The Mayo Clinic defines hoarding as the excessive collection of things, along with the inability to discard them.
Such behavior creates unsanitary conditions and, in severe cases, the inability to function normally.
Although hoarding has become more recognized in recent years thanks to television reality shows, it is a psychological disease that experts say is often related to or a symptom of obsessive-compulsive disorder. The major issue, they say, is that many people who have the disorder fail to recognize it as a problem, making treatment extremely challenging.
Although hoarding carries both denial and shame for many people, there is hope for change in the form of therapy and anti-clutter strategies.
Dr. Amy Austin has encountered only one case of hoarding at her Palm Desert practice. "Unfortunately, she stopped coming," said Austin. "She was not ready for treatment."
Austin, who is an addiction specialist, says hoarding is more of an obsessive-compulsive disorder, but, like addiction, those with hoarding disorders are resistant to change. "What we are talking about is an anxiety disorder. People decrease levels of anxiety by hoarding."
When a patient comes to Austin with this problem, they first talk about the issues in the person's life, including their relationships. "If they need a psychiatrist, we can work with one for possible medications," said Austin. "Treating an obsessive-compulsive disorder is commonly a combination of therapy and medication."
Is there hope for treatment?
"I always come from a place of hope," said Austin. "No one is broken — they just need help. There is hope for everybody and anything."
A fresh start
Cory Chalmers, owner of Steri-Clean, which serves California's Coachella Valley, is a hoarding cleanup specialist.
"In 1995, I was working as a paramedic in the San Bernardino area," says Chalmers, who says he learned the art of compassion and discretion in that job. "As a result, I began cleaning crime scenes so that relatives of victims would not have to see their loved ones' homes (in that condition). Immediately, I started getting calls to also clean homes of hoarders."
A production company contacted Chalmers and wanted to shoot a pilot for a reality series on his crime scene cleanups, but network executives said it was "way too much reality." However, one of the homes was also the home of a hoarder, and they liked that idea.
"The original name for the series was Dirty Work, but it evolved to Hoarders," said Chalmers, who stresses that the A&E series is different from real life in many ways. "The cases we air are people who are willing to change and have gone through therapy."
There is no doubt that Chalmers has seen a lot of hoarding reality. "We've had people who urinate in buckets because their bathrooms are so full of stuff," said Chalmers, who speaks to groups across the country. "At the end of the day, we have to remove the Dumpster right away or the next day we will find that people have taken everything out again."
Leslie Spoor, owner of Executive Errands in Palm Desert, Calif., has experienced a few hoarding situations in her business, which offers to "simplify your life" — from absentee home checks to party planning, as well as office support and spring cleaning.
"People will call thinking they want it done (cleaning the accumulation)," said Spoor, "but it can be very difficult. We usually end up doing a tiny little bit at a time to give them a chance to adjust to the idea of throwing things away. You have to slow yourself way down and be very gentle with the process."
According to Spoor, these clients often experience extreme attachment to things, and long-term success is rare unless they get help. "But at least they get some part-time normalcy when we are done," said Spoor.
She remembers one client who contacted her but was reluctant to get help. "What we ended up doing was involving the entire family in the process, and it made a huge difference," said Spoor. "At least it made a difference in the main living areas. Sometimes, people get to the point where they are overwhelmed and don't know where to start."
In that particular case, Spoor said they found all sorts of trash stashed under the couch. "I suggested we put two trash cans by the couch so that things could go in there instead — it was just common sense, but it is traumatic for them and totally overwhelming."
Signs of hoarding
Here are signs that might indicate someone you know is a hoarder: • Acquiring or failing to throw out a large number of things that appear to have little or no value. • Cluttering the home to the point that it is unlivable. In extreme cases, the home is unsanitary. • Distress, anxiety and impairment of work or social life. The hoarder will think of things to do outside the home — any distraction that keeps them from cleaning or changing their environment.
Treatment strategies
Dr. Gerald Nestadt, director of the Johns Hopkins Obsessive-Compulsive Disorder Clinic, offers six anti-clutter strategies: • Make immediate decisions about mail and newspapers. In other words, throw away unwanted paper immediately. • Think twice about what comes into your home. When you do buy something new, discard something else to make room for it. • Set 15 minutes aside daily to de-clutter. This takes the task from overwhelming to manageable. • Dispose of anything you have not used for one year. • Follow the OHIO rule: Only Handle It Once. Don't move things from one pile to another. • Ask for help. Seek out a mental health professional if you are overwhelmed and cannot cope.