Collecting problems: Hoarding

We have all known pack rats.  Maybe we have occasionally been guilty of stockpiling unnecessary stuff ourselves. But when this behavior starts interfering with our daily routine it becomes hoarding. Hoarding—the excessive collection of items, along with the inability to discard them—often results in cramped and unhygienic living conditions in homes, resulting in narrow pathways winding through stacks of clutter. 

Although hoarding can be found in people of any age, race, education, socio-economic status, gender or nationality—it is more prevalent in older adults.  They are unaware that their living circumstances pose a danger to themselves and to others, yet they are unable to change their behaviors on their own.

We do not know how many people are hoarders in the country because most do not seek help. Some studies estimate that two to five percent of Americans exhibit hoarding behaviors. One of the few comprehensive studies—a 2009 initiative of the Department of Aging and Adult Services and the San Francisco Mental Health Association—estimated that between 12,000 to 25,000 people in San Francisco struggle with hoarding behaviors.

People who hoard often don't see it as a problem, making treatment challenging. Not enough is known about the disease to determine whether it's an addiction or a compulsion. But intensive treatment can help people who hoard understand their behaviors and live safer, more meaningful lives.

Hoarding—also called compulsive hoarding and compulsive hoarding syndrome—can be a symptom of obsessive-compulsive disorder (OCD). Most people with OCD know that their obsessions and compulsions make no sense, but they can't ignore or stop them. Most older adults who hoard don't have other OCD-related symptoms. 

The National Institute of Mental Health reports that OCD affects about 2.2 million American adults.  The problem can be accompanied by anxiety disorders or depression. It strikes men and women in roughly equal numbers and usually appears in childhood, adolescence, or early adulthood. One-third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families. The course of the disease is quite varied.

Initially, families or caregivers might approach the problem as simply an issue of cleaning up the house or apartment. But compulsive hoarding is not only a health and safety issue, it is also an expression of psychological trauma. If we don’t address the underlying problem—the reasons for hoarding—the behavior will come back within a few months.

If you suspect a hoarding situation in your neighborhood or with a family member you need to seek professional help. A comprehensive list of resources for San Diego can be accessed through telephone listings through the San Diego Boarding Task Force, which include a list of county, city, university and private agencies that treat hoarding victims and their families. The website also includes local support groups and vendors:  http://www.hoardingtaskforce.org/san-diego-hoarding-collaborative/.  Addressing the root of the problem of hoarding might resolve long standing issues, and make their lives safer and more meaningful.