.

If hoarding goes unaddressed, it can lead to family members experiencing resentment, anger, and in some cases, depression. Children may be impacted socially, and if living conditions are dire enough, the family may lose custody of kids or pets.

Addressing hoarding to help improve quality of life for your family can lead to a much happier home and better health outcomes for all household members.

McLean Is Here To Help

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McLean provides world-class treatment for disorders like hoarding and OCD. Call us today at 617.855.2776 to learn more about treatment options.

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How To Help a Loved One With Hoarding Disorder

If you believe someone close to you may have hoarding disorder, it’s important to address the issue with compassion. Their condition is not their fault.

When suggesting that a loved one receive help, a good place to start is researching local therapists, support groups, workshops that specialize in hoarding disorder, and online resources.

Friends and family members of those with hoarding disorder can find it beneficial to care for their own mental well-being.

Many family members also experience shame and stigma about their loved one’s condition. They struggle to understand the situation and often don’t know what to do. They may also need support for any challenges stemming from growing up in a cluttered home, or from relationship difficulties that living with someone with hoarding disorder can pose.

Friends and family of people with hoarding disorder can benefit from individual therapy, family therapy, group therapy, and support groups.

A patient’s outlook for recovery is greater when their family members receive treatment. This is because therapy can help family members understand some of the reasons behind their loved one’s behavior. They can learn how to support a loved one throughout recovery.

The following aspects of the family-focused harm reduction model from the Oxford Handbook of Hoarding and Acquiring may be helpful to consider when supporting a loved one:


It’s important to learn about hoarding disorder and understand that the behavior is not your loved one’s fault.

  • It can be helpful to remember that hoarding disorder is not a choice; your loved one may find it distressing to part with items
  • Your friend or family member with hoarding disorder may not recognize or acknowledge their condition
  • Tasks like cleaning a room, which may be easy for you, can be difficult for your loved one

Effective Communication

How you express your feelings about the situation can go a long way in supporting and encouraging your loved one.

Avoid using language that blames the person with hoarding disorder. When possible, use “I” statements to describe how the behavior affects you. For example, instead of saying, “This place is such a mess,” say, “I’m concerned about your safety.”

Consider using your loved one’s terms for objects as a way to relate to their way of seeing things. If they refer to their “treasures” or “things,” consider using these terms, as well. Keep in mind that many people with hoarding disorder also object to the term “hoarding.”


When possible, take steps to foster a healthy relationship with your loved one.

Ask before you clean up or move objects. Although you may think you’re helping by decluttering your friend or family member’s possessions, they could feel controlled or disrespected. If you ask first, you’re more likely to foster trust.

Consider spending time with your loved one in their home for brief social activities. Even though you or your loved one may feel uncomfortable in the cluttered environment, this step could help your loved one feel more accepted. It may also motivate them to take steps to organize some areas.

Helping someone with hoarding behaviors can be a complicated process.

Often, individuals with hoarding disorder have a hard time recognizing the extent of the issue. They may also have difficulty coping with other responsibilities, such as returning calls, washing dishes, checking mail, or paying bills.

As part of their condition, a loved one may have irregular sleep patterns, find it challenging to adhere to regular therapy, and struggle in their interactions with others.

Because they take comfort in their possessions—in some cases, including pets—they can find it distressing to part with them.

How to Help With Animal Hoarding

Animal hoarding is a complex situation. People who hoard animals often start out with a genuine desire to help. They are attached to their pets, even if they cannot care for them.

With the best of intentions, individuals with hoarding disorder can sometimes take in more animals than they can care for. However, this type of hoarding creates suffering for the animals and unsanitary conditions for the people living with them. If the carer can’t provide the right nutrition or veterinary care for the pets, it may be time to re-home some of the animals with loving families.

Giving up pets can be difficult—but remember that pets deserve healthy, happy living conditions, too.

The American Society for the Prevention of Cruelty to Animals (ASPCA) recommends calling your local chapter of the Humane Society of the United States, your local humane law enforcement department, police department, animal welfare organization, or veterinarian as a first step in getting people and animals the care they need.

Children With Hoarding Disorder

Since hoarding behavior often begins in the preteen and early teen years, it’s essential to find therapy for children who show hoarding behavior.

Often, parents are involved in the treatment of their children’s hoarding disorder. As part of therapy, parents learn how to cope with their child’s behavior in a healthy and productive way.

Hoarding disorder is a condition that becomes progressively worse with age. Receiving treatment early can help prevent a lifelong struggle with the condition.

Don’t Give Up—Help and Hope Are Out There

If you or a loved one is hoping to overcome hoarding disorder, it’s important to know that help is available. Mental health professionals, support groups, and local agencies can provide tools and support for recovery.

Admitting that you or a loved one needs help is just the first step, but it’s an important one. Know that you aren’t alone.

By participating in therapy and support groups, you can learn more about hoarding disorder and how widespread it is. You can find understanding and develop skills to overcome this often-misunderstood condition.

Want More Information?

You may find these resources helpful:

International OCD Foundation (IOCDF)
The IOCDF offers robust resources including information on therapists, clinics, and support groups in your area that specialize in hoarding disorder.

The National Alliance on Mental Illness (NAMI)
NAMI provides links to networks of hoarding cleanup services and mental health professionals who specialize in hoarding disorder.

Hoarding Cleanup
Hoarding cleanup offers professional cleaning services for people with hoarding disorder as well as free, anonymous support groups for people with hoarding disorder and their loved ones.