What is hoarding disorder?

Hoarding disorder is when you have significant and often irrational difficulty letting go of things or throwing things out, regardless of their value. You may want to save the items for future use, and there is a lot of distress associated with discarding them.

This leads to an accumulation of possessions and rubbish that clutter your living areas.

Hoarding disorder is a recognised mental illness, which progressively gets worse.

People with hoarding disorder may have a lack of insight into their condition and often have a lot of shame related to their situation.

If you have hoarding disorder, you may not be able to recognise that:

• you have a problem or if you do you may not know what to do about it
• you cannot use your surroundings due to the clutter

What’s the difference between collecting and hoarding?

Many people collect things as a hobby — from stamps to magazines to teacups. But there are differences between collecting and hoarding.

People who collect things are more likely to display or store their collection in a specific place. Collectors are also more likely to use or enjoy their collection.

By comparison hoarders tend to:

• keep things because they believe they have a use in the future — but often these things aren’t used
• keep things in a disorganised way, with no specific way of storing them

With hoarding, your belongings tend to take over large areas of your home.

People with hoarding disorder accumulate possessions because it is upsetting to get rid of them.

There is little association between collecting and hoarding disorder.

What are the symptoms of hoarding disorder?

Almost anything can be hoarded. However, items hoarded are often:

• of low financial value such as newspapers
• in poor condition, such as take away containers
• relatively easy to get if needed
• unlikely to be seen as meaningful by other people

What sort of things do people hoard?

Someone with hoarding disorder may accumulate anything, but common items include:

• clothing
• ornaments
• broken items — for spare parts or to repair them
• kitchenware
• car parts
• old bills
• newspapers
• magazines, books and brochures

Items inherited from a deceased estate may be especially problematic. This is because they can be numerous, sentimental, and associated with grief and loss.

Animal hoarding

Animals can be hoarded too, especially small domestic ones, such as:

• cats
• rabbits
• dogs
• birds

Animal hoarding can easily lead to squalor. Both animal food and animal waste easily mount up. People in the house can be at risk of:

• parasites
• zoonotic disease — diseases that can be caught from the animals

The person may believe they are caring for the animals. But in reality, they may not be doing this very well.

What causes hoarding disorder?

The reasons why people begin to hoard are not fully understood. It can be a symptom of another condition. Sometimes hoarding may be due to:

• mobility problems
• intellectual impairment or the development of dementia
• mental health problems

Hoarding disorder often starts early in life. It is associated with some personality traits, such as:

• perfectionism
• difficulty being able to make decisions
• procrastination (delaying tasks until later, often by finding distractions)

Perfectionism in hoarding is associated with fear of making mistakes, losing or misplacing a specific item and of later regret.

Related conditions

People with hoarding disorder may have another illness, such as:

• acquired brain injury
• autism spectrum disorder
• attention deficit hyperactivity disorder
• obsessive-compulsive disorder
• schizophrenia

When should I see my doctor?

See a doctor or mental health professional if you think that you or a family member has signs of hoarding disorder.

Your doctor should be able to refer you to a psychologist with experience in hoarding disorders. They can also advise you on other services that may be able to help.

Your doctor will also be able to check that any other physical health conditions are recognised and being treated.

How is hoarding disorder treated?

Cognitive behavioural therapy (CBT) is the recommended treatment for hoarding disorder.

CBT encourages you to talk about how you think about:

• yourself
• the world
• other people

It also explores the relationship between your behaviour, thoughts and feelings.

CBT can help reduce how bad the hoarding disorder is. It will help you to work on:

• goal setting
• organising and problem solving skills
• sorting and getting rid of things
• reality checking

At the end of treatment, you will have a better understanding of the problem.

Some antidepressants have shown some benefits in hoarding disorder, but the evidence for their use isn’t strong.

How to help someone with hoarding disorder

Helping someone with hoarding disorder is stressful and takes patience and understanding.

It's usually not a good idea to:

• criticise the person
• use blunt, negative language — such as this place is a dump
• clear the rubbish away

This won't solve the problem and the clutter often builds up quickly again.

You can encourage them to seek help and offer support. SANE Australia has useful tips to help someone who hoards.

Complications of hoarding disorder

Hoarding can make it hard to move around your home.

This can make it hard to:

• clean your home
• maintain your personal hygiene — because you can’t get to the toilet or washing facilities
• have visitors
• allow tradespeople in for essential repairs

You may not be able to sleep in your bed, because it is covered in things.

Hoarding can also lead to safety risks. Hoarding can:

• be a fire risk
• attract insects and rodents
• cause trips and falls

If the piles of things collapse, you may become trapped.

Hoarding disorder can lead to squalor — which is living in an unsanitary environment.

Resources and support

For advice and to get connected to local mental health services, call Head to Health on 1800 595 212. Check the operating times.

FriendLine supports anyone who's feeling lonely, needs to reconnect or just wants a chat. You can call them 7 days a week on 1800 424 287, or chat online with one of their trained volunteers. All conversations with FriendLine are anonymous.

If you need to talk to someone about your mental health, call Beyond Blue on 1300 22 4636.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.