Hoarding Disorder is characterized by an inability to get rid of superfluous, old, and unusable items. Patients feel distressed and stressed at the thought of having to dispose of these items – even if they have no material or commemorative value.
What is hoarding disorder?
Hoarding disorder is a mental disorder in which the sufferer has persistent difficulty in getting rid of unnecessary and superfluous items. If these items were to be thrown away, the patient would feel distressed and hopeless. Even the mere thought of having to throw things away causes the patient to become deeply stressed and distressed.
Because they don’t throw away anything, over time, the patient accumulates a lot of things (most of which are worthless, badly damaged items that can’t be used) in the house. The state of hoarding objects is quite different from the preservation of mementos.
Hoarding disorder causes patients to live in cramped, unsanitary spaces with low air quality due to the accumulation of items from day to day. Similar to other psychiatric disorders, hoarding disorder can have a mild to severe onset.
For mild cases, hoarding items just makes the living space quite cramped. Conversely, someone with a severe hoarding disorder can face devastating effects. However, the patient herself is completely unaware of her abnormal behavior. This is the reason why the treatment of hoarding disorder is relatively difficult, many patients constantly deny the disease and refuse treatment.
According to statistics, about 2-6% of people suffer from hoarding disorder to varying degrees. Symptoms of the disease usually have a mild onset in adolescence. Over time, the condition becomes more severe and causes profound effects on quality of life. Most symptoms become more pronounced from the age of 30 onwards. Therefore, treatment for hoarding disorder should be initiated as soon as possible to avoid effects on health and quality of life.
Symptoms of hoarding disorder
Hoarding disorder is characterized by an inability to get rid of unnecessary items. The thought of having to dispose of items causes the patient distress and stress. These symptoms usually appear during adolescence and early adulthood.
Over time, symptoms become more severe. According to experts, hoarding disorder will become more pronounced in middle age and at the same time will be much more difficult to treat than in the previous period.
Hoarding disorder has quite obvious symptoms including:
- Buy too many unnecessary items and the applicability is not high
- Having difficulty disposing of old, badly damaged and unusable items (including those with no commemorative value). This persistent condition causes the patient to accumulate a large amount of unnecessary items in the house.
- There is a painful feeling of having to dispose of these items. Even the thought of throwing things away makes the patient sad and stressed.
- It always feels like everything is needed and will have to be used at some point. Some patients feel that nothing should be wasted and that they feel safe hoarding items around the house.
- Many people confuse hoarding disorder with collecting. However, collectibles are often rare or well-liked. Meanwhile, patients with hoarding disorder keep all of their belongings involuntarily – even though they are severely damaged and no longer usable items.
- Over time, more and more stored furniture makes living space cramped and causes a lot of trouble in life.
- Experts have found that most people with hoarding disorder are perfectionists, procrastinators, indecisive, and have problems organizing or planning something. These characteristics have many similarities with obsessive-compulsive personality disorder.
In the early stages, it is difficult for people around to recognize abnormal signs. However, when the symptoms are severe, the patient himself and the people living together will face a lot of trouble.
Overcrowded furniture can overwhelm every room in the house. This leads to a variety of effects such as inability to shower, go to the toilet, narrow sleeping space, discomfort, etc.
Unhygienic living space
Frequent conflicts with family members because of intentionally keeping unnecessary items. The house is always in a state of clutter, clutter and it takes a lot of time to find the items you are looking for.
Animal hoarding is a type of hoarding disorder. People with this disease can adopt feral cats and dogs in an uncontrolled manner resulting in large numbers ranging from a few dozen to hundreds of animals.
Animals can be kept in the house or kept free, but they all have the common characteristic that they are not properly cared for and periodically checked for health. Most of them have dermatological, digestive, respiratory diseases, etc. because of unsanitary conditions.
Causes of hoarding disorder
Like other psychiatric disorders, the cause of hoarding disorder is unknown. However, some experts support the hypothesis that this pathology is related to the following factors:
- Disturbance in the concentration of neurotransmitters in the brain
- Psychological trauma (often related to past poverty, deprivation, etc.)
The age of onset of hoarding disorder ranges from 11 to 15 years of age. Therefore, experts say that indecisiveness and steadfastness may be factors that increase the risk of disease. People with this personality often have difficulty choosing and can’t get rid of things that are no longer worth using.
Is hoarding disorder dangerous?
If only looked at in general, some people think that hoarding disorder is not dangerous but only causes trouble in life. However, in fact, this disease can cause many serious complications if not examined and treated promptly.
As mentioned, the symptoms of hoarding disorder tend to get worse over time. This means that the amount of stored furniture and items will increase significantly. Hoarding items will make living space cluttered, cramped, unsanitary environment and low air quality.
In addition to the effects on functioning and physical health, emotional distress at the thought of having to throw things away can develop over time. This increases the risk of psychological and psychiatric disorders. Hoarding disorder has profound effects on the health and quality of life for the patient and his or her loved ones.
If left untreated, this condition can cause the following complications:
- Frequent falls, injuries due to furniture piled up on the floor and areas such as balconies, bathrooms, etc.
- Conflict with family members and sometimes have to live alone because of not being able to get along.
- Living a closed life, social isolation.
- There are physical health problems such as breathing, skin and hair problems due to an unsanitary living environment and low light.
- Increased risk of other mental disorders such as anxiety disorders, depression, obsessive-compulsive disorder, etc.
In addition to the above problems, people with hoarding disorder also have difficulty in dating, finding work, etc. People with early onset of illness and severe symptoms are almost impossible to get married because few people accept the habit. Stock up on superfluous and unnecessary items.
Diagnosis of hoarding disorder
Hoarding disorder rarely goes unnoticed, with most patients presenting for other psychological problems such as stress, anxiety disorders, or depression. Most patients are also often misdiagnosed because they themselves do not consider hoarding as abnormal. Therefore, the patient rarely mentions this to the doctor.
Hoarding disorder is usually diagnosed based on clinical presentation. In addition, the doctor will also talk with family members and ask to see photos of the patient’s home to make an accurate diagnosis.
Hoarding disorder is diagnosed when the patient meets the following criteria:
- Having persistent difficulty getting rid of excess furniture and items that are no longer usable.
- There is a thought that redundant items may need to be used at some point. At the same time there is a sense of security when these items are stored in the house.
- Patients experience distress, discomfort, and stress at the thought of having to remove the item.
- Stored objects make living space cramped (except in basements or storage), which affects the function of the room (e.g. too much furniture in the bedroom causes the patient to lie on top of items, cramped, cramped sleeping space, etc.).
- The accumulation of superfluous objects causes patients to reduce their occupational and social functions, etc.
Currently, most psychiatrists use the DSM-5 diagnostic criteria to definitively diagnose hoarding disorder.
Treatments for hoarding disorder
Hoarding disorder is a fairly common but little-known mental disorder. Most patients do not perceive their behavior as abnormal and do not realize the negative effects of hoarding unnecessary items.
Currently, the treatment of hoarding disorder is quite challenging. However, if actively treated, the storage of items will be significantly improved and the patient can also stabilize a long life.
The following are methods used in the treatment of hoarding disorder:
Psychotherapy is the mainstay of treatment for hoarding disorder. This method is carried out by means of communication to change the psychology of the patient, thereby improving the abnormality of emotions, thinking and behavior. Currently, cognitive behavioral therapy is the most effective method for hoarding disorder.
This therapy focuses on changing the patient’s mindset (thoughts) about hoarding things. This is quite difficult because the patient himself has a strong belief that items are essential and not necessarily thrown away. Therefore, it will take a long time for the specialist to change the wrong thinking and help the patient to resist the thought of having to hoard excess belongings.
In cognitive behavioral therapy, the therapist will also teach the patient how to sort items to know what to keep and throw away. Many experts find people with hoarding disorder to be indecisive and unstable. Therefore, the specialist will also help the patient change these personality traits to make it easier to dispose of unusable objects.
Psychotherapy can be done individually, in groups, or as a family. Usually, the specialist will ask the patient to intervene in many forms of therapy at the same time to achieve the best results. During the treatment process, it is very important to support the family, colleagues, friends, … to help the patient be more decisive in getting rid of unnecessary items.
2. Drug use
There is no medication that can improve the excess stocking caused by a hoarding disorder. However, antidepressants can be used to improve stress, distress, and sadness from having to throw things away. Among them, serotonin reuptake inhibitors (SSRIs) are the most commonly used drugs.
Treatment of hoarding disorder takes a long time because the patient herself is completely unaware of the abnormality in her behavior. Family and people around should encourage the patient to be motivated to change. Avoid the situation of blaming, criticizing, causing conflicts to arise and hurting the patient’s psychology.
Hoarding disorder is a relatively common mental disorder that has received little attention. Because the cause is not clear, there is no way to prevent this syndrome. The only way to minimize the effects of the disease is early detection and treatment.