Hoarding: Are we defined by our things?

Hoarding used to be referred to as collecting or saving items. Family members were sometimes called pack rats who seemingly never threw anything away. Whatever the term, people who participate in hoarding activities have gone from being virtually unheard of to almost being a household word. People who hoard have trouble resisting acquiring things and tend to save too many possessions, which eventually start to create problems in their living space.

How many items are too many?

Acquiring too many items usually happens when the situation becomes overwhelming and intimidating along with thoughts of getting rid of possessions. Our possessions tend to own us instead of us owning our possessions. Because this condition has caused so much anguish for so many, hoarding has been given a diagnosis as a disorder by the American Psychiatric Association and is published as such in the Diagnostic and Statistical Manual of Mental Disorders. With these acknowledgements, education and treatments have become available.

What are the four main criteria that define hoarding disorder?

1. Persistent difficulty in discarding or parting with possessions regardless of their value. Hoarding is about the volume of possessions and how the items are organized.
2. The difficulty of discarding possessions acquired is due to a perceived need to save the items and the distress associated with getting rid of them.
3. These symptoms result in the accumulation of possessions that congest and clutter a person's active living areas and substantially compromise their intended use. A hoarding disorder may be so bad that portions of the home are difficult to use or access.
4. The accumulation of items causes clinically significant distress or impairment in personal, social, occupational or other areas of functioning. Ask yourself this question: Does your stuff interfere with your being able to live comfortably, and is your living environment safe?

Why do people hoard?

There are multiple reasons people hoard, including:

• Some believe that items may be useful or valuable to them in the future.
• Items have a sentimental value, are unique or irreplaceable.
• Some items may be conceived as too good a bargain to pass up or throw away.
• Items a person acquires also may jog a pleasant or a sentimental memory.
• The person can't decide where the item belongs so they just keep it.
• They may feel safe from the outside world when surrounded by their things and don't want to let past experiences go without these items.

Some studies indicate these behaviors start during childhood or early adolescence and after a bad traumatic experience. Studies also show this may run in families, either from role modeling or genetics. Statistics show that the rate of hoarding may be 5 percent, or 1 in 20 people.

How can I help?

Educate yourself about what a hoarding condition is and what it can lead to. Realize in most cases you need to respect the person's freedom of choice as to what they want in their own home. You may suggest to the person you know that they see a medical provider who may recommend a consult with a mental health expert in this field. There also are other resources in the community. If there are safety or health issues in the home, you may want to consider notifying other legal or community resources. Avoid confrontational situations with the person, but try to help with gentle recognition and strive for gradual change. Most importantly, aim to provide understanding, compassion and hope.

By Mayo Clinic Health System staff