The Mayo Clinic defines hoarding as the excessive collection of items or animals and the inability to discard them. Other sources report that hoarding can be viewed as the acquisition of, and inability to throw out worthless items that appear to have no value. Some hoarders live in spaces that are so cluttered, the living area is unusable. And some exhibit significant distress or impairment caused by their hoarding behaviors.
Neuropsychiatric Connection
Hoarding has been observed in several neuropsychiatric disorders including schizophrenia, dementia, intellectual and developmental disabilities, depression and eating disorders as well as in the non-clinical population. People with obsessive compulsive disorder (OCD) who hoard and chronically save items, may have what is loosely called “compulsive hoarding syndrome”.
OCD and Hoarding?
What is the connection between OCD and hoarding? In people with OCD, the presence of hoarding symptoms has been associated with increased risk of comorbidities or co-occurring psychological disorders, impaired activities of daily living (ADLs), reduced insight, especially into their own hoarding behavior, poor response to standard psychological and pharmacological treatments, and a distinct genetic and neurobiological profile.
Compulsive hoarding occurs in between 20% and 30% of people with OCD. Roughly 5% of these people are disabled due to this condition. They respond poorly to antidepressants as well as cognitive behavioral therapy.
There are important differences between compulsive and non-compulsive hoarders. Compulsive hoarders experience behaviors earlier in life, are compelled to create order, symmetry, and exhibit counting compulsions and indecisiveness. They tend to be older when they seek treatment and have more family and social problems. Many compulsive hoarders are anxious and depressed. They lack insight, have lower global functioning, social phobias and personality disorders.
Snapshot of the Average Hoarder
While it is difficult to profile all hoarders, there are certain characteristics most share. It is believed there are roughly 2 million hoarders in the United States who are predominantly female, older, unmarried or divorced, are socially dysfunctional and unemployed. Most do not see their behavior as problematic. Interestingly, many hoarders have no psychiatric issues whatsoever.
Many hoarders live unstructured days. They sleep during the day and stay up at night, as if their internal clock was turned around. They many times forget to take their prescribed medications and forget to have them refilled at the pharmacy. Sometimes, they don’t renew prescription drugs at all. They have low motivation and are embarrassed by their clutter.
What do People Hoard?
This is where it becomes both interesting and sometimes dangerous, depending on what is being hoarded. Some people are considered “shopper hoarders” and will purchase dozens upon dozens of items they may not need. An example of this is the purchase of 100 bottles of ketchup that will be stored in the basement. Some people consider themselves “collectors” of many items including records and CDs, books, newspapers and magazines. They may hoard clothing, containers (e.g. boxes, milk cartons and egg crates). Others hoard mail that dates back ten or more years. There are paper hoarders, those who hoard food (fresh and rotten), garbage, trash and human waste. There are also those who hoard animals.
Final Thoughts on Hoarding
This is a big topic, and a short article such as this one cannot cover all of the information known about hoarding. For instance, what are symptoms and risk factors involved in hoarding? Are there successful treatments or medications? Is OCD really associated with hoarding and what do sceptics say? While much is known about hoarding, there is still so much that is not yet understood. Hopefully with more research, we will have a better understanding of this interesting and sometimes dangerous phenomenon.
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