We might want to keep a top, even though it doesn’t fit us any more, or a torn shoe as it might have some sentimental value. We all have difficulty in parting away with things that matter to us. However, hoarding is when we struggle to discard many unnecessary objects, and we collect more than we can throw away. Besides leading to unhygienic and overcrowded surroundings, hoarding can also lead to problems in relationships and hinder living a normal life. Hoarding disorder becomes worse as time progresses. It can also occur along with other mental illnesses simultaneously and requires care and treatment.

What is hoarding disorder?

Hoarding is a mental disorder, states the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. “Anxiety disorders come in a variety of forms. Although it is considered to be a kind of anxiety disorder called obsessive-compulsive disorder (OCD), hoarding disorder is a discrete illness”, explains psychologist and psychotherapist Priyanka Kapoor. A person with a hoarding disorder has an intense need to save a lot of things, whether or not they are valuable financially, and they become extremely distressed when they try to part with them.

Symptoms of hoarding disorder

Hoarding disorder impairs daily life. Anxiety symptoms such as palpitations, dyspnea, insomnia, sweating, or psychosomatic symptoms such as tense muscles, stomach problems, or bodily aches are common in nearly all forms of anxiety disorders, including hoarding disorder, explains Kapoor.

Other signs of hoarding disorder include the inability to part with possessions. “There is intense stress that comes with trying to discard items, the worry that one will need them later, the uncertainty of where to put things, the fear that others will handle them are some of the symptoms,” adds Kapoor. This often leads to living in unusable spaces because of clutter and withdrawing from friends and family.

Articles from newspapers, books, clothes, and recycling items are commonly hoarded objects, states UK's NHS, adding, that people who suffer from hoarding disorders are reluctant to ask for help, as they feel that the things that they have collected might be taken away from them. They are also ashamed and isolated from their families.

What are the causes of hoarding disorder?

Hoarding disorder is caused as a coping mechanism to deal with their insecurities and other anxieties within. It is a fairly common disorder. The International OCD Foundation states that two to six per cent of people suffer from it. While anyone can get it, older adults are at higher risk of showcasing symptoms. However, its symptoms may begin to appear during the ages of 11 to 15 years and become severe with every decade. Some people with hoarding disorder recognize that their hoarding-related beliefs and behaviours are problematic, but many don’t.

1. Genetics

Hoarding disorder is more likely to occur in families where there is a history of anxiety or other mental health issues. A study, published by the US Department of Veterans Affairs, states that 50 per cent of variance in hoarding disorder is due to genetics.

2. Childhood trauma or traumatic event

Trauma experienced as a child can cause a host of problems, including anxiety, sadness, OCD, phobias, and hoarding behaviour. Traumatic life events are very common in the lives of hoarding disorder patients. Hoarding disorder starts to appear in mid-childhood, due to early life stress, states a study, published in the Journal of Obsessive-Compulsive and Related Disorders. The development of hoarding symptoms is linked to any stressful or traumatic event, like divorce or the death of a loved one.

3. Mental health condition

Hoarding disorder may coexist with other OCD symptoms in people who already have them. There can be other disorders like ADHD and borderline personality disorder is also prone to having this disorder. Psychological difficulties such as anxiety, and depression are often seen in hoarding disorder patients, states the NHS. It also adds that hoarding disorder was part of Obsessive Compulsive Disorder (OCD) or Obsessive Compulsive Personality Disorder (OCPD) until 2013, after which it was seen as an independent disorder.

Hoarding disorder may be an outcome of dealing with insecurities and other anxieties. Image courtesy: Freepik

4. Low self-esteem

A fragile ego and low self-esteem can also contribute to hoarding disease. They feel somewhat validated and given some security as a result. A study, published in Neuropsychiatric Disease and Treatment, reported that patients with hoarding disorders reported less confidence in their memories, and also overestimated the consequences of forgetting.

What is the diagnosis and treatment for hoarding disorder?

A clinical psychologist will identify OCD and other anxiety disorders, including hoarding disorder, using the patient's case history, mental state evaluation, and other diagnostic tools, states Kapoor.

Treatments for hoarding disorder include cognitive behavioural therapy (CBT). This can happen in a group setting or individual sessions. Here, the session will be focussed on the reasons why someone finds it tough to discard items. It works on changing the thought process behind the practice of hoarding.

Other therapies include systematic desensitization, which is a therapy that focuses on the treatment of anxiety and phobias. Here, a person would be gradually exposed to objects, and situations that produce anxiety while engaged in a relaxation activity simultaneously. Dialectal behavioural therapy and commitment therapy can also be used.

Psychiatric medication may also be necessary, depending on the severity of the issue, to help control the symptoms. Hoarding disorder is caused by several hidden and underlying problems that need to be addressed and can only be handled via psychotherapy, adds Kapoor.

Can you prevent hoarding disorder?

While prevention might not be possible, there are a few ways to stop the severity. We must identify the early warning signs of trauma, despair, and anxiety. These can become severe as hoarding disorder if early warning indicators are disregarded. “It is usually best to seek therapy as soon as emotional issues arise. It's important to develop the resilience needed to handle challenges,” explains Kapoor.

While hoarding disorder cannot be prevented, early diagnosis and treatment can help with the severity. Image courtesy: Freepik

If there are additional difficulties, such as problems in our relationships or careers, they must be taken care of as well. “Don't just put up with the hardships and live with it. Living with it can lead to the development of anxiety disorders, hoarding disorder being one of them,” says Kapoor. Dealing with low self-esteem issues is crucial, as it is the root cause of most mental health difficulties.

How to live with a hoarding disorder?

Depending on how bad the hoarding disorder is, it can be quite difficult to operate normally in daily life. Thus, leading a balanced life through yoga, breathing, meditation, and physical activity is crucial to preserving mental equilibrium. Continued therapy is also necessary as long as the problem's underlying cause remains unresolved.

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