Hoarding Disorder vs. Messiness

What is Hoarding Disorder?

Hoarding disorders used to be considered a subtype of obsessive-compulsive disorder, but in 2013 it was classified as a separate mental health diagnosis.

Hoarding disorders have two main characteristics: First, the tendency to acquire and keep an excessive number of items that seem to be of limited value or useless to the average viewer, but they are actually very important to the person collecting them. 

The second characteristic of hoarding disorder is that the items collected tend to fill the house in such a way that the person collecting them can no longer use the room as intended. Thus, one can no longer sleep in bed, use one's bathroom to get ready in the morning, shower or prepare meals in the kitchen.

How is hoarding different from clutter?

There are a few key aspects that differentiate between hoarding disorder and clutter. In hoarding disorders, the person usually intentionally acquires things, they have a strong attachment to these items, and they care a lot about what happens to these items. 

If you come into the house of someone who has hoarding diseases and offer to clean them up or throw things out, it will cause them a lot of suffering. On the other hand, someone who lives with a lot of clutter or is just messy doesn't have a strong attachment to these items, and they are usually quite relieved - or at least don't care much about it - when you offer to clean up their apartment.

Why are people saving?

People are saving for the same three reasons, whether they have a hoarding disease or not.

The first is that we all save because things are very useful; they have instrumental value. "I save a hammer, for example, because I have to hammer things occasionally."

The second reason we save is sentimental; so the object reminds us of a person, place, or thing that was important to us.

And the third reason why we save is the intrinsic value. In other words, it makes us happy or it triggers joy.

People with hoarding disorders actually save for the same reasons, but they have different thoughts and beliefs around these objects. So, if I throw away something that has sentimental value, and I have a hoarding disorder, I may be afraid that I will lose that memory or connection to that experience or person. If I throw away something that brings joy, I fear that I may never get it back.

Warning signs for hoarding disorders

The first thing to consider is health and safety. If too much clutter fills a house, it can be a fire hazard, both because of the inability to get out of a window or door in the event of a fire and because of the high flammability content. Things start to be stored near sources of fire or heat, radiators get blocked, that sort of thing. 

There is also concern about stumbling and falling. In particular, papers that are most commonly hoarded can be very slippery and a danger to residents. When a house starts to fill up with clutter, it also becomes really difficult to clean this stuff, so we also become a bit more susceptible to the accumulation of dirt or the attraction of pests, something like that.

The second warning sign that things are getting out of control is that it is beginning to cause some kind of distress in your life. Either it is causing conflicts with your family members or your friends, or it is becoming really difficult to get things done; just everyday things like getting ready for work or doing your laundry or taking care of your family, and it can contribute to the isolation and withdrawal of people who were important to you.

Is there a treatment for hoarding diseases?

It is important to know that there is a treatment for hoarding diseases. Therapy helps, there are support groups and there are some really great books that can be helpful.

If you think you have a hoarding problem, the first thing you should do is get more information. There are a lot of great resources that really help you distinguish whether it is really a hoarding problem or something else masquerading as major depression or obsessive compulsive disorder.

The second thing I would recommend to you if you think you have a hoarding disorder is to approach your support system. Find someone you trust and have a conversation with them. Let them know that you are having difficulties, invite them to your home and show them; maybe try a little bit of intentional discarding and see if it creates any anxiety for you.

What to do for a friend or family member who may have a hoarding disorder?

When families are worried about their loved ones, the very first thing we want to do is roll up our sleeves and clean up the house, and that is probably the very last thing we should do. 

Remember, hoarding disorder is an anxiety disorder, and when someone comes into the house and starts disposing of our belongings, the person with hoarding disorder will react with a lot of fear and grief and even anger. So the best thing we can do is protect your relationship with that person. Express your concerns openly and honestly and focus your attention on their well-being and not on the mess or stuff around them.

Schedule with a CHI Health Mental Health Therapist if you'd like to talk more about hoarding disorder.

Resources for Patients

• International OCD Foundation (IOCDF) Virtual Hoarding Center
• Steketee, G. & Frost, R.O. (2010). Stuff: Compulsive hoarding and the meaning of things. Boston, MA: Houghton Mifflin Harcourt.
• Tolin, D., Frost, R.O., & Steketee, G. (2013). Buried in treasures: Help for compulsive acquiring, saving, and hoarding (treatments that work). New York: Oxford University Press.
• Tompkins, M.A. & Hartl, T.L. (2009). Digging Out: Helping Your Loved One Manage Clutter, Hoarding and Compulsive Acquiring. Oakland, CA: New Harbinger Publications.