What it is
Hoarding Disorder involves persistent difficulty discarding or parting with possessions—regardless of their actual value—due to a perceived need to save them and distress about letting them go. This leads to clutter that congests living areas and impairs their intended use. It’s not laziness; it’s a treatable condition.
Hoarding can affect safety (falls, fire risk), health (pests, mold), relationships, and finances.
Common signs and symptoms
- Difficulty discarding items (papers, clothes, containers, mail, purchases)
- Strong urges to save items and distress when discarding
- Cluttered living spaces; rooms can’t be used as intended (e.g., kitchen counters unusable)
- Excessive acquiring (buying, free items, “just in case”)
- Indecision, perfectionism about the “right” way to organize
- Social isolation, embarrassment, family conflict; possible legal/housing issues
Hoarding differs from collecting: collections are organized, purposeful, and don’t impair function.
Why it happens
- Information processing challenges: decision-making, categorizing, memory confidence (“I’ll forget without the item”)
- Emotional attachments: items feel linked to identity, memories, or responsibility
- Beliefs: overestimation of usefulness/value, fear of waste, avoidance of regret
- Traumatic/loss events and co-occurring conditions (depression, anxiety, ADHD) can contribute
What helps
- Evidence-based therapy: CBT for Hoarding
- Sorting and discarding practice in real settings with skills training
- Decision rules (keep/discard criteria), categorizing, and “good enough” organizing
- Reducing acquiring; practicing tolerating regret/uncertainty
- Exposure to discarding-related distress; building maintenance routines
- Skills and supports:
- Start small: one surface, one category, or a 15-minute timer
- Safety-first: clear exits, heaters, and stoves; reduce trip hazards
- Accountability partner or support group (in person or online)
- Medications:
- SSRIs may help some, especially with co-occurring anxiety/depression; evidence is mixed—therapy is primary
- Avoid harm:
- Sudden, forced cleanouts without therapy usually backfire and increase distress and re-accumulation
When to seek help now
- Safety hazards (blocked exits, fire risks, pests, unsanitary conditions)
- Eviction warnings or legal issues
- Severe conflict with family or inability to use essential rooms
- Thoughts of self-harm or not wanting to live (seek urgent help)
How to talk to a clinician
- “Clutter has built up to where I can’t use parts of my home. Discarding causes intense distress. I’d like CBT for hoarding with hands-on sorting practice and help reducing acquiring.”
Outlook
Progress is gradual but real. With CBT-hoarding, practical skills, and support, many people restore safety and function and keep clutter from returning.
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline (call/text 988); Crisis Text Line (text HOME to 741741)
- Find care: Psychology Today (filter for hoarding/CBT); FindTreatment.gov; NAMI HelpLine (nami.org/help)
- Hoarding-specific: International OCD Foundation Hoarding Center: iocdf.org/hoarding
- Local support: 211 for housing/code enforcement and cleaning assistance; Community Health Centers (findahealthcenter.hrsa.gov)
- Low-cost/community: Open Path Collective; community-based hoarding task forces (search “hoarding task force” + your city)
- Insurance tips: Verify in-network mental health benefits, telehealth, deductible, copay/coinsurance, prior authorization, out-of-network reimbursement, out-of-pocket max; record rep name/date/reference number
- Safety steps: Install smoke detectors, clear pathways to exits, keep flammables away from heat sources
- Urgent options besides ER: Mobile Crisis via 988 (where available), behavioral urgent care
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.