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Published on September 17, 2019

messy, over-stuffed garage

Hoarding and Mental Health

Hoarding – the excessive gathering of stuff, to the point of overflowing, disorganized living conditions — can affect anyone. In extreme cases, the habits can spiral out of control, creating hazardous conditions for not only the person who faces the problem, but their friends and family, too.

Matthew Christiansen, PhD, clinical psychologist with Avera Medical Group Family Medicine Mitchell, shared these definitions and some insight on the condition known as hoarding.

What It Is

Anxiety is often at the root of hoarding behaviors.

“The reasons people keep many items can vary, but with hoarding they often feel sentimental, they may see that the stuff has some intrinsic value, or one day will, or they think the stuff they’re keeping is instrumental to future success,” said Christiansen. “It is becoming more prevalent in our society because people have more access to things.”

Retail stores that specialize in low-cost items often appeal to hoarders, who may purchase hundreds of inexpensive items, thinking they need to have a tremendous amount of something like coat hangers or clothing.

Clutter can lead to uncleanliness, and those conditions can cause an unsafe living environment, especially one where evacuating from a fire is nearly impossible due to all the stuff.

Why It Happens

While anxiety can make hoarding behaviors worse, the condition is most often seen as similar to obsessive compulsive disorder, and people who exhibit the behavior may start as young adults. “We have seen it in children, but it is rare,” he said. “Young adults may start hoarding, and then it will become gradually worse as they get older. It often flares up due to stressors that make the person feel the need to go get more stuff.”

How to Help

Treatment is possible, but friends and family who aim to help a person overcome hoarding behaviors should realize that one session with a psychologist or counselor isn’t going to change things all at once.

“You have to have the person on board if you’re hoping to help them,” Christiansen said. “If you simply gather up the clutter and throw it out, it could make things worse. They need coaching, rules and relationships in order to get control of the behavior.”

People who hoard, and their loved ones who are trying to help them stop, can use these four questions for any purchase:

  • Do I have an immediate use for the item?
  • Is it affordable for me?
  • Will I manage and maintain this purchase?
  • Do I have a place to keep it?

“If the item passes all four of these questions, then they can go ahead and get it,” said Christiansen. “The rules can help them to realize they have a distorted sense of reality. You can also ask their permission to help sort things out or clean things up. If you do, they will be an ally in the effort.”

Helping hoarders sort between things to keep, to “maybe” keep and to throw out is helpful, too.

“When it interferes with your life and the distress of the clutter and disorganization becomes an issue in their life – that’s when friends and family have to reach out and help,” he said. “But the most effective help will take time, working with a professional, and require effort in relationships with the person who is having the problem.”

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