What is hoarding disorder (HD)?
Hoarding disorder is associated with three key features:
Ongoing and significant difficulty getting rid of possessions (i.e., throwing away, recycling, selling, etc.), regardless of their value; and strong urges to save and/or acquire new, often non-essential, items, that if prevented leads to extreme distress. Non-essential includes items that are both useless (i.e., broken), as well as those with limited value (e.g., 10 skirts in every color but never worn)
Living space is severely cluttered preventing it from being used for its intended purpose.
Significant impairment in social, occupational, and other important areas of functioning as evidenced by:
Impaired physical health
Missed work and compromised employment
Financial problems
Housing instability including threat of, or actual, eviction
Social isolation
Emotional distress
Family stress
Two additional specifications include: 1. Whether the individual is also engaged in excessive acquisition (It is currently estimated that upwards of 80-90% of individuals with hoarding also experience excessive acquisition of items through collecting, buying, and even theft.), and, 2. Whether the individual has any insight or awareness that their behaviour is problematic.
Frequently asked questions
I love to shop—does this mean I'm a hoarder?
At the heart of consumerism is the desire to acquire. This desire is fueled by many factors including meeting emotional and functional needs as evidenced by purchasing something because it makes one feel good or because the item is needed for work. The majority of individuals are able to moderate their desire to acquire based upon their financial budget (i.e., spending within one's means), space limitations (i.e., bigger space allows for more stuff), and function (i.e., obtaining items one will use), among other variables. Even if individuals acquire more than they can afford financially, space-wise, or functionally, this does not mean s/he has a hoarding disorder.
I'm a collector—does this mean I'm a hoarder?
While there are a few similarities between collectors and someone with hoarding disorder, there are far more differences. Collectors, hobby enthusiasts, and curators engage in socially accepted, methodical acquisition of a narrow range of specific items that together form a cohesive category. They often are able to discard items as needed (e.g., removing from a collection a cheap replica of a porcelain figurine that was mistaken for the real thing). Collections are kept in an organized manner, and are identified as having meaning, purpose, and value not just for the collector, but also for the broader community. Examples of collections that meet these criteria include 50s memorabilia, folk art, or coins. While what is considered "meaningful" and "valued" is socially constructed, collecting does not prevent the individual from engaging in activities of daily living such as maintaining employment, paying bills, socializing in their homes, and more. Finally, collecting often decreases over the lifespan. In contrast, individuals struggling with hoarding disorder typically engage in saving and/or acquiring of unrelated items that have little to no use or value (e.g., 50 broken kitchen appliances), that are kept in a chaotic and disorganized manner, and generate shame and secrecy in the individual. Furthermore, the individual is unable to discard items even when they are aware of the item's lack of value/use, leading to excessive acquisition of non-functional items and resulting clutter, and in extreme cases, squalid living conditions. As a result, friends and family are often concerned for the individual's emotional and physical, health and well-being, with hoarding resulting in severe limitations in social and occupational quality of life. Finally, hoarding often increases over the lifespan plateauing several decades after onset.
I have a hard time getting rid of things—does this mean I'm a hoarder?
The longer we live, especially if we stay in one location for many years, the more we acquire. And for many, the longer we have something, the harder it can become to part with it. This may be due to an emotional attachment, such as not wanting to part with a favourite toy from childhood or a painting your deceased grandparent left to you, because they have sentimental value. Or it might extend to every day items of less value, but items that may come to serve a purpose in the future, such as owning three coffee pots in case one breaks. While these items may be hard to part with for various reasons, keeping them is of less concern if you have the space to store these items, they are not interfering in your general living space, and were someone in great need of a particular item, you would then be able to part with it.
My child is only messy in her room. Does she really have HD?
Recognize that simply because your child has less access to space in the home, and limited independence and financial means, does not mean that hoarding cannot occur. For these reasons hoarding presents differently in youth than in adults (who have greater means to acquire and keep possessions). A bedroom with huge quantities of seemingly non-valuable items (e.g., papers, rocks, broken or disused toys, old books and magazines no longer being read, wrappers, empty boxes or containers, etc.), packed into every crevice is one tip off. Another is insistence and persistence to acquire new items, after which those items often lay, discarded, in a corner somewhere. Finally, the severity to which your child responds when you try to stop them from keeping or acquiring items is a clue. Major tantrums or aggressive outbursts over your removing empty wrappers and containers from your child's bedroom, is a message that there is a problem. Even a child who only appears to have a "messy" backpack and bedroom can still have a problem with hoarding.
My child always wants the latest toys. Does he have HD?
The vast majority of cultures worldwide place some emphasis on consumerism, and this often begins early in childhood. Children quickly learn that our identities are entwined with the objects we posses, and most youth can tell you what the current trends are and why it matters to own the latest X. Children delight and gain comfort in having collections of various sorts. During the preschool years this helps children learn about categorization, belonging, and other important concepts. As they mature, collections assist with developmental skills such as organization and problem solving, as well as providing a sense of control and mastery over their own possessions. It is also very common for children to develop emotional attachments to items and to struggle to part with items once these are no longer needed. However, in youth with HD all of these factors are magnified. These youth struggle to self regulate, failing to recognize that the number of items or degree of their behaviour is problematic. They lack the ability to sort through items that are useful versus useless, or to predict what will and will not be needed into the future. They engage in extreme behavioural outbursts if asked to discard an item, or if prevented from acquiring a desired object. This is not one small tantrum, but many huge explosions, every single time a limit is set. The child's bedroom may look like the inside of a chaotic bazar, with drawers, closets and other space crammed full. And if this is not the case, it would be if not for the ongoing cleaning intervention of an adult. In conclusion, it is not the consumption or collection of goods that is of concern, but the number, degree and related impact on functioning that sets apart consuming and collecting, from hoarding.
About the author
Anxiety Canada promotes awareness of anxiety disorders and increases access to proven resources. Visit www.anxietycanada.com.
