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Hoarding: More Than Just a Mess

Hoarding is a common problem that is difficult to treat.
By Eric Metcalf, MPH
WebMD Feature
Reviewed by Joseph Goldberg, MD

Judith Kolberg is accustomed to walking into cluttered homes. As a professional organizer, the Decatur, Ga., woman helps clients straighten messy closets, tame stacks of paperwork, and bring order to their chaos.

In the past 25 years, she’s also entered the homes of about a dozen people who could be diagnosed as hoarders -- and countless others who came close.

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“It’s a pretty sensory experience, let me put it that way. There’s obviously the assault on your eyes of the quantity of the clutter, then there’s the appreciation of what a mishmash the clutter is. Sometimes there’s more than your average share of odor, dust, mold, or other types of structural damage,” she says.

This problem has gained wider visibility in recent years, thanks in part to several hoarding-related television shows. Two percent to 5% of Americans may meet the criteria for being hoarders, says psychologist David Tolin, PhD, a hoarding specialist and author of Buried in Treasures.  Panic disorder might affect 1%, and obsessive-compulsive disorder maybe 2%. We’re talking about a surprisingly common disorder that had never really been recognized,” he tells WebMD.

Hoarding’s effects can extend beyond an overstuffed home. It can put people’s health at risk. It can damage families. It can affect surrounding neighborhoods. And treating it requires more than a big box of trash bags.

The Root of Hoarding: What Lies at the Bottom of That Pile

Experts usually draw the line between a merely messy lifestyle and hoarding “when it comes to the person’s ability to function,” Tolin says. “Lots of people may acquire things they don’t need, but if it’s not the sort of thing that causes an inability to function adequately, we don’t call it hoarding. If they’re no longer able to cook meals in their own home, if they can’t live safely in their own home, if they’re a threat to others, that’s where we’d say it crosses the line.”

People may hoard objects for many reasons, says Michael Tompkins, PhD, a psychologist and co-author of Digging Out: Helping Your Loved One Manage Clutter, Hoarding, and Compulsive Acquiring. These include:

  • An intense emotional attachment to objects that others see as trivial -- or even trash. They’d feel a sense of major loss if they had to throw this stuff away.
  • A sense that many items have an intrinsic value, like others might see in artwork or driftwood.
  • The assumption that an item might be useful someday, which compels them to save far more than “the drawer of hinges, thumbtacks, string, and rubber bands” that many of us keep.

In the past, experts saw hoarding as an “an outgrowth of obsessive-compulsive disorder (OCD)," Tolin tells WebMD. “But as we have more studies coming in, we’re increasingly seeing that it’s not. It seems like there is not a particular special or strong relationship with OCD. Much more common are problems like major depression disorder, anxiety, and attention deficit disorder.”

Studies have found that the frontal lobe within the brain of someone who hoards tends to work differently, he says. This region is crucial for weighing options and thinking rationally. As a result, their priorities are different from those of non-hoarders, and “those are things we can imagine might feed into a hoarding problem,” Tolin says.

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