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Hoarding Disorder- An Overview

Understanding Hoarding - For Hoarders and Helpers

Hoarding is a disorder that affects millions of Americans every day. Although it makes for great TV, it is a serious condition that is not only embarrassing and inconvenient, it can be damaging to one’s health and life.

In this article, we look at hoarding from two perspectives: the hoarder and the helpers.


What hoarding is - Hoarding is a psychological disorder that is often based in loss and pain that can date back decades. It is an uncontrollable compulsion to save and keep things, even when they have no further value or might be harmful to the person’s health.

What hoarding isn’t - Hoarding isn’t something that people choose to do. It isn’t simply collecting or storing. Hoarding isn’t something that people can just get over. No amount of yelling, screaming or swearing will make hoarding disappear.

Understanding the Psychology of Hoarding

Hoarding is a recognized psychological condition. It is an accepted diagnosis that is described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM is the accepted source for definition, diagnosis and treatment guidelines of most psychological disorders. The DSM is updated periodically to reflect changes in medicine’s understanding of psychology.

The DSM-5 defines hoarding as:

  1. Persistent difficulty discarding or parting with possessions, regardless of their actual value.

  2. This difficulty is due to a perceived need to save the items and to distress associated with discarding them.

  3. The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (eg, family members, cleaners, or the authorities).

  4. The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining an environment safe for oneself or others).

  5. The hoarding is not attributable to another medical condition.

  6. The hoarding is not better explained by the symptoms of another mental disorder (eg, obsessions in obsessive-compulsive disorder, decreased energy in major depressive disorder, etc).

  7. Specifiers

  • With excessive acquisition

  • With good or fair insight

  • With poor insight

  • With absent insight/delusional beliefs

Source: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

As you can see from the criteria above, it’s about more than just keeping things. Some of the criteria deal with how the hoarding affects one’s social life.

If you are the hoarder, it might not seem like this is you, but if you’re reading this, it means you’re concerned. If you can, ask a loved one. Your children, partner, or a close friend might be able to give you a more honest assessment.

If you are a helper, this might all sound right, or just some of it. If that’s the case, you need to move gently. The hoarder might not be ready to listen. It’s good to open the door to the conversation, but this isn’t something that can’t really be forced.

You are not alone

According to an article in Scientific American (1), there are between 5 and 14 million hoarders in the US. That’s about twice as many people as have OCD (obsessive-compulsive disorder). Even though there are so many hoarders, it’s not a commonly talked about disorder simply because people are embarrassed by it.

It feels to many people that it’s simply something that they do, except it’s out of control. The worst parts of hoarding for the hoarded is embarrassment and a lack of control. Similar to a gambling or a drug addiction, the hoarder knows that what they’re doing isn’t healthy, but they can’t stop themselves.

Hoarding Disorder versus OCD

Hoarding disorder is described as “a persistent and unrelenting preoccupation” versus “repetitive, unwanted, and intrusive thoughts that trigger anxiety.” (2)

Hoarding disorder is consistent. It never goes away. For most hoarders, it is more like an addiction to drugs where they are seeking the thrill of the next score. With OCD sufferers, the need to satisfy their urge causes anxiety that can only be satisfied by doing whatever it is that they are anxious about.

For most hoarders, there is little anxiety until they are confronted with the need to get rid of a possession, even if that possession is actually trash. OCD doesn’t have the ‘acquisition’ component that hoarding does. Most people with OCD aren’t focused on gathering items as much as they are with cleaning, organizing, or otherwise manipulating the items that they already have.

Helpers: How You Can Help

Helping someone overcome their hoarding tendencies is not typically something that can happen without professional aid. The hoarder will need to break through thought patterns and change their entire lifestyle.

With that said, there are things that you can do and should not do to make the transition easier.

Watch your expectations

It usually takes someone years to become a hoarder. It’s a slow process that happens almost imperceptibly. It will often start with a tragedy or a difficult event and from there a rationale develops that many things are necessary to save “just in case”.

You need to approach the situation with patience and kindness. On the A&E Show, “Hoarders”, they go in and try to change someone’s life in a couple of days. This usually will involve at least one family member (or the hoarder) walking away. There are angry tears and yelling.

In reality, the goal is to help someone slowly reverse their course. It took years to get here and it will take years to go backward. Celebrating even the smallest successes will go along way to changing their thought patterns. A single bag of trash or a clean table should be noted and celebrated.

Below we will go deeper into how a hoarder can change their environment. Simply do everything you can to lovingly help this process along.

Getting resources and support

There are lots of resources for hoarders. For example, in Chicago, we’re here, HoardingHelpers. We specialize in helping hoarders get their lives cleaner. There are similar services in other cities as well.

One of the most important resources is psychological help. A psychologist or psychiatrist that specializes in hoarding disorder can help to pave the way for success.

If your loved one isn’t quite ready yet, it can be important have someone in the wings to help them and you.

There are some online resources available as well, so it can help to know what exists and what can be done. In some cases, you can find therapists that are available to assist with your efforts.

Speaking to your loved one

Patience is vital. Here are some suggestions on how to speak to your loved one.

  • Acknowledge their problem. Identify with them and make it clear that they aren’t being judged. Make sure that they understand that this is not who they are, but a problem that you need to tackle.

  • Let them know that this disorder can cause them illness and likely causes them to miss important things that are happening around them. For example, a hoarder is not likely to be able to have their grandchildren around. Remind them about how awesome it will be when they can do that.

  • Take the time to understand why they do what they do. Ask about when it started. Do they remember a time when it wasn’t happening? How do they feel when they buy new things? The more you understand, the more you can work within their issues and concerns.

Be Consistent

Again, while it makes for great TV, this isn’t a 3 day process. In fact, if you watch at the end, you will see that the show offers ongoing therapy and assistance. That’s what makes it cool.

Be sure that if you start this ball rolling you can follow through. Your loved one can’t have just a weekend of your attention, then have you head off to work on Monday. You will need to be able to stop by and help every day for a while. You will need to call and check in for months, maybe even years.

Their life change is going to take them a terribly long time and you will need to be there for the whole thing.

When You’re the Hoarder

Firstly, let us congratulate you. The very first step in fixing any problem is to acknowledge that there might be a problem. That you are here reading this is a HUGE first step.

We are honored to be a part of what might be the most amazing change in your life.

So let’s get started!

If you have any questions, no matter where you are in the world, please call us at 773-865-3172/872-239-4197 or email us. We are here to help with this problem. We’ll work to find you whatever resources you need.

Starting small

The idea of cleaning up everything you have accumulated can seem very overwhelming. In fact, it is, so let’s start small.

Choose one small area - Pick the corner of a room or a single table to clear off. Once that’s cleared and cleaned, you can go onto another place, but for now, just the one spot. So, once you have found a small space, you can get started.

Do a little everyday - You don’t need to tackle even this small area all at once. Every day you need to go to your clean area and do a little bit until it’s done. Here are a few simple rules to follow to get the job done:

  • Work in the same place every day - If you focus on one place, you will see progress. If you move about you won’t see a change and it can get disheartening.

  • Do at least 15 minutes a day - You don’t need to work all day every day, but do at least 15 minutes every day and you will make great progress in no time.

  • Make a timetable - Set a goal for completion of your chosen area. For example, set a goal to complete the kitchen table in one week. That way, you don’t find yourself dragging it out.

  • Celebrate your success - When that first area is done, treat yourself. Don’t go out and buy something to bring home. Maybe go out for ice cream with a friend or take yourself to a movie.

Finding new rewards - Up to now, you have probably been rewarding yourself with things. If you had a successful day, you would buy something or go get something to take home. If you had a bad day, you would bring something new home. If you were feeling anxious, something new would come into the house.

Look for new ways to handle those same feelings. Here are a few examples:

  • When you’ve had a good day, go out and spend the day with someone you love. If you have grandchildren, take them to the park. If you have a good friend, take them to lunch. If you can’t think of anyone, take yourself to a movie or to a beach. Reward yourself with memories; good memories are the best thing to save.

  • If you find yourself having a bad day, try spending time with someone that you can vent to. If you can’t do that, one of the best ways to ‘get back at the universe’ is to not let yourself get derailed. Continue your work on your area, regardless of what the day was like.

Look for anything that will make you happy or happier that doesn't involve bringing items home.

It can be helpful to think about what made you happy in the time before you began hanging onto everything. It’s possible that was long enough ago, you might not remember, but if you do, think about those things.

How to decide what to keep and what to let go of

The hardest part of your journey will be to decide what to keep and what to let go of. There are some simple rules for you to follow here to. If you follow them, you will likely find that letting go of things that aren’t necessary will be much easier

  1. Only take 10-20 seconds to decide- The longer you debate, the more likely you are to talk yourself into keeping things that you don’t need or really want.

  2. Can it be replaced - If it’s a priceless family heirloom, then you should keep it. If you can go to Walmart or Target or the grocery store and replace it, let it go. It’s just a common thing and you’re worth more than common things.

  3. Don’t churn - Churn is when you move things from one part of the house to another. It can be tempting to move things from your small work space to another part of the house, but they you’re just moving the problem, not really fixing it.

  4. Don’t hang onto things for others - Saving stuff for other people is one of those things that many hoarders do. Don’t hang onto this stuff. If the person wants it, they should have already come to get it. If they don’t want it, why hang onto it? If it’s something that you’re keeping for a little person for when they grow up, give it to the parents and let them decide.

  5. Make clear rules for helpers - If you will have helpers, let them know exactly what the rules are. Here are some sample rules:

  6. If it’s moldy, throw it out.

  7. If it’s dangerous, throw it out.

  8. If it’s part of my special collection (like a doll or a statuette), please ask me first.

These rules are yours and your helpers should live by them. So should you. If you made a rule and you start to change your mind, trust the self that wasn’t as scared as you are now.

Getting Through

It’s hard to get through this. It’s as hard as giving up smoking or drugs. It’s not going to be easy and no one should let you think that it will be. Nonetheless, people do give up drugs and smoking every day and you can give this up. Your life will be better, healthier and more fulfilled when it’s packed with the love and moments that you’re missing now.

Here are a few ideas that can help you get by

  • The bad feeling of losing an items is not as strong as the good feeling of a clean house.

  • Visualize all the things the your house will be able to do when it’s clean and safe:

  • Family gatherings

  • Friendly visits

  • Children and grandchildren to visit

  • Being able to make a nice dinner

  • Walking through your house easily

  • Feeling physically better

  • Knowing that you were able to overcome this disorder

  • Getting professional help

  • Professionals are judgment-free

  • They can work to help you understand and change

  • They will look for the root of the problem, where it started

Keeping it clean

Now that you have cleaned even a small spot, you need to keep it that way. This can be tough, but you can keep control of your urge to fill that space.

Keep the help coming - Now that you’ve had success, don’t stop and don’t let go of the help. For anyone, the worst thing that we can do after overcoming an addiction is to get back into our own heads. Let your helpers, whether they are professional or family and friends, keep coming over. They are your touchstone to how well you’re doing and staying on course.

Keep people coming to the house - Make sure that you keep friends and family coming over to visit even if they know nothing of the hoarding. Having other people visit us helps us to see our home through other people’s eyes. Everyone cleans before company arrives, so you won’t be an exception or abnormal.

Try to catch yourself - Every day, take a few minutes to look around and ask, “Is this better or worse than it looked yesterday?” If you want to, take photos so you can compare day to day or week to week. Like many problems in life, hoarding is a slow and creeping process that we don’t notice has gone awry until after it already has. Once it’s there, it feels overwhelming and impossible to overcome.

A Couple More Notes for the Hoarder

  • This is not your fault - Somewhere along the way, you developed this disorder. It’s a choice that you made, but an addiction that you fell into.

  • You are not the disorder - You might be a hoarder, but hoarding is not who you are. It’s simply something you do that you can change. You will probably always be a recovering hoarder and that’s a badge of honor.

  • This will be a learning process about yourself - Hoarding is rarely about stuff. It’s always about emotions and usually a trauma that changed your life. In fact, in many ways, the traumas that start hoarding rewrite your brain. The problem is that they rewrite them in ways that aren’t helpful. Therapy and willpower can rewrite it again to what it’s supposed to be.

Some extra notes for the Helper

Here are few follow-up notes for the helper.

  • You need to read everything above, please. It’s important that you understand what hoarding is and what it means to have it.

  • Remember: The number one thing that you can do is to be patient. It took years for your loved one to get here and it might take years to come back from it.

  • Be sure to visit often. It’s really easy for a hoarder to slip backward, so your presence can be the touchpoint to keep things under control. Every day will be battle for them and knowing that they have an ally will be a huge help.

  • Frustration is part of the process for you and them. If you feel yourself getting frustrated, try to walk away and share it with someone on your support team. The hoarder in your life will be fragile and nearly any push can take them off course. Try not to let them see your frustration.

  • Work with their professional assistance. If your family member or friend gives permission for you to be involved, you can work with the therapist or psychologist to keep the ball rolling.


There are a number of drugs that might be prescribed to help with hoarding disorder. Usually the drugs are SSRIs (serotonin reuptake inhibitors). These are the same drugs that are used to treat depression.

Your doctor or psychiatrist will prescribe the right drugs. Sometimes, it will take a couple of tries to get the perfect drug for you. Be patient.

It’s important to keep taking whatever you’re prescribed. If you’re having bad side effects, call your doctor right away. Do not stop taking your medicine without your doctor’s permission.

We Believe in You!

At HoardingHelpers, we work with people who have hoarding disorder every day. They are courageous and good people fighting against a part of themselves that can be overwhelming.

We need you to know that we believe in you! We know that this disorder can be beat. We see it happen every single day. Like everything in life that’s worth doing, it’s not easy, but it can be done.

Any time you need us, please call us. 773-865-3172 or 872-239-4197 or email us at

Who we are provides cleaning and removal services for all types of hoarding situations. We are dedicated to providing relief and hope for Hoarders and their family members.

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