Anxiety Disorders Center:  Compulsive Hoarding

Click here if you would like information about a current study of compulsive hoarding being conducted by the Anxiety Disorders Center.  Note: This study is only available to people who live within a 40-minute drive from Hartford.

Click here for information about treatment available at the Anxiety Disorders Center. 

Click here if you would like to receive information by mail or e-mail about compulsive hoarding, a list of hoarding treatment providers nationwide, information about upcoming research studies, and announcements for new self-help references for compulsive hoarding.  Note: this option is available to all, regardless of where you live.

Click here to view or purchase Dr. Tolin's book Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding

Click here to read the Hoarding Newsletter published by the New England Hoarding Consortium.

Do you have Compulsive Hoarding?	Print this questionnaire
Do you buy or collect an excessive amount of items, more than you really need?	YES	NO
Do you experience difficulty discarding items—even those that others might consider to be of limited value?	YES	NO
Is your home cluttered to the point that you cannot use all of the living spaces as they were originally intended (for example, unable to cook in the kitchen, unable to sit on the furniture)?	YES	NO
Does the clutter in your home, your buying/collecting, or your difficulty discarding cause you to feel very distressed?	YES	NO
Does the clutter in your home, your buying/collecting, or your difficulty discarding cause significant impairment in your family relations, social life, work, or other important areas of functioning?	YES	NO
Have the clutter in your home, your buying/collecting, or your difficulty discarding led to problems with neighbors, social service agencies, landlords, or city officials?	YES	NO

You might have Compulsive Hoarding if all of the following are true:

• You answered YES to items 1, 2, and 3
• You answered YES to at least one of items 4, 5, or 6

Note: This questionnaire is for informational purposes only and is not intended to function as a psychological or psychiatric assessment.  Diagnosis of psychiatric disorders requires a careful evaluation by a trained professional. Click here to learn how to get help for this condition at the Anxiety Disorders Center.

Questions and Answers about Compulsive Hoarding

Is hoarding a kind of obsessive-compulsive disorder?
Right now, compulsive hoarding is considered by many researchers to be a type of obsessive-compulsive disorder. However, for some people, compulsive hoarding may also be related to:

• Impulse control disorders (such as impulsive buying or stealing)
• Depression
• Social anxiety
• Bipolar disorder
• Certain personality traits

How common is compulsive hoarding? What are its features?

• We don't know exactly. Some researchers have guessed that about half of one percent of the population suffers from compulsive hoarding, but the actual number may be much higher.
• People usually start hoarding during childhood or early adolescence, although the problem usually does not become severe until the person is an adult.
• Compulsive hoarding may run in families.
• Many people with compulsive hoarding do not recognize how bad the problem really is; often it is a family member who is most bothered by the clutter.

What causes compulsive hoarding?
Compulsive hoarding is thought to result from problems in one or more of these areas:

• Information processing. People with compulsive hoarding often have problems such as:
  • Difficulty categorizing their possessions (for example, deciding what is valuable and what is not)
  • Difficulty making decisions about what to do with possessions
  • Trouble remembering where things are (and so they often want to keep everything in sight so they don't forget)
• Beliefs about possessions. People with compulsive hoarding often:
  • Feel a strong sense of emotional attachment toward their possessions (for example, an object might be felt to be very special, or a part of them)
  • Feel a need to stay in control of their possessions (and so they don't want anyone touching or moving their possessions)
  • Worry about forgetting things (and use their possessions as visual reminders)
• Emotional distress about discarding. People with compulsive hoarding often:
  • Feel very anxious or upset when they have to make a decision about discarding things
  • Feel distressed when they see something they want and think they can't feel better until they acquire that object
  • Control their uncomfortable feelings by avoiding making the decision or putting it off until later

Treatment for Compulsive Hoarding

There is no "cure" for compulsive hoarding, meaning there is no treatment that will make the problem go away completely and never come back at all. However, some treatments may help people to manage the symptoms more effectively.

Medications
Research studies using antidepressant medications (that increase the level of serotonin activity in the brain) show that some people with compulsive hoarding respond well to these medications, however, many do not. People with compulsive hoarding do not appear to respond as well to medications as do people with other kinds of obsessive-compulsive symptoms.

Cognitive-behavioral therapy
Cognitive-behavioral therapy is a form of counseling that goes beyond "just talking". In this form of treatment, the therapist often visits the person's home and helps them learn how to make decisions and think clearly about their possessions. There have not been as many studies of this kind of treatment, therefore it's hard to say with certainty how effective it is for hoarding. However, the available evidence suggests that cognitive-behavioral therapy is effective for many people with compulsive hoarding, perhaps more so than medications.

Click here for tips for overcoming Compulsive Hoarding

When a loved one hoards

In our hoarding clinic and research program, one of the most common inquiries we get is: "My [mother, father, sibling, friend, spouse, etc.] has a terrible hoarding problem. But he/she doesn't seem to recognize that it's a problem and isn't interested in doing anything about it. How can I make him/her see that this is a problem and get the help he/she so badly needs?"

The short answer:  In most cases, you can't. That is, assuming that your loved one is an adult who is legally competent to manage his/her own affairs (meaning he/she has not been declared incompetent by a judge and appointed a legal guardian), and the clutter is not immediately life-threatening, he/she has the right to hoard, even though the hoarding might have terrible consequences for his/her quality of life.

The long answer:  Even though in most cases you can't make the person do anything, you can alter your approach to minimize the likelihood of getting a defensive or "stubborn" reaction. Often, it's tempting to start arguing with the person, trying to persuade them to see things the way you do. This kind of direct confrontation rarely works. We find that the best way to help people increase their motivation to work on the problem is to start with three key assumptions:

1. Ambivalence is normal.

2. People have a right to make their own choices.

3. Nothing will happen until the person is ready to change.