By Mohammed Adil Sethi, Content Team Academic
Hoarding is a DSM-IV mental disorder where an individual has marked difficulty in discarding or abandoning owned possessions (Ferreira et al. 2020; Ricci et al. 2023). This informative piece will cover the differences between hoarding and collecting items, the prevalence of hoarding anxiety disorder, its consequences, diagnosis, associated mental health conditions, and treatment options.
The Difference Between Hoarding And Collecting
Hoarding is considered a subcategory of a distinct form of collecting, however, it is essential to understand that the two are distinct. Collectors usually buy items in a coordinated, purposeful and selective manner. They have a given speciality, and are well-informed about the items that are being collected. These items are then lovingly placed, appreciated and cleaned, without becoming an intrusion in the collector’s home, or their everyday life. Whilst buying behaviour may be carefully planned, and may involve considerable preparation on the part of the consumer, hoarding entails purchase decisions made without prior planning (Jaisoorya et al. 2020). These items accumulated by hoarders are random and have no connecting characteristics. They are often piled up in creative or purposeful ways, making the habitation of living spaces difficult.
Obsessive collecting of items is not a question of not wanting to tidy up, or of being lazy. It is a manifestation of a mental illness associated with anxiety disorder. Possessing and keeping things often helps reduce anxiety for a while, but this is only temporary. The effects are magnified by the clutter which becomes a source of anxiety in the long run. This makes depression worse, forming a cycle that is hard to circle out of without seeking help from a professional (Vieira et al. 2022).
Prevalence and Demographics
Hoarding disorder is evident in about 2.6% of the population, with prevalence rates increasing amongst individuals over the age of 60, and amonsgt those with psychiatric conditions, particularly anxiety and depression (American Psychiatric Association 2021). There does not seem to be any difference in the prevalence rate of the disorder across different countries, irrespective of the culture practised, but it is rampant among both men and women. Personality disorder starts occurring during adolescence and progresses with time, with the symptoms becoming more severe (American Psychiatric Association 2021). People often do not get treatment until middle age, and by that time the disorder is severe, usually interfering significantly with one’s life.
Consequences of Hoarding Disorder
Hoarding disorder has an impact on one’s life across the various areas of functioning. The first and probably the most obvious one is the impact on the living environment of the person with hoarding mental disorder (National Health Services 2022). Whenever the clutter piles up, the living spaces may not be usable, and this may pose some health risks, and may increase the risk of accidents. Some of the problems are fire risks, falling risks, and poor sanitation, considering that the structure cannot be cleaned efficiently (National Health Services 2022).
There are social and emotional effects that are prevalent alongside signs of hoarding disorder. People with hoarding disorder may have marital or family problems (domestic abuse, for example). Their symptoms and their living conditions may inconvenience their friends and relatives (American Psychiatric Association 2021). This may result in them becoming outcasts. They may lock everyone out, or they may be too shy to invite people into their houses for fear that the latter will glimpse into their lives and pity them. In the long run, such isolation leads to feelings of loneliness and consequent depression, which definitely worsens the mental health state of the person (Schou et al. 2020).
Diagnosing Hoarding Disorder
A diagnosis of hoarding disorder will follow an evaluation by a therapist, where the symptoms and the effect of hoarding on the life of the affected individual are considered. Diagnostics criteria are as follows: persistent difficulty in discarding items that the individual believes to be of little value or usefulness, and significant distress/ impairment in social, occupational or other important domains (National Health Services 2022). This may include an interview of the affected person, and sometimes their family members, and it may also involve questionnaires, or rating scales, to determine the extent of hoarding the person may exhibit.
Hoarding disorder is a complex and severe mental health issue, and not everyone suffering from this disorder is fully aware of the fact that they indeed have a problem that needs professional help. In scenarios where the person does not accept the fact that they have a problem, it may be challenging to make him or her accept that they need treatment (Prosser et al. 2024).
Associated Mental Health Conditions
Hoarding disorder is usually not seen in isolation, but is usually accompanied by other psychiatric disorders. Persons with hoarding disorder also present other psychiatric disorders such as anxiety disorders, depression, ADHD, and OCD (American Psychiatric Association 2021). These interrelated disorders can all cause difficulties in the treatment process of hoarding disorder as each of them must be treated individually, for example, hoarding disorder is different from OCD, but it interacts with it. Some patients diagnosed with hoarding disorder might use the treatments applied to OCD patients (American Psychiatric Association 2021).
Treatment Options
Cognitive behavioural therapy (CBT) is found to be the most helpful treatment method for hoarding disorder since it deals with changes in the perception and behaviour of the hoarder (National Health Services 2022). In CBT one is made to change the thinking that is associated with hoarding, and learn how to face the related anxiety with the aim of gradually stopping the process of hoarding (Kuwano et al. 2020). This process is ordinarily long-drawn, and needs a lot of patience and dedication, but it may drastically enhance the lifestyle of the patient undergoing therapy (Timpano et al. 2020). Family members can support and help in the process of cleaning the house, but it is necessary to do it gently so that the patient does not have more anxiety. In other circumstances, the family therapist can be of assistance as relationship problems are common in families who have a member who suffers from hoarding disorder (Gledhill et al. 2021; Mahnke et al. 2021).
Conclusion
Hoarding disorder is a severe and disabling illness, which impacts the lives of millions of people globally. Although it is related to OCD, it is a different disorder that has to be treated separately and needs proper management. CBT helps in treating individuals who suffer from hoarding disorder, and with proper support from family members, the quality of their life improves, most especially when they seek help early enough. The process of recovery is not always easy, and can take a lot of time. It always involves complete dedication, and help from the patient’s side alongside support from family members.
