17682 Hoarding Disorder

Overview

Hoarding disorder is a mental health condition in which a person has ongoing difficulty getting rid of or parting with their possessions, even items of little value. Over time, this leads to a large amount of clutter that takes over living spaces and interferes with daily life.

Yes. It is thought to affect about 2 to 5 out of every 100 people. That makes it a fairly common mental health condition.

Hoarding disorder can develop in anyone, but it often starts in the teenage years or early adulthood. It can be diagnosed in children, teenagers, and adults, and it becomes more severe with age.

Symptoms

Common symptoms

• Keeping a large number of possessions that most people would consider worthless or unnecessary
• Being unable to let go of items, even when they are broken, useless, or cause clutter
• Feeling extremely upset or anxious at the idea of throwing anything away
• Living spaces becoming so cluttered that they cannot be used as intended, such as cooking on the stove or sleeping in the bed
• Difficulty organizing items, decision-making, and procrastinating on tidying
• Avoiding visitors, family, or friends because of embarrassment or shame about the clutter

Symptoms in children

• Collecting and keeping many items, but also showing distress when asked to throw anything away
• Finding it very hard to discard schoolwork, toys, packaging, or food items
• Hoarding that significantly affects their ability to do homework, play, or have friends over

Symptoms in older adults

• Clutter accumulating over many years, sometimes unnoticed by others
• Strong attachment to items due to memories or the fear of losing important information
• Increased risk of falls, fires, or hygiene problems in the home

Causes

Main causes

• The exact cause is not fully understood, but it is likely a mix of genetics, brain function, and life experiences
• Some people develop hoarding after a stressful or traumatic event, such as losing a loved one or losing a home
• Hoarding can also be linked to other mental health conditions like depression, anxiety, or obsessive-compulsive disorder

Risk factors

• Family history of hoarding or other mental health conditions
• Having a personality that tends toward indecisiveness, perfectionism, or avoidance
• Experiencing loneliness, social isolation, or major losses in life
• Living alone, where there is no one to question the clutter

When to see a doctor

See a doctor urgently if:

• If clutter is making your living environment dangerous or unsanitary, seek help right away
• If you or someone else feels like they may harm themselves or someone else, get immediate emergency support
• If you are facing eviction or legal trouble because of hoarding, contact your local housing support service urgently

Book a routine appointment if:

• If you feel your saving behavior is causing stress, embarrassment, or getting in the way of everyday life
• If family or friends have raised concerns about the amount of clutter
• If you want to learn ways to reduce clutter and manage your urges, but don't know where to start

Diagnosis

A doctor or mental health professional will talk with you about how you have been feeling and behaving. They may ask questions about why you keep items, how hard it is to throw them away, and how much the clutter affects your home and daily life. They may also speak with someone you trust, with your permission, and may ask to see photos of your living space.

Tests that may be done

• No blood test or scan can diagnose hoarding disorder
• Your care team may use a questionnaire or checklist to assess the severity
• They will look for other conditions such as depression, anxiety, or memory problems that could be related

What to expect at your appointment

The first meeting is usually a conversation, not a judgment. The professional’s goal is to understand your situation and offer support. With your agreement, they may refer you to a mental health specialist who can provide therapy and practical help.

Treatment

Treatment for hoarding disorder most often involves talking therapies, especially cognitive behavioral therapy (CBT). It may also include help to manage stress and, sometimes, medication for related problems like depression or anxiety. The aim is not to gain control over you, but to help you build skills to sort, decide, and live more comfortably in your space.

Self-care at home

• Start with a small area — like one drawer or one table — rather than tackling the whole home at once
• Practice making small decisions about keeping, recycling, donating, or throwing out items
• Use the 'hotspot' method: choose one frequently used area and clear it a little each day
• Set a timer for short clearing sessions, such as 15 minutes a day, and take breaks
• Ask a trusted friend or family member to support you without taking over

Medical treatments

For some people, a doctor may prescribe medication to help with symptoms of anxiety or depression that make hoarding worse. Medications should always be discussed with a healthcare professional, and they are usually used together with therapy, not on their own. Do not take any medication for hoarding without a doctor's guidance.

Living with this condition

Living with hoarding means finding a balance. You can keep meaningful items, but you also have to keep your home safe and usable. It may help to think of your home as a space for you to live in, not just a storage area. Each small step — opening a path, clearing a chair, filling one bag for donation — moves you toward a more comfortable home.

Lifestyle tips

• Build a daily routine that includes time for self-care, like showering, cooking, and rest
• Try to invite trusted people over occasionally, even if it is just for a short visit
• Look for local supports such as decluttering volunteers or occupational therapists who understand hoarding
• Reduce stress with simple activities like walking, deep breathing, or listening to music

Diet and exercise

There is no special diet for hoarding disorder, but eating regular, balanced meals and getting some physical activity can help steady your mood and energy levels. This makes it easier to cope with the emotional work of sorting and discarding.

Mental health and emotional wellbeing

Hoarding often leads to shame, loneliness, and low self-esteem. It can strain relationships with family and friends. It is important to remember that hoarding is not your fault, and getting treatment can also improve your emotional well-being, confidence, and sense of control.

Prevention

It may not be possible to prevent hoarding disorder entirely, especially if it runs in families. But getting help early, learning healthy ways to manage stress, and seeking treatment for anxiety, depression, or obsessive-compulsive symptoms can stop hoarding from becoming severe.

Complications

If left untreated

• Unsafe living conditions, including risk of falls, fires, and trip hazards
• Poor hygiene from mold, dust, pests, or spoiled food in the home
• Social isolation and damaged relationships with family and friends
• Problems with eviction, loss of housing, and financial strain
• Physical health problems from breathing in dust or mold, or from falls

Long-term outlook

Hoarding disorder can improve with the right support. Many people learn to manage their clutter and regain a healthier, more comfortable living space. Recovery is a gradual process — it is normal to have setbacks. With persistence, therapy, and support, you can make meaningful progress and feel more at home in your own life.

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