Hoarding Disorder - Causes, Symptoms, Diagnosis, and Treatment

What Is Hoarding Disorder?

An individual experiencing hoarding disorder feels an overwhelming need to buy and collect things irrespective of their need and use. Like many other mental illnesses, individuals suffering from hoarding disorder do not see an issue or a defective pattern in their life; they often consider this as a personality trait or their way of living life. This makes the disorder more serious and complicated, as the individual is unable to recognize the problem and is in denial of their condition; they do not ask for the help they so desperately need, which makes the treatment part more tricky.

In cases where an individual realizes they have a condition and requires professional help, they hesitate to ask for help as they feel remorse, guilt, and shame in admitting the condition. During this phase, people around them must provide all the help they need and support them in making decisions. One must remember while helping that this is not just a materialistic issue; it is linked to mental health problems, and forcing an individual into doing things they are comfortable with may tip them in the wrong direction, causing more harm than good and may even cause an anxiety attack.

The severity of the condition is important to take notice of. Often milder forms of hoarding disorder are unnoticeable as every individual has things they cannot detach from but hoarding new things and not letting go of the previous articles is the red flag feature of hoarding disorder. The severe form of hoarding disorder is quite noticeable as the living conditions, and hygiene takes a step to worsening, and also, the individual's relationship with others can become unpleasant due to the disorder.

What Causes Hoarding Disorder?

Similar to other mental disorders, the cause of hoarding disorder is yet to be known. However, psychologists have discovered the risk factors that may trigger hoarding disorder and the associative mental illnesses whose complications may cause hoarding disorder.

The risk factors of hoarding disorder are:

• Positive familial history.

• Trauma to the head (causing brain damage).

• Traumatic or stressful events in the past.

• The unexplained urge to buy things.

• Individuals get excited and are compelled toward free articles and discounted prices.

• History of neglect (includes self-neglect).

• Living alone (often living alone gives individuals the freedom to buy or hoard things without restriction).

• Near-death experience.

• Death of a parent or close family member.

• Sensitive behavior (over-emotional nature).

• Indecisiveness (inability to make decisions).

Associated mental health conditions are:

• Depression (episodes and bouts of severe depression or major depressive disorder).

• Psychosis (the combination of symptoms resulting in an impaired relationship with reality).

• Schizotypal (eccentric or odd personality disorder).

• Obsessive-compulsive disorder (OCD).

• Attention-deficit hyperactivity disorder (ADHD).

• Anxiety disorders.

• Post-traumatic stress disorder (PTSD).

What Are the Symptoms of Hoarding Disorder?

The characteristic feature of hoarding disorder remains the inability to suppress the urge to buy things and store them in a cluttered manner. However, there is more to the disorder than its characteristic feature. Some of the symptoms of hoarding disorder are:

• Soured relationships.

• Distrust others concerning their possessions.

• Bad at categorizing.

• Financial instability.

• Often in debt.

• Faces difficulty in everyday tasks such as cleaning, laundry, and cooking.

• Harmful attachment to the hoarded articles.

• Toxic behavioral traits such as indecisiveness, perfectionism, and procrastination.

• Messy house.

• Feels safe with the hoarded articles.

• Bad at processing their emotions and feelings.

• Difficulty throwing away their possessions.

• Inability to make decisions.

How to Diagnose Hoarding Disorder?

After the inclusion of hoarding disorder in the mental illness category, the Diagnostic and statistical manual of mental disorder, fifth edition (DSM-5), provided criteria to diagnose hoarding disorder. The criteria state individuals must show the following symptom in order for the official diagnosis to read hoarding disorder. Symptoms include:

• Individuals face difficulty throwing or parting with their belongings.

• The root cause of the difficulty is their (over) emotional attachment to these possessions or articles.

• This difficulty or negating the idea of discarding ordinarily results in clutter formation around their living space.

• Hoarding has both mental and physical symptoms. Mental symptoms include stress with the idea of discarding articles, and physical symptoms include poor hygiene and injury (minor) due to unjust space in the living space.

• Hoarding is not a complication due to other medical conditions such as cerebrovascular diseases (diseases concerning the brain, like thrombosis and hemorrhage) and Prader-Willi syndrome (a common complication of the disorder is the inability to suppress urges).

• The symptom of hoarding disorder is not due to other mental illnesses.

What Is the Treatment of Hoarding Disorder?

The treatment of schizoaffective disorder does not have any physical symptoms and has more mental or psychological symptoms. Hence, the treatment plan for the disorder focuses on the mental health of the patient. The treatment plan consists of psychotherapy. Psychotherapy, also known as talk therapy, aims at resolving and helping individuals talk about their insecurities and urges, which compels the patient to hoard articles. For psychotherapy to work, the patient must be willing enough to talk and trust their counselors.

Psychotherapy includes cognitive-behavior therapy (CBT) and motivational interviewing.

1) Cognitive-Behavioral Therapy (CBT): Cognitive-behavioral therapy is one of the most implemented therapies in the treatment plan. With the help of cognitive-behavioral therapy, the patient is made to feel at ease to talk about their fears and their compulsion to hoard. The counselor helps the patient by:

• Making them become self-aware of their condition.

• Discovering the reason behind their urge to hoard.

• Helping them to compartmentalize or organize their thoughts and their possessions.

• Helps them to make decisions.

• The counselor explains the importance and meaning of decluttering.

• Teach them relaxation therapies and skills.

• Make them comfortable about their condition and explain the chances of hospitalization.

2) Motivational Interviewing: This form of therapy is directed toward addicts and has been proven to be quite effective. Hoarding disorder comes under addiction to hoarding articles and belongings. Talking and continuing this form of therapy helps the individual understand their addiction to shopping and collecting articles. The individual is made aware of the situation and that they need help. They receive the help they require and start their journey toward recovery.

By the end of the treatment, individuals suffering from hoarding disorder understand the disorder, identify their symptoms, and in case of relapse, would not shy away from asking for help.

What Are the Other Associated Diseases?

In some cases, the hoarding disorder is linked to other mental illnesses like:

• Obsessive-compulsive disorder (OCD).

• Anxiety disorders (often general anxiety disorder).

• Depression.

• Attention-deficit hyperactivity disorder (ADHD).

• Substance abuse disorder.

• Paranoia.

• Schizotypal (a milder form of schizophrenia).

• Dementia.

What Are the Complications of Hoarding Disorder?

Except for the cluttered mess at home, and the untrusting relationships, hoarding disorder can also lead to certain complications such as:

• Increased risk of injury due to clutter and messy living spaces.

• Fights at home.

• Socially isolated or in solitude.

• Mistrust behavior displayed towards others.

• Poor professional life.

• Poor hygiene may lead to health complications.

• Increased risk of panic attacks.

• May develop a general anxiety disorder.

• Episodes of clinical depression turned into major depressive disorder.

Conclusion:

Hoarding disorder is a mental condition. As its namesake, it does not appear to be only about hoarding; it involves mental illnesses or could be complications of mental illnesses. People have difficulty accepting their condition and its symptoms. More so, they are not aware of such conditions and have difficulty asking for help. People receiving treatment for hoarding disorder understand their conditions and their unhealthy attachment to their possessions. Hoarding disorder is a treatable condition when correct and proper treatment is provided at the correct time.