6 Red Flags of Hoarding Disorder

Hoarding Disorder has been suggested to affect between 2 percent and 6 percent of adults, according to the DSM-V (APA, 2013), and the disorder crosses gender lines. Some data suggest that men suffer from it at a higher rate, although clinical data indicates that women are more likely to present for treatment.

Hoarding disorder seems to develop over time, with older adults (55 or older) being three times more likely to exhibit the behavior than those in younger age groups. However, hoarding behaviors typically start showing up in childhood and adolescence, but grow more distressing over time.

Hoarding refers to the pattern of collecting “stuff” and being unable to let go of the “stuff” one has, which may be in any state from mint condition to complete disrepair. With the popularity of the television series, Hoarders, it’s clear that people are fascinated by the practice of gathering and holding tight to all types of things, animate and inanimate.

For the same reasons that we might slow down to watch a tragedy unfold or view a medical procedure on YouTube, humans are fascinated by the bizarre and the horrifying. However, when you or someone you care about is an active and prolific hoarder, the fascination can cycle into dismay and even disgust pretty quickly.

While often we want to imagine that individuals who suffer from a disorder such as this are somehow “different than” or “less than” ourselves, a recent systematic review of the literature revealed something quite interesting about hoarders and their cognitive abilities (Stumpf, 2022). Compared to control groups, there were no differences between the hoarders and the control group in the areas of attention, episodic memory, working memory, information-processing speed, planning, decision-making, inhibitory control, mental flexibility, language, and visuospatial ability.

The only area in which there was a difference was in categorization skills. This finding may have you nodding and thinking, “Yes, that makes sense.” When asked to begin decluttering and discarding items, hoarders feel significant distress at categorizing what to keep and toss. Thus, the ability to discern between the value of an item or the value/characteristics of an item may spill over to larger problems with categorization.

Collectors, the Clutter Tolerant, and Hoarders

Here’s a “cheat sheet” to help you discern whether someone is a collector, clutter tolerant, or hoarder:

• Collectors selectively choose what they want to add to their collections, and items make sense as a group. Collecting reflects intention. Collectors value the pieces of their collections and may even feel an emotional tie to their collections. However, they don’t randomly gather “junk.” Whether replicas, mugs, character-themed items, or movie memorabilia, each acquisition has intent and appreciation.
• Clutter tolerant folks may use the “stacks on flats” method of storing items that they haven’t “processed” yet. Clutter might be stacks of dirty clothes or even clean clothes in the bedroom–on a chair, floor, or the bed. Anywhere but the hamper or in drawers. Newspapers, magazines, books, and mail were common items that cluttered homes until all of these contents became available electronically. This shift may actually have helped some folks tame clutter. However, empty shipping containers, packaging materials, take-out containers, empty drink cans or bottles, and dirty dishes remain common clutter makers. This clutter often piles up in basements, attics, and closets from the floor up. People tend to recognize the clutter in their homes, don’t enjoy its presence, and are cognizant that it’s not the best way to live.
• Hoarders are emotionally tied to their clutter and suffer from an inability to distinguish what is “trash” or “treasure.” Often, a room is stacked with garbage or junk mixed in with items that hold significant value. Hoarders suffer from “clutter blindness” in that they can’t even recognize their homes' unsanitary and potentially hazardous state.

Braving Entry Into the Hoarder's Home

When you arrive at a hoarder's home, if hoarded items include food waste or animals, you may notice the stench before you step across the threshold. The odor of putrid food, animal urine, or feces may keep some from even entering. If you enter, you’ll likely notice that there’s nowhere to sit, as flat surfaces are stacked with debris, clutter, or even new and unused items with price tags still attached.

Some rooms may be impossible to enter due to the stacked clutter overflowing onto the floor or spilling out the doorway. Anyone living in the home may no longer be able to easily accomplish basic daily tasks due to the clutter that blocks their every move. Bathtubs and showers may serve as storage bins; kitchen counters may be piled high, and even the oven or fridge may morph into storage bins rather than functional kitchen appliances.

Health and emotional issues often keep the hoarder from leaving their home, so facilitating treatment for the disorder may require extra effort.

6 Symptoms of Hoarding Disorder

Every hoarder may be collecting something highly unique–or collecting junk with no rhyme or reason. However, the following six symptoms are reliable indicators of a clinical case:

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1. Difficulty letting go of possessions, regardless of their actual value or condition.
2. Feeling a “need” to save items that may no longer be in serviceable condition and experiencing distress when letting them go or thinking of letting them go.
3. The inability to let go of possessions produces a state of clutter that negatively affects living space and living conditions. Furniture becomes storage for possessions, and rooms become storage rooms; chairs and sofas may be receptacles for possessions, and there may be no way to walk through the home and no place to sit.
4. The behavior leads to significant distress or impairment in multiple areas of functioning–social, professional, and health/safety conditions in the home.
5. The behavior cannot be traced back to a brain injury or other medical condition.
6. The hoarding behaviors cannot be traced back to other mental disorders such as obsessive-compulsive disorder, depression, psychosis, or neurocognitive disorders.

For some ideas on how to help a person who shows signs of hoarding, here are some suggestions.

To find a therapist near you, visit the Psychology Today Therapy Directory.

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