Some display symptoms following a stressful or traumatic life event, such as a divorce, accident, or the death of someone close. Despite their disordered and sometimes unsanitary living conditions, some people with hoarding disorder may not identify their behavior as problematic.
Therefore, it can take multiple attempts to begin a conversation about changing their habits. Pushing your loved one to make major changes at once, trying to take charge, or cleaning away their possessions behind their back will only alienate the person, destroy their trust, and add to the family conflict. That starts with taking a step back and exploring how your own actions—or those of other friends or family members—may be contributing to the hoarding problem.
Keep your expectations realistic. Expecting your loved one to become perfectly neat and organized is setting yourself up for disappointment. Changes tend to happen gradually and there will likely be setbacks along the way where the person reverts to old patterns of behavior.
Can you settle for having your loved one live in a cluttered but safe environment, for example? Manage stress. Dealing with someone who has hoarding disorder can cause a lot of stress, anxiety, and tension—and that can rub off on the hoarder. The more stressed and anxious they become, the more likely they are to revert to negative behaviors.
Try to make time to relieve stress and regain your inner calm through exercise , meditation , or other relaxation techniques. Resolve conflict in a positive way. While conflict is a normal part of every relationship, dealing with a loved one who hoards can trigger strong emotions in anyone. But reacting with angry or hurtful comments, refusing to compromise, or rejecting the things that are important to the hoarder will only push you apart.
Instead, you can learn to resolve your differences in healthier ways that can bring you closer together. Whether the hoarder is a close friend, partner, or family member, you may forget that the disorder is just one aspect of their identity, not the only thing that defines them as a person.
Try to look beyond their accumulation of stuff or animals and find other ways of relating. Bonding over other interests or hobbies can help nurture an atmosphere of trust and cooperation. Spend time talking about other issues and interests. Go for a walk, visit a museum, attend a concert, or take up a new hobby together. People with hoarding disorder are often socially isolated, so your non-judgmental support can be crucial in helping them change their behaviors.
We all have our strengths and weaknesses. Address any underlying conditions. Encouraging them to treat the underlying condition may help improve their hoarding symptoms. One of the toughest aspects of helping someone with hoarding disorder is motivating them to start and stick with the process of changing how they accumulate items.
The prospect of discarding existing possessions and resisting the urge to purchase more can be emotionally harrowing for the hoarder. Motivating them can take patience, understanding, and lots of encouragement.
Make harm reduction the focus. When setting goals with your loved one about organizing their living space, emphasize reducing the risk of accidents and injuries rather than eliminating clutter. To keep the hoarder motivated, make it clear that the aim is only to get rid of enough items to keep the person safe. As you move ahead with the process, your loved one may become more comfortable making decisions about things to discard. Set achievable goals. When decluttering, aim to tackle just a small pile or a single drawer at first.
Start with items that your loved one finds easiest to throw away—old bills may be less distressing to discard than letters or photographs, for example.
While you want to avoid them delaying decisions, the final say should always be theirs. What triggers the person to acquire more things? Once you identify what triggers them to accumulate more possessions, you can find healthier ways to deal with the urges.
Celebrate even small victories. Clearing away just a few things is reason to praise your loved one—and yourself. While medication may help for underlying issues such as anxiety or depression, cognitive behavioral therapy CBT is the primary treatment for hoarding disorder. Whether in a group or one-on-one setting, CBT can address the negative thoughts that contribute to hoarding disorder and help the hoarder develop new patterns of behavior.
Working with the right therapist can help your loved one to:. Help your loved one to research therapy options, make and keep appointments, and stay on schedule. For your loved one. In addition to therapy, talking regularly to others facing the same challenges can help your loved one to feel less isolated and alone.
It's not easy to treat hoarding disorders, even when the person is prepared to seek help, but it can be overcome. The main treatment is cognitive behavioural therapy CBT. The therapist will help the person to understand what makes it difficult to throw things away and the reasons why the clutter has built up. This will be combined with practical tasks and a plan to work on. It's important the person takes responsibility for clearing the clutter from their home. The therapist will support and encourage this.
Antidepressant medicines called selective serotonin reuptake inhibitors SSRIs have also been shown to help some people with hoarding disorders.
CBT is a type of therapy that aims to help you manage your problems by changing how you think cognitive and act behaviour. It encourages you to talk about how you think about yourself, the world and other people, and how what you do affects your thoughts and feelings.
Regular sessions of CBT over a long period of time are usually necessary and will almost always need to include some home-based sessions, working directly on the clutter.
This requires motivation, commitment and patience, as it can take many months to achieve the treatment goal. The goal is to improve the person's decision-making and organisational skills, help them overcome urges to save and, ultimately, clear the clutter, room by room. The therapist won't throw anything away but will help guide and encourage the person to do so.
The therapist can also help the person develop decision-making strategies, while identifying and challenging underlying beliefs that contribute to the hoarding problem. The person gradually becomes better at throwing things away, learning that nothing terrible happens when they do and becomes better at organising items they insist on keeping. At the end of treatment, the person may not have cleared all their clutter, but they will have gained a better understanding of their problem.
They will have a plan to help them continue to build on their successes and avoid slipping back into their old ways. Page last reviewed: 12 June Next review due: 12 June Home Mental health Mental health conditions Back to Mental health conditions.
Hoarding disorder. Hoarding is considered a significant problem if: the amount of clutter interferes with everyday living — for example, the person is unable to use their kitchen or bathroom and cannot access rooms the clutter is causing significant distress or negatively affecting the quality of life of the person or their family — for example, they become upset if someone tries to clear the clutter and their relationship suffers Hoarding disorders are challenging to treat because many people who hoard frequently do not see it as a problem, or have little awareness of how it's affecting their life or the lives of others.
If not tackled, it's a problem that will probably never go away. Why someone may hoard The reasons why someone begins hoarding are not fully understood. Mental health problems associated with hoarding include: severe depression psychotic disorders, such as schizophrenia obsessive compulsive disorder OCD In some cases, hoarding is a condition in itself and often associated with self-neglect. These people are more likely to: live alone be unmarried have had a deprived childhood, with either a lack of material objects or a poor relationship with other members of their family have a family history of hoarding have grown up in a cluttered home and never learned to prioritise and sort items Many people who hoard have strongly held beliefs related to acquiring and discarding things, such as: "I may need this someday" or "If I buy this, it will make me happy".
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Treatment of hoarding disorder in adults. Phillips KA, et al. Merck Manual Professional Version. Brakoulias V, et al. A meta-analysis of the response of pathological hoarding to pharmacotherapy. Psychiatry Research. Tolin DF, et al. Cognitive behavioral therapy for hoarding disorder: A meta-analysis.
Depression and Anxiety. Ale CM, et al. Family-based behavioral treatment of pediatric compulsive hoarding: A case example. Clinical Case Studies. Morris SH, et al. Hoarding in children and adolescents: A review. Child Psychiatry and Human Development.
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