Hoarding disorder

Hoarding disorder involves the accumulation of things coupled with an inability to part from possessions to the point that an individual’s living space is no longer functional and has become hazardous. Assorted belongings, clutter and trash pile up on tables, countertops, furniture, and beds. Stoves, sinks, bathtubs, and even toilets may become unusable. Movement might be restricted to narrow pathways through piles on the floors. In some cases, multiple animals are involved. Fecal matter, mold, and rodents may be ignored by the individual with a hoarding disorder. People can lose housing and important relationships because of their hoarding behaviors but they either cannot stop the behavior or have little to no insight to the risks and consequences of their behavior. Hoarding disorder is a disturbing condition that may look like self-neglect because the individual who is hoarding does so at their own peril. Approximately 75% of individuals with hoarding disorder also have an anxiety or mood disorder. It is not considered a hoarding disorder if the situation is caused by a neurocognitive disorder such as dementia.

Signs & Symptoms

  • Items saved are usually newspapers, magazines, clothing, bags, books, paperwork and mail

  • Items accumulate to the degree that living areas can no longer be used for their purpose

  • Trash accumulates among the items.

  • Rooms, hallways and staircases are cluttered – not just one or two rooms

  • The individual experiences extreme distress at attempts to discard or clear items

  • The accumulation of items causes relationship problems and impairs social and occupational functioning

  • Conditions become hazardous and often times unsanitary, especially in the presence of multiple animals

  • The individual has longstanding and extreme difficulty discarding or parting with items (regardless of the value of the item)

  • The main reasons given for difficulty in parting with items are strong sentimental attachment, perceived future usefulness of the item, aesthetic value of the item, concerns for being wasteful or fear


There are television shows and stories about cleanups and total transformations of the homes of individuals who hoard. In truth, cleaning up is not treatment. Research on the treatment of hoarding behavior has concluded that there are a few approaches to the treatment of hoarding that are effective. Cognitive behavioral therapy and coaching seem to be most effective as the individual needs ongoing support for behavioral changes and the development of decision-making skills and coping strategies. Treatment takes time and good clinical expertise. In some Maryland communities, problems with hoarding have led to the establishment of task forces within public agencies to address the issue.

Immediate Help

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