Hoarding May Lead to No Space, Money, But Is it a Mental Disorder?

Endless unpacked things in your wardrobe, yet you can’t shopping? You might be struggling with hoarding.

(Netflix’s latest offering ‘Tidying Up with Marie Kondo’ is based on the concept on getting rid of the clutter in your home and transforming your life. FIT is re-publishing this piece to show why hoarding might not be a healthy sign.)

Do you have unpacked packages lying in your wardrobe? Have the contents of your wardrobe spilled over into the room, the adjacent room and the whole house? Do you find it hard to part with things even if you have no use for them and they’ve just been lying around without any purpose at all?

If you have answered in affirmative to any or all of these, dear reader, then you may have a hoarding problem. You may be planning to buy more items, which you absolutely don’t need, even as you read this article, but before you hasten to get that done, here’s a look at hoarding.

Is Hoarding a Mental Disorder?

Previously hoarding was not considered a mental disorder, says Dr Soumiya Mudgal, Consultant Psychiatrist at a leading hospital in New Delhi, and was only seen as a symptom of the Obsessive Compulsive Disorder (OCD). However, recent observations and conclusions have proven that hoarding fits modern definitions of a mental disorder, adds the doctor.

Dr Samir Parikh, Director of the Mental Health and Behavioural Science department at another leading hospital in New Delhi, says that a hoarding disorder is “characterised by persistent difficulty in discarding or parting with possessions, regardless of their actual value. This difficulty is typically due to a perceived need to save the items, along with an experience of distress associated with discarding them.”

He also connects hoarding with OCD:

Hoarding disorder is part of the obsessive-compulsive and related disorders. There is no single causative factor that could be implicated, as it is a combination of temperamental, environmental, genetic and physiological factors that leads to the development of a hoarding disorder. For example, indecisiveness is a prominent feature of individuals with hoarding disorders. However, personality factors in isolation can not be implicated as a causal factor for such a disorder.

Additionally, Dr Mudgal says that it’s common to see hoarding exist in relation to other mental disorders as well which include anxiety, depression, dementia and in some cases, even schizophrenia.

When it comes to specific personality types that are more prone to hoarding, Dr Mudgal mentions avoidant, dependent, schizotypal and paranoid.

Degrees of Hoarding

All of us like to indulge and we often forget when to stop. Our usual splurges every now and then are simply human follies and not a mental health problem you need to worry about.

When the symptoms begin to lead to a significant interference in our daily functioning, including congested or cluttered areas impeding their intended use, inability to maintain a safe environment for self or others, feelings of distress as well as an impact on personal social as well as occupational functioning.

Dr Samir Parikh

Think of hoarding as a problem to be targeted only when it begins to cause problems in your everyday lifestyle. It could have financial ramifications - you’re spending on all your money on things you don’t need, perhaps you have no savings and your finances indeed are in a deplorable situation. It could also be leading to practical problems like running out of space or what Dr Mudgal calls “severe domestic squalor”, or emotional problems like feelings of regret after shopping, but still unable to stop from buying more items.

A person’s home is so unclean, messy, and unhygienic that people of similar culture and background would consider extensive clearing and cleaning to be essential. Accumulated dirt, grime, and waste material extend throughout living areas, along with possible evidence of insects and other vermin. Rotting food, excrement, and certain odours may repel other people, accumulation of waste to such a degree that it interferes with occupant’s ability to adequately clean up the dwelling.

Dr Soumiya Mudgal

When to Reach Out for Help?

Dr Mudgal lists down four essential points to identify whether or not hoarding needs help:

• Excessive Acquisition: Hoarding with squalor may be associated with greater public health implications including the presence of mosquitoes, rodents, vermin, infestations, excreta, pathogens, fire hazards and sewerage problems.
• With Good or Fair insight: When a person recognises the problem at least to an extent, but can’t part away with things. This can be caused because of distress due to emotional association or the significance one attaches to these items, especially if they are linked to a person or an event and are accompanied by the fear of forgetting them.
• With Poor Insight: When a person fails to even acknowledge that they have a problem in spite of all dysfunctionality associated with it.
• With Absent Insight/Delusional Beliefs: Complete denial of illness, indifference to the consequences of hoarding behaviours, inflexible beliefs in relation to possessions, or even defensive reactions against change.

These are the conditions where help is much needed for the person and if they can’t recognise the problem, early interventions by friends and family may be required. Thus, prompt identification is absolutely required.

How Can Hoarding be Treated?

Hoarding can be treated with both medication, if it’s reached a severe level, or by using of cognitive behavioural therapy.

• Medication: Medication like antidepressants and antianxiety pills can be prescribed by a mental health professional, says Dr Mudgal. It’s important to seek medication if the hoarder also shows signs of anxiety disorder , social anxiety disorder, depression, substance abuse and eating disorders.
• Therapy: Cognitive behavioural therapy that includes training in decision making and categorizing can be used. It’s also important to expose the person to the practice of discarding and make them habituated to it, in both home and work environments, says Dr Mudgal. It can be achieved gradually with baby steps, until the person is made to move on to bigger, lifestyle changing practices with regards to hoarding.

Dr Parikh agrees and says that a combination of pharmacotherapy and behaviour therapy has been found to be the most effective in dealing with this treatable disorder.