What is hoarding disorder?

Hoarding disorder is when someone persistently has difficulty letting go of or throwing things out regardless of their value. They have a perceived need to save the items and there is distress associated with discarding them. This leads to an accumulation of possessions and rubbish that clutter the person’s living areas.

Many people collect things as a hobby or for sentimental reasons — from stamps to their kids' teeth, but for people with hoarding disorder they accumulate possessions because it is distressing for them to discard them.

People who collect things are more likely to display or store them in a specific place, rather than have them take over large areas of the home. Collectors are also more likely to use or enjoy their collection, whereas someone with hoarding disorder may argue that they are keeping something because it will have a use in the future — and often it doesn’t.

Someone with hoarding disorder will also store the items in a disorganised or cluttered way, with no specific space to store them.

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

A person with hoarding disorder may have a lack of insight into their condition, seemingly not able to recognise that they have a problem, or that they cannot use their surroundings due to the clutter.

What sort of things do people hoard?

Someone with hoarding disorder may accumulate anything, but common items include clothing, ornaments, kitchenware, car parts, old bills, newspapers, magazines, books and brochures.

Items that are hoarded are often low in value, in poor condition, and could easily be replaced. Items inherited from a deceased estate may have emotional ties, and can be a problem sometimes.

Animals can be hoarded too, especially cats, but also rabbits, dogs and birds. The person may believe they are caring for the animals, but in reality may not be doing this very well. Animal hoarding may lead to squalor, as animal food and waste accumulate, and pests are attracted.

Complications of hoarding disorder

Often, people who hoard have difficulty moving around their home because of the number of things they have accumulated. The person may even no longer be able to maintain or clean their home.

The person may not be able to sleep in their bed, because it is covered in possessions, or access the toilet or washing facilities because of accumulated items.

Hoarding can lead to safety risks for the occupants of the home, such as falling and trip hazards and fire risk. In addition, infestations by rodents or insects can create a health hazard.

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

Who gets hoarding disorder?

Hoarding disorder often starts early in life. It is associated with some personality traits, such as perfectionism, not being able to make decisions and procrastination (delaying tasks until later, often by finding distractions).

Perfectionism in hoarding is associated with fear of making mistakes and of later regret.

People with hoarding disorder may have another mental illness, such as anxiety, attention deficit hyperactivity disorder or obsessive-compulsive disorder.

Is there any treatment for hoarding?

Cognitive behavioural therapy (CBT) is the recommended treatment for hoarding disorder. Certain antidepressants have shown some benefit, but are not in general use.

How to help someone with hoarding disorder

Helping someone with hoarding disorder is stressful and takes patience and understanding. You can encourage them to seek help and offer support. SANE Australia has useful tips to help someone who hoards.

Resources and support

If you think that you or a family member has signs of hoarding disorder, see a doctor or mental health professional. Your GP should be able to refer you or your family member to a psychologist with experience in hoarding disorders and advise on other services that may be able to help.

A GP will also be able to ensure that any physical health conditions are being managed.

You can also call one of the free mental health helplines for support and advice.