Have you ever known someone who would have mountains of trash in their house? Some of you may know such people, and some of you may not. Regardless, this action is identified as the major symptom of a real medical condition called compulsive hoarding, better known as "Hoarding Disorder." It is very common, with estimates suggesting that nearly 20 million Americans suffer from the condition. That's more than the number of autistic and bipolar Americans combined.
While hoarding has gotten pretty big on the news lately (especially with how everyone has been mass hoarding toilet paper), Hoarding Disorder itself is not very well known. Why isn't it? The answer to that lies in how we commonly view people with HD.
Have you ever known someone who would have mountains of trash in their house? Some of you may know such people, and some of you may not. Regardless, this action is identified as the major symptom of a real medical condition called compulsive hoarding, better known as "Hoarding Disorder." It is very common, with estimates suggesting that nearly 20 million Americans suffer from the condition. That's more than the number of autistic and bipolar Americans combined.
While hoarding has gotten pretty big on the news lately (especially with how everyone has been mass hoarding toilet paper), Hoarding Disorder itself is not very well known. Why isn't it? The answer to that lies in how we commonly view people with HD.
People with Hoarding Disorder often hoard objects which have no worth. It often pains them to throw these objects out because they feel the same sentimental value towards these objects as a person would feel to someone they love. Once they do get rid of it, there's an intense feeling of loss that follows, similar to how one would feel if they lost a valuable, personal possession. Many people with HD claim that they don't want to get rid of the "stuff" because they may need to use the objects again, later. Some people with HD may also seek out new objects, without regard for whether they are free or purchasable. This is what separates it from collecting.
Collectors usually focus on one thing and they always try to keep it all organized. However, this is not what happens with people diagnosed with Hoarding Disorder. In their case, stuff accumulates and builds up into mountains of trash in their houses until their appliances are inaccessible and they can't open their fridge to grab a bite or sleep in their bed because it is filled with junk. At this point, it is no longer clutter. The trash is now interfering with their lives. In severe cases, people can't move through their homes properly to the point where it is unsanitary and may even pose a fire hazard.
In the 1990s, psychologists assumed that Hoarding Disorder was a variant of OCD, a disorder that can cause people to become attached to certain objects or repeat certain actions. This idea was assumed as true. It made sense since hoarding was a symptom that was commonly used to diagnose OCD, with 20-40% of OCD patients doing some hoarding. In addition, it's easy to see how hoarding can be associated with the obsessive fear of being wasteful or losing important items. However, 80% of hoarders, beyond the accumulation of trash and junk, showed no other symptoms of OCD. Furthermore, there are major differences in how people with OCD feel about their compulsions in comparison to people with HD; people with OCD are often bothered by their compulsions while hoarders usually aren't. In addition, hoarders aren't always thinking about hoarding like how people with OCD are always thinking about their compulsions.
In a 2012 study of 107 volunteers, which included hoarders, people with OCD, and a control group, researchers imaged these people's brains while they decided whether to keep or shred newspapers and mail. As you would expect, hoarders struggled with the task and they often expressed anxiety and indecisiveness. In the second task, the same items came from the volunteers' own homes. In this task, the hoarders showed much higher brain activity in two parts of the brain than people from other groups: the Anterior Cingulate Cortex and the Insula, regions that are important for decision-making and emotion. Researchers think that this abnormal brain activity causes hoarders to overvalue useless items and feel extreme loss when they throw the items out.
There are many triggers to HD. Many studies suggest that HD is genetic, and it can be passed down through generations. Other studies suggest that trauma may also be a risk factor. The death of a family member or an abusive relationship may develop the condition or worsen it in the traumatized individual. Researchers have also uncovered that 75% of people with HD have or had depression, anxiety disorder, or ADHD.
There are treatments that exist, however. One of them is called cognitive-behavioral therapy (CBT). CBT is a psycho-social intervention therapy that aims to improve mental health. It focuses on relieving the individual of harmful cognitive distortions, improving their behaviors and emotional regulation, and helping develop coping strategies that are aimed at solving the individual's current problems. Therapists can help patients by giving them a set of questions to help them tell whether an object is worth keeping, phrases like: Do I need this now? What is the worst thing that can happen if I get rid of this? By helping them learn which things to keep and which things to throw out, therapists can improve the conditions of patients with HD and push them in the direction of recovery.