Hoarding Behavior: Anxious Response or Lazy Lifestyle?

Many broken and useless items are cluttered together, piled up along a wall.If you’ve done any channel surfing at all in the last year or so, you might have come across a couple of documentary shows (Hoarders on A&E; Hoarding, Buried Alive on TLC) featuring people who are living with massive amounts of clutter and/or trash in their homes. The piles of “stuff” often reach to the ceilings, and there is barely space to stand, much less walk across a room. The programs show professional organizers and psychotherapists working with people to clean out their homes. If you’ve seen either of these shows, then you know what I mean when I say it’s something you don’t forget easily. Although the people being featured on the shows are treated with respect and compassion, the images are shocking and disturbing. How does this happen? Why do people do this? Can they be helped?

Contrary to what you might think, people experiencing compulsive hoarding are not just being lazy or careless. They are experiencing an anxiety related condition; although, there is disagreement in the medical/psychiatric community as to whether hoarding is its own issue, or that compulsive hoarding is a subtype of obsessive compulsive disorder (OCD). Although many people experiencing OCD also exhibit hoarding behavior, not all people experiencing OCD also hoard, and many people who hoard have no other symptoms of OCD.

People who compulsively hoard do experience excessive extreme anxiety, doubting, checking, and reassurance seeking before discarding items, which does suggest a close relationship to OCD. However, recent research suggests that compulsive hoarding may also be associated with a range of other psychiatric conditions, in addition to OCD. Compulsive hoarding behavior has been reported in disorders including schizophrenia, social phobia, eating disorders, depression, and dementia. In studies of the brain, researchers compared neurochemical activity and patterns of blood flow in the brain of people who compulsively hoard and people who experience OCD who did not hoard. They found that the neurochemical activity and blood flow patterns in people who hoard were different than those in people with OCD, suggesting that compulsive hoarding is a separate symptom/condition from OCD.

Many, if not most, people have a certain amount of clutter in at least one part of their homes. Where is the line between average messiness and compulsive hoarding? Hoarding behavior includes:

  • Acquiring and keeping, indefinitely, a large number of possessions which appear to be useless or of limited value
  • Living in spaces so intensely cluttered as to preclude activities for which those spaces were designed
  • Significant distress or impairment in functioning caused by the hoarding (e.g., health problems, inability to keep a job, difficult relationships or lack of relationships with other people)
  • Reluctance or inability to return borrowed items; impulsiveness and compulsion to acquire more “things” sometimes leading to stealing or shoplifting

Why/how does a person cross the line from messiness to hoarding? There are several proposed explanations for the causes of hoarding behavior. Investigators have suggested that errant cognitive processing leads to hoarding. These include information processing deficits, meaning that people who hoard have substantial problems focusing and sustaining attention, difficulty categorizing and prioritizing their possessions, and difficulty in making decisions about their possessions.

Maladaptive beliefs about, and extreme emotional attachment to, possessions may also contribute to a person’s hoarding behavior. People who hoard have an exaggerated sense of responsibility for their possessions, and desire complete control over them. They experience intense emotional distress (anxiety, grief, or guilt) about the ideas of discarding or losing an object, leading to avoidance, and escape in the form of saving and acquiring.

There are also studies showing that difference in brain activity and /or brain injury can lead to hoarding behavior. Scientists have identified the areas of the brain involved in hoarding. One study showed reduced glucose metabolism in certain areas of the brains of compulsive hoarders. Some people with traumatic brain injury, stroke, and neurodegenerative diseases have also developed hoarding behavior.

In the past, clinicians have used the same treatment methods for compulsive hoarding that they used for OCD, with poor results. While medication, cognitive behavioral therapy for OCD, exposure and response prevention therapy have all been effective treatments for OCD, they have been shown to be of little benefit for compulsive hoarding. People with hoarding behavior have high instances of poor insight, refusal of treatment, lack of cooperation, and inability to recognize hoarding as a problem, all contributing to difficulty in effective treatment.

There is hope for people who hoard, though. In a recent study, researchers designed a new cognitive-behavioral treatment especially for treating compulsive hoarding. In this treatment, motivational interviewing (getting people excited about the seriousness of the hazards of hoarding and the benefits of clearing out their homes), skills training for organizing and problem solving, and modification of beliefs about possessions are emphasized. Also, treatment includes frequent off-site sessions in which therapists helped people to sort, discard, and learn to resist acquiring more items. People typically respond more positively when the therapists are at the home with them, assisting them with sorting and discarding.

The sight of such intense messiness and disarray is certainly disturbing to see, but knowing that hoarding is a symptom of a person who is possibly experiencing severe emotional distress, hopefully, helps to engender compassion and patience in friends and family members. Information about help for hoarding can be found online at www.ocfoundation.org/hoarding/.

© Copyright 2010 by Becki Hein, MS, LPC. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Geriant Jones

    June 21st, 2010 at 11:05 AM

    I am pretty sure I do not suffer from any mental disorder but I do have trouble throwing out old stuff that I no longer need…I always think that it could come to use someday and just end up putting it at some place.I find it again sometime when my mom forces me to clean my room but then I just cannot bring myself to put away things…Maybe I’m just scared to lose those things…?I do not know :(

  • s.hurley

    June 21st, 2010 at 2:57 PM

    I like to keep my room clean and tidy but my brother is just the opposite…you may even find a week’s old pizza in his bedroom!
    we do not take this very seriously because most guys are like that but after reading this blog,I feel scared…I feel like there may be something wrong with him…what should be the next step?should we take him to a doctor/therapist?

  • A.Nixon

    June 22nd, 2010 at 10:33 AM

    I am somewhat of an opposite…as soon as I feel that something is not of use,I just throw it away…my sister has a problem with it because I once happened to throw away some stuff that she actually wanted but then I am just like that…and I do not think there is anything to change…is there?

  • Mary

    July 20th, 2018 at 6:39 PM

    Yes there is something to learn…If it doesn’t belong to you, leave it alone.

  • Becki Hein

    June 29th, 2010 at 6:39 AM

    Thanks for you comments! In response to your questions:
    Many people have trouble letting go of “things” in their homes. There is a fine line between clutter,full closets, and hoarding. When there gets to be so much stuff everywhere that the floors are covered, there is nowhere to sit, and barely enough room to walk, then the line may have been crossed. Still, many people are able to keep most rooms in their homes liveable and have one room (their bedroom or junk room) where things are really piling up. I don’t think that classifies as hoarding. When the clutter becomes so huge that it intereres with everyday living and navigating through the home, and the “stuff” is on the person’s mind nearly all the time, the line to hoarding has probably been crossed.

  • Becki Hein

    June 29th, 2010 at 6:48 AM

    to s.hurley: Is your brother’s room just really messy, or does he tend to keep stacks and stacks of things? How old is he? Again, there is a difference between “really messy” and hoarding. THere are other questions to be asked in determining if he should see a therapist: Does he have any other symptoms of severe anxiety or depression? Is he able to function in daily life? Does he clean up the mess or throw things out once in a while? How old is he? How long has it been like this? There are several things to consider, and a consultation with a counselor might help to clarify your brother’s specific needs. ( many counselors offer short, free initial consultations)

  • Becki Hein

    June 29th, 2010 at 6:54 AM

    to A.Nixon:
    It sounds like you are able to let things go when you need to and there is nothing wrong with that! The only thing I would say is that you be careful to respect other people’s property and make sure you ask them before throwing their things away. If that only happened once or twice by accident, then sure, there’s nothing to really change. If people seem to be frequently upset with you for throwing their things away, then you want to think about being more careful and respecful of other people things.

  • Becki Hein

    June 29th, 2010 at 6:58 AM

    to Geriant:
    It is hard to let go of things sometimes! One of the ways I help myself get rid of old stuff is to tell myself that if I haven’t used it in 1 year, then I will give it away to someone who can use it now. Since I have’nt used it in a year, it’s unlikely I will need it anytime soon, and if I do happen to need it, I’ll go out and get a nice fresh new one! (whatever it is!) It’s kind of a waste for things to be sitting around not being used when someone else might be needing them. Geriant, these are just the thoughts I think so I can let go of some of the stuff in my closets! You can adjust them if you want to try them out!

  • Diane W.

    February 15th, 2012 at 12:43 PM

    my question is i understand hoarding… i don’t understand the filthinest…. and my problem is with paper i have a fear of tossing it…. i’m afraid something is going to get pass me with information on it….. i mean like prescriptions that are refilled have lots of info….. the envelope the medication info page then your precription on the bottle… too much info…. to get in the wrong hands…. tyvm

  • Diane W.

    February 15th, 2012 at 12:45 PM

    yes

  • jennifer

    April 18th, 2012 at 12:32 PM

    I am a hoarder due to alot of trauma in my life and relationaships that have gone bad. I have searched the computer for advice. I get anxiety when I see the amount of things. I do know where to begin to clean up. I have given alot of thing away, but have no room to store things I am keeping. Also my social life is terrible because I will not invite anyone over. I have a focusing problem and really want to get better. There is no support group for hoarders in my area. Help…

  • jennifer

    April 18th, 2012 at 12:38 PM

    i LIVE IN BUFFALO NY and there are no support groups or therapists out here and need help. Where do I go?

  • Jennifer H

    May 19th, 2020 at 3:02 AM

    Hi Jennifer, so sorry you are hurting. When I searched for “hoarding support group buffalo new york”, i did get a suggestion. If that doesn’t work for you or the group no longer meets, maybe you could ask a reference librarian for help? I suffer from hoarding disorder and I have been working through “Buried in Treasure”. Luckily, Dallas has two support groups and I live nearby. Wishing you the best of luck in finding some help and someone to talk to that is compassionate and understanding. Jennifer H..

  • Linda

    June 17th, 2012 at 1:36 PM

    I’ve always been pretty messy, but I can’t stand filth; so I keep things pretty clean…even my trash cans. I am a procrastinator and get distracted easily. I am 4 years behind on my business bookkeeping and have become more and more overwhelmed and unable to face it as time goes on. I sold some stuff in a garage sale last year, and my neice-in-law, without asking me, threw away all my odd socks that she could find without checking with me…now I have the matches! That made me very angry, but she is so touchy I just bit my tongue; but I am still angry about it. I need someone to help me get organized, especially with my paperwork, but haven’t had to money to hire someone yet. I am bipolar, which doesn’t help matters…although I am fairy under control on my meds.

  • Danny McKinney

    February 22nd, 2014 at 1:03 AM

    Sometimes, hoarding can be an issue not resolving the situation. It’s like someone is hiding something from home and not discussing the situation what’s going on ? Cause, there’s crime going on like stealing and borrowing other people’s personal things. People think they are wasting their time, by telling the truth. There’s too much drama going when somebody were asked not to take anything for granted. Very shameful.

  • Mary E

    August 14th, 2015 at 1:38 PM

    I am bi-polar, procrastinator, and believe I have adult ADHD. Also, I am on disability so I am home every day. My excess stuff has lived in boxes for years. I want to know why it’s so hard to get rid of things I know aren’t being used and probably won’t be used. Also most of the posts I read above have at least one problem I seem to have letting go. I like to think of myself as a problem solver and I have come up with some ideas that maybe will help someone else wanting to tackle their hoard or clutter. Take one room at a time and write down all the different things in it, or take pictures of it, and then you can see exactly what you have. I also figured out a grid system for working on a room. Take a piece of paper, graph paper if you have some, and divide the room you want to organize, into either 4, 6, or 8 sections, depending on the size of the room, or the amount of areas you can work on at one time, and clean/purge each section a little at a time. Maybe some days you can work on more than one section, or you can reconfigure your graph. It will take time to do this, but eventually the clutter will be gone, you haven’t overdone it at one time so you are over tired, and it also will help you have a nice, clean room that you can be proud of. I think it will also help you to be motivated to start working on the other rooms. I also think asking myself “Do I really need this?” will help me decide what’s to be kept and what’s to be donated to charity or thrown away. I like your idea about getting rid of things that haven’t been used for at least a year. I hate to say it, but I am feeling better now that I know I am not the only person experiencing this problem. I try to keep the living room, kitchen and dining room straight, but the rest of the rooms are pretty cluttered at my house right now. Reading this article has helped to be motivated to get up and start working!!! Taking some of your advice and others and my own!!! Now I just have to quit procrastinating!!!!!

  • Jean W. B.

    July 10th, 2016 at 5:41 PM

    my friend keeps a filthy house. Her countertops are loaded with dishes, both clean and dirty, food, mail, pots and pans, items that belong in the pantry, numerous small appliances that are never used, dish towels, all piled up. There is not an inch of clean counterspace. There are always boxes and bags of whatever standing on the floor, in the corners, in the hallway, in the laundry room. The stove, microwave and refrigerator are disgusting. She recently started a small kitchen fire by setting something on a hot burner because there was no counter space to use. Move to the dining area where the table top is invisible under all the junk that’s collected there. Clothing hangs from all the chairs. The TWO hutches are stuffed full of stuff, with more piled on any open space. The desk has loads of papers and what not piled on it. She has added some small shelving units to the dining area to hold more junk when she ran out of room elsewhere. The living room has a couch and 2 chairs along with about4 small tables, all covered with stuff, including old mail, manicure supplies, pens, papers, dirty Kleenexes, shoes all over the place, magazines strewn around the floor, partially eaten food and snack bags throughout the kitchen, living room and dining area, and all the furniture has a thick layer of dust on it. If I go to her home, I need to wind around the hazards on the floor to get to a seat and then I usually have to clear it off, and move several pairs of shoes out of the way. The bathroom has a large vanity that is covered with bottles, towels tossed on it, hair supplies, whatever. Again, no counter top shows. I live nearby and she actually comes to my house and says I have to go to the bathroom as soon as she walks in the door. I guess she wants to use a bathroom that’s been cleaned in recent weeks. I was only in the bedroom once and that was enough for me. There’s a small bed in the room along with a dresser, and all available floor space is covered with clothes, some folded and piled up and some just in heaps on the floor. The attached garage has shelving units for organizing, but they are stuffed full of things that I have never seen her use. I suspect she moved them with her and never touched them again. Instead, there are piles of things in the garage too, including cleaning supplies, lots and lots of soda and bottled water, shoes, boots, jackets. Its as if she gets to the door and dumps everything. Again, to enter through the garage, I need to clear a walkway. She no longer has guests over; in fact, she has actually asked if she could host a gathering at my house instead! She recently wanted to come to my house to cook out, and I can imagine it’s because her grill is too filthy to use it and she didn’t want to clean it. She needs some home repairs done but won’t call a handy man because her home is too messy. She has admitted this a few times, but not lately. She is almost 70. She is going to get hurt with all the hazards she has laying around the house. She has chronic diarrhea, which I can’t help but believe may be related to the unsanitary cooking conditions. She eats out several times a week and I think this is why. She recently made dinner and gave me some of it, insisting I try it while she was there. I said I wasn’t really hungry but she was insistent so I took a bite, told her it was very good, and that I would have it the next day. I put it down the garbage disposal when she left. Using my bathroom with her stomach issues makes me nervous and I immediately clean it again after she leaves. Its one thing that she’s ok living like this, but I don’t want it spilling over into my home. About 2 years ago I spent over a week at her house organizing her kitchen cupboards and pantry, at her request. She said she was so embarrassed that I had to see how she lived, and that she had no organizational skills. I made light of it and said that when we were done, all I ask is that she keep it that way. Of course, that didn’t happen. What more can I do to get her help? She has 6 sisters and a couple of brothers, most live in the area, but only one comes in the house. I’m not sure if this is their choice, or my friends wish. Help.

  • Rosemary

    January 5th, 2017 at 1:28 AM

    Jean, she is lucky to have you but also needs professional help. Her/your story is the same as that of my son/mine, and he is only 38, but his life is lonely and unsociable, That’s why I am on line searching for information.

  • lorne g

    January 20th, 2017 at 6:02 AM

    My sister in law is a dangerous hoarder. She now lives with us and the collecting is happening here what do we do? She has all available space that someone could not see.if you understand packed full. to look at the room it looks ok but underneath and behind is a different story

  • Kathy

    February 2nd, 2020 at 12:48 AM

    I’m becoming a hoarder and it’s scaring my so badly because I don’t know how to fix it, and I’m afraid I will never be normal again. I’m coming out of a deep depression from some events that traumatized me a couple of years ago, and now I’m so overwhelmed by all the mess that I’ve made and the stuff I’ve accumulated that I can’t even make myself begin to clean it up. It’s just going to get worse. I used to be an outgoing person and I’ve become shy and withdrawn now (thank God I have a job that requires me to be social, or I might be a downright hermit). I need help but my family is tired of dealing with me and I’m too embarrassed to let anyone see my home. I called a couple of counselors in the area but no one returned my call. I feel extremely isolated and sometimes I wonder what’s the point of tomorrow? I need help.

  • jennifer h

    May 19th, 2020 at 2:33 AM

    Hi Kathy, i’m so very sorry that you have been through traumatic experiences. That must be so awful. No wonder you are depressed. I suffer from hoarding disorder and I know how isolating it can be. I don’t know what area you live in, but have you checked with your local mental health org or public library? I found a support group and we are working through the book “Buried in treasure”. I still have severe problems, but I can’t not emphasize enough how important it has been for me to have found kind people with the same problem who do not judge! There are Facebook groups, too. Please try to remember that you are not your mental disorder. Anxiety makes the hoarding worse for me so I do better when I make myself exercise and meditate. I’m no doctor, but I’m sure you need help for your ptsd first. The stuff is a symptom of the trauma, I’d guess. I hope you can find some kind of support group. There are ones for depression, ptsd, anxiety, and hoarding in my area. Please don’t give up on yourself! Sending support your way!

  • jennifer h

    May 19th, 2020 at 2:40 AM

    Oh, and also, we have several members who are doing so well that you’d definitely call them “normal” now. Ha ha. I think they are better than normal because they are kind and compassionate and helpful. They worked very hard. One needed therapy and another meds and therapy but both are recovered hoarders. So, it IS possible! : ) They give me hope every day.

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