Do's And Don'ts: Helping With Hoarding Disorder

Living with a loved one experiencing hoarding disorder can be extremely distressing. It distinctly affects your ability to be as close to that person as you would like. Perhaps you have difficulty spending time together because the hoarding disorder takes up space, like an elephant in a very disorganized room.

You probably want to help your loved one. Maybe you've tried a few solutions, but nothing seems to work. This article aims to help you understand hoarding, its symptoms, causes, and supportive ways to help and maybe just as importantly, how to stop enabling someone experiencing hoarding disorder on the road to recovery.

According to the American Psychiatric Association, hoarding affects anywhere from 2 to 6 percent of the population. The cause of hoarding disorder is currently unknown, but that does not mean that there are not any effective treatments available that can help provide relief. CBT, or cogntive behavioral therapy, is one of these treatments that are widely available. CBT has worked for countless patients by changing their thoughts toward their possessions. Using CBT, they will gradually become less distressed about holding onto possessions and will have a decreased desire to keep future ones. By reducing the effect that these items have on the person, CBT and other treatments can help people recover from hoarding disorder.

What Are The Symptoms Of Hoarding Disorder?

According to the Mayo Clinic, "Hoarding disorder is a persistent difficulty discarding or parting with possessions because of a perceived need to save them. A person experiences distress at the thought of getting rid of the items. Excessive accumulation of items, regardless of actual value, occurs." This serious mental health disorder can lead to dangerous living conditions, malnutrition, and poor personal hygiene. While the cause of hoarding is unknown, experts agree it is important for someone experiencing hoarding disorder to seek professional help as soon as possible after symptoms are identified.

Symptoms of hoarding range from mild to severe. In general, someone experiencing hoarding disorder accumulates and saves large volumes of possessions, regardless of their value. They may experience extreme attachment to inanimate objects and severe anxiety when making decisions. These items pile up to the point that they create difficulty using a space for its intended purpose (like a kitchen or bathroom). Occasionally, some of these symptoms can be explained by other disorders, such as decreased energy to clean, depression, or obsessive-compulsive disorder (OCD). However, someone experiencing hoarding disorder displays a unique combination of symptoms:

• Acquiring and saving items regardless of their value

• Feeling extreme distress at the idea of getting rid of possessions

• Accumulating possessions to the point that it makes rooms unusable. For example - piling stacks of newspapers on seating and dining areas, piles of clothes on the bed, forming heaps of possessions in hallways making it difficult to navigate the home

• Having poor organization or losing important items or documents in the clutter

• Experiencing conflict with those who try to remove items from the home

As symptoms increase in frequency and intensity, the person may experience isolation from others and health issues related to compromised living conditions.

How Do I Know If My Loved One Has Hoarding Disorder?

If your loved one experiences a combination of the symptoms listed above, it is important to encourage the person to seek professional help. The earlier the person seeks help, the more successful the treatment tends to be. Perhaps you see the clutter in your loved one's home as hoarding, but the person only thinks it is messy. If this is the case, it can be useful to use this Clutter Image Rating guide from the Obsessive Compulsive Disorder Hoarding Center. If rooms closely match image 4 or above in the three scenarios, it is very likely your loved one is experiencing hoarding disorder.

Both activities involve acquiring items to which a person gives a special value that may go beyond the item's actual worth. Someone experiencing hoarding disorder, on the other hand, is often embarrassed about the status of their living situation. They also may avoid inviting people into their homes.

If you start seeing these traits developing in a friend or loved one, it may be time for that person to seek professional advice and treatment.

What Are The Causes Of Hoarding Disorder?

You may wonder why someone experiencing hoarding disorder keeps so many possessions when it seems so obvious that the behavior is unhealthy. Very little is known in the psychology community about what causes a person to begin to hoard. Experts say hoarding tendencies often begin as young as puberty, but most people who seek professional treatment for the disorder do not do so until they are 50 or older.

Some believe hoarding disorder tendencies are related to inherited brain patterns and are related to anxiety or obsessive-compulsive disorder. For some, hoarding begins following a significant traumatic experience.

People who hoard say they acquire and keep items for a variety of reasons:

• They believe an item will be useful or valuable in the future

• They feel an item has sentimental value, is unique, or is irreplaceable

• They feel an item is too good of a bargain to pass up or throw away

• They think items will help them remember an important person or event they might otherwise forget

The Don’ts Of Attempting To Help Someone With Hoarding Disorder

Someone experiencing hoarding disorder experiences extreme distress at the idea of getting rid of their possessions. It may be tempting to simply clean up for someone like this. However, like many psychological disorders, forcing someone to change is often not effective and may even backfire and make the problem worse.

• Don't remove things from someone experiencing hoarding disorder's home without consent. It may seem like if they could just start with a clean slate, the person would be much better off, but getting rid of clutter does not address the extreme emotional distress caused by the idea of losing valuable or important items. Throwing things away or getting rid of them without permission is not successful in the long term. Someone experiencing hoarding disorder is likely to revert right back to old behaviors. On top of that, they may become very upset with you. This can diminish the chances of them seeking professional help.

• Don't expect the cleaning process or the healing process to happen overnight. It takes a long time for someone experiencing hoarding disorder to get to the point of having a house that is unsafe, and it can take a long time to change both the environment and the behaviors that caused it.

• Don't enable the behavior of someone with hoarding disorder. While taking items against a person's will is not helpful, adding to their clutter by buying or giving them things or taking them on shopping trips is just as bad. Avoid adding to the clutter by showing your love in other ways and spending time doing activities not related to consumption.

• Don't clean up after someone with hoarding disorder. Just like removing things without permission, cleaning up after someone experiencing hoarding disorder could keep them from addressing the deeper issues that are leading to hoarding in the first place.

• Don't expect perfection. Just like with dieting, spending money, gambling, or drinking, someone experiencing hoarding disorder is likely to experience setbacks even after receiving professional treatment. See these for what they are -- normal human imperfections -- and keep showing love and support.

The Do’s Of Attempting To Help Someone With Hoarding Disorder

Now you know what not to do if you have a loved one who hoards, but you may be wondering if there is anything you can do to help them. While the disorder that leads to hoarding will likely be something your loved one must face for the rest of their life, there are steps you can take to help someone experiencing hoarding disorder reclaim their space and their lives.

• Do encourage the person with hoarding disorder to seek professional help. You cannot force a person to get help against their will, but you can encourage someone by helping them find a therapist and resources in their community to help them get the help they need.

• Do take the time to learn about hoarding disorder. While TV shows about hoarding may spread awareness about the disorder, many experts say these shows portray an incorrect picture of hoarding and how to help a person who hoards. Look for credible sources like the Mayo Clinic, the National Alliance on Mental Illness, and the American Depression and Anxiety Association of America.

• If someone with hoarding disorder asks for help with their belongings, you can help them. During or after receiving professional treatment, someone experiencing hoarding disorder may seek your assistance in managing the accumulation of clutter in their home, car, and other spaces. Help when you can or consider seeking professional movers and cleaners if the task becomes too daunting.

• Do listen to your loved one and see them as a person who is more than their hoarding disorder. Try not to judge them for their hoarding any more than you would judge someone for having a physical health ailment like diabetes or asthma. Hoarding is a mental disorder. It is not something a person simply chooses to do. Your support and openness will go much further toward encouraging your loved one to seek professional treatment than your judgment or disappointment.

• Do recognize positive changes someone with hoarding disorder makes. Hoarding doesn't happen overnight, and it won't be solved overnight. Encourage and praise your loved one if you see them attempting to clean or organize a small space or making the decision to talk to a professional. Your love and support will be instrumental in helping someone experiencing hoarding disorder get on track and stay there.

Online therapy can be a convenient, stress-free, yet effective way to start addressing hoarding behaviors, and at BetterHelp, licensed counselors and therapists who are trained to modify behaviors and use techniques such as CBT are available to help people who struggle with hoarding to overcome their thoughts, feelings, and anxiety, about separating from their belongings. People living with a hoarding disorder may be more inclined to engage in online therapy because they can enjoy a sense of agency that the platform allows in letting participants schedule appointments from a preferred space and time. If a person with a hoarding disorder feels comfortable showing their home to their therapist, online counseling easily allows participants to turn the video function on and off. 

Online therapy has shown effectiveness in treating compulsive hoarding. In one recent study, 261 participants were divided into a waitlisted control group and a web-based self-help group. Online CBT, the primary treatment mode for the experimental group, was effective in that all of that group’s participants showed reductions in clutter and hoarding symptoms over 15 months. Researchers also established a correlation between group engagement and hoarding severity, with less posting activity associated with greater hoarding severity. 

In a separate investigation, researchers evaluated the efficacy of online acceptance and commitment therapy (ACT) on a sample group demonstrating symptoms of hoarding disorder. Participants – all identifying as women – attended an average number of 13.7 sessions across 31.5 days, and two-thirds provided behavioral input at the six-month follow-up. According to their reports, 100% showed reliable change, 60% showed clinically significant change, and 60% showed both reliable and significant change in decreases of symptom impairment. Additionally, many participants experienced increased quality of life and overall psychological flexibility.

Adapting to life without hoarding will take time, and will be challenging, but by giving people the skills they need to cope, people can live a life free of hoarding. Additionally, maintenance and regular check-ups may also be required to make sure that the individual does not relapse back into old habits. Online therapists at BetterHelp are experienced in administering various treatment methods, including CBT and ACT, and you can match with a counselor best suited to support you or a loved one with hoarding disorder by taking the initial questionnaire. Read below for some reviews of BetterHelp counselors, from people experiencing similar issues.

Therapist Reviews

I am not worried about being judged, and I appreciate the times when she empathizes or relates to parts of my life. Dr. Morritt is thoughtful in her responses in a way that allows me to let go, grow, and see other points of view."

"I began working with Courtney during a time when I was very anxious, overwhelmed, stressed, and needing someone to help me work through the chaos in my mind. Courtney was so empathetic, understanding, and non-judgmental, and encouraged me to let go of things that were no longer serving me. Courtney always checked in to see how I was doing if I hadn't been messaging her and that meant a lot to me. I felt respected, heard, and validated. I would recommend her to anyone."

Takeaway

As many as one in 50 Americans go through a hoarding disorder, but hoarding treatment is available to 100 percent of those who have hoarding disorder. When one considers their friends and loved ones, the effects of hoarding are much more widespread. There is no perfect solution to helping a loved one experiencing hoarding disorder, but patience, love, and understanding are key and encouraging your loved one to seek professional help is probably the most effective step you can take.