Hoarding – the Hidden Disorder Of Many Older Adults
A hoarding disorder is a mental health condition that is characterized by excessive urges to acquire and, secondary urges to save – which results in highly cluttered living environments.
These are both distressing and result in day-to-day disruption in living.
Why Does It Tend To Be Middle-Aged And Older People Who Hoard?
Some older adults are more inclined to hoard for a few reasons.
Firstly, older adults often feel a greater attachment to possessions due to the nostalgia and sentimental value they hold.
Over their lifetimes, these individuals have accumulated a significant amount of belongings, and subsequently, they struggle more with the decision-making required for clutter reduction.
Also, cognitive issues associated with ageing can frequently hamper their organizational/ categorization skills.
The Risk Hoarding Poses To Older People
Older adults who live in highly cluttered environments are at a much greater risk to themselves – for several different reasons, whether they have a hoarding disorder or not.
One is that their ability to ambulate or move around in a highly cluttered environment is quite compromised, making them much more likely to slip and fall.
Most older adults also tend to be on multiple medications, and trying to manage your medical condition in a highly cluttered household is really quite difficult.
Another reason that older adults are at greater risk, is that they actually cannot manage the clutter in their environment in the way they could have when they were younger.
They tire more easily. Plus many of them have painful conditions of one sort or another.
The Effects Of Hoarding On Other Family
If it’s lifelong hoarding behavior, whereby an older adult has been continually hoarding objects, the effects upon other family members are really quite significant.
Particularly for individuals who grew up in heavily cluttered homes.
Imagine the shame and embarrassment of growing up in a home where you couldn’t bring any friends to.
Imagine as a child trying to do your homework in a highly cluttered, messy, environment.
Imagine trying to keep track of your homework and your backpack – and amongst other things, maintain your personal hygiene…all amongst piles of boxes and other junk .
This disorder has enormous effects on people who grew up in homes like this.
The result of this upbringing, is that these children become adults and many carry a lot of resentment, given their experiences living in a highly cluttered home like that.
That anger and resentment can manifest itself in their interactions with their loved one who still engages in hoarding behavior. This results in personal strife.
Family Resentment Can Worsen The Hoarding Problem
All of that anger and distressed interpersonal relationships worsen the hoarding problem. In turn, that increases the danger that an older adult faces, because no one is actually monitoring their safety.
Because very often family members don’t really want to have anything to do with them and their hoarding problem.
When you have someone who has multiple co-occurring issues or conditions, which one do you tackle first?
What we should do in a mental health capacity is start with the problem that the person is most motivated actually to work on.
At the same time, these other co-occurring conditions can present challenges to treating that problem, which in this case is a hoarding disorder.
People With Hoarding Disorder Often Suffer From Depression
About 70% of individuals with hoarding disorder have co-occurring major depression.
Those people who are suffering from major depression have low energy, low motivation, are more easily fatigued and are more easily frustrated.
Many are resigned to their situations and think, what’s the point – and this leaves them really quite hopeless.
Getting someone with a major depression actually to work on another problem is quite a challenge.
What we should maybe do in a situation like that, is perhaps treat the major depression first.
Because if we don’t treat the major depression first, it’s not likely we will be able to help them tackle the hoarding disorder.
Which is a difficult problem to treat in itself.
Then there are other things like ADHD, something like a quarter to a third of individuals with hoarding disorder have a co-occurring attention deficit hyperactivity disorder.
What we know about ADHD is that it’s very difficult for people with significant ADHD to initiate and sustain tasks.
Even when they are open to help and initiate an action plan or homework practice – if they have a co-occurring ADHD, they may not actually get around to taking any positive action.
The Treatments For Hoarding Disorder
It does not appear that the medications that we currently have are really helpful in the direct treatment of hoarding disorder.
However, we do have medications that are very effective in treating something like major depression or treating something like ADHD.
In working with someone with hoarding disorder who has these other co-occurring conditions, there may be other treatments available that we would want to connect them with.
There’s a lot of work to be done in terms of getting the word out that hoarding is actually a serious problem. The dissemination of information on this topic is still surprisingly limited actually.
It would be good to see more research about strategies, skills, interventions and techniques. Also research into understanding why more hoarders don’t seek help.
Many individuals don’t seek help because they fear authorities will discover their home situation.
They are concerned that if authorities discover the problem, then things may start to spiral out of their control very quickly.
And subsequently, they could actually lose their living situation.
Frequently Asked Questions About Hoarding
- How do you treat hoarding disorder? Hoarding disorder is treated primarily through cognitive-behavioral therapy (CBT). This approach addresses the emotional attachment to items and the anxiety of discarding them. Sometimes, medications like selective serotonin reuptake inhibitors (SSRIs) may also be prescribed. In severe cases, a multidisciplinary approach involving social workers and professional organizers may be necessary.
- What are 3 symptoms of hoarding disorder? Three symptoms include difficulty discarding items, accumulation of excessive clutter, and significant distress or impairment in daily life due to the clutter.
- How is hoarding disorder treated? Treatment involves cognitive-behavioural therapy (CBT) to modify beliefs about possessions and improve decision-making. Medications such as SSRIs can also be used. Support from family and community resources can be beneficial.
- How to prevent hoarding disorder? Early intervention is key. Recognizing and addressing signs in childhood or adolescence, fostering organizational skills, and addressing any underlying mental health issues can help prevent the disorder’s onset.
- What causes a hoarder to hoard? Various factors can contribute, including trauma, anxiety, decision-making difficulties, and a deep emotional attachment to objects. Genetics and upbringing might also play roles.
- What are the types of hoarding? Types include object hoarding, animal hoarding, and data hoarding. Each type reflects a different kind of attachment and accumulation behavior.
- Is there a test for hoarding disorder? There’s no specific “test,” but clinicians use structured interviews and assessment tools to evaluate the severity and impact of hoarding behaviors.
- How is hoarding diagnosed? Diagnosis is based on clinical assessment, observing the accumulation of clutter, and noting distress or impairment in functioning caused by the hoarding.
- How to help hoarding disorder? Providing empathetic support, facilitating professional therapy, and assisting in decluttering without judgment can help those with the disorder.
- How is hoarding disorder diagnosed? Through clinical evaluations that assess the extent of hoarding, the distress it causes, and its impact on daily functioning.
- What causes hoarding disorder in the brain? Brain imaging studies suggest differences in areas governing decision-making, attachment, and emotion regulation. It might be a combination of genetics, upbringing, and environmental triggers.
- What personality disorder causes hoarding? Hoarding can be a symptom of obsessive-compulsive personality disorder (OCPD), but it’s important to differentiate between OCPD and hoarding disorder, which is a distinct condition.
- How common is hoarding disorder? It’s estimated that 2-6% of the population may have hoarding disorder, making it a relatively common mental health condition.
- How to get rid of hoarding disorder? A combination of therapy, medication, and supportive interventions is best. Decluttering should be gradual and collaborative.
- Hoarding disorder is part of which category in the DSM-5? The DSM-5 categorises hoarding disorder as “Obsessive-Compulsive and Related Disorders.”
- What disease is hoarding? Hoarding is considered a mental health disorder, specifically identified as “hoarding disorder” in clinical settings. It’s distinct from collecting and is characterized by excessive accumulation and inability to discard items.
We should Probably Take Hoarding Disorder More Seriously
We have effective treatments for many psychological problems. It would be good to see hoarding disorder taken a little more seriously.
So whatever we can do to lower the stigmatization of hoarding disorder and the barriers facing individuals with this problem will be welcome.
It might encourage more people with this condition to come forward for help.
If you are suffering from this problem, or have a loved one who is suffering from the problem, you might want to reach out to a psychiatrist in your area . UK here and US here.
