Why Does a Person Become a Hoarder?

Medically Reviewed on 3/5/2021

What causes hoarding?

Hoarding is a severe psychological disorder where a person gathers an excessive number of items and stores them. The reasons someone become a hoarder include altered brain connections, genetics, stress, OCD, environmental factors and altered levels of serotonin.
Hoarding is a severe psychological disorder where a person gathers an excessive number of items and stores them. The reasons someone become a hoarder include altered brain connections, genetics, stress, OCD, environmental factors and altered levels of serotonin.

Doctors point to several potential causes for a person to become a hoarder.

  • Altered brain connections: Studies showed that abnormal brain development and brain lesions could lead to compulsive behaviors of hoarding. Sometimes, hoarding may begin after brain damage due to surgery, stroke, brain injury or infections. Compulsive hoarding is often seen in individuals who have autistic spectrum disorder or attention deficit hyperactivity disorder (ADHD).
  • Serotonin and obsessive-compulsive disorder (OCD): Research showed that the chemical serotonin seems to play a part in OCD. It is a chemical that the brain uses to transmit information. Altered serotonin levels may play a role in compulsive hoarding as well. Hoarders may develop the condition much later in life. In addition, hoarders have less awareness that their condition is abnormal compared to patients with OCD.
  • Hereditary: As per research, up to 85 percent of people with compulsive hoarding usually name at least one other family member who has this problem. Hoarders may also have grown up in cluttered homes themselves and derive comfort from the clutter.
  • Environmental conditions: Those who have faced early deprivation may develop hoarding as a coping mechanism later in life. This can be usually found on psychological examination of the patient.
  • Stressful life events: Stressful life events such as a divorce or death of a loved one may trigger hoarding behavior.

Other mental health conditions such as social phobia or fear of social interactions, bipolar disorder, specific phobias or fears, anxiety and depression may give rise to compulsive hoarding behavior. Usually, hoarders may suffer from loneliness, substance abuse or alcohol dependence.

What is hoarding?

Hoarding is a severe psychological disorder. Hoarding is a disorder where a person gathers an excessive number of items and stores them. This is usually in a chaotic manner and results in unmanageable amounts of clutter. Hoarding can have a huge impact on a person’s ability to function independently and can carry a high level of risk for themselves and others. It can cause high levels of distress for those who live with a hoarder or who are close to a person who hoards. It can cause difficulties for communities working with people who hoard. Signs of a hoarding disorder may include

  • Keeping or collecting items that may have little or no monetary value
  • Finding it hard to categorize or organize items
  • Having difficulties making decisions
  • Struggling to manage everyday tasks, such as cooking, cleaning and paying bills
  • Becoming attached to items and refusing to let anyone touch or borrow them
  • Having poor relationships with family or friends

Treatment options: There is no cure for obsessive-compulsive hoarding, but there are ways to assist the hoarder and help them transition effectively to more healthy behaviors.

Medications

  • Antidepressant medications (that increase the levels of serotonin in the brain) have been shown in research studies to lead to improvements in some compulsive hoarders. 
  • Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants, are most commonly used to treat hoarding. 
  • Research involving paroxetine (Paxil), an SSRI, has shown that it may improve hoarding symptoms as well as other obsessive-compulsive disorder (OCD) symptoms. 

Cognitive-behavioral therapy

  • Medication alone cannot hope to treat the underlying behavior. For this, cognitive-behavioral therapy (CBT) may be more effective. 
  • CBT is more than just talk therapy. It goes beyond talking with the therapist. The therapist often visits the hoarder’s home and helps them to think more clearly about their possessions and learn to make decisions about them. 
  • CBT helps patients to
    • Gradually confront things they fear to feel less afraid.
    • Learn healthier ways to cope with stressful situations.
    • Become aware of and subsequently change how they think in critical situations.

Individual and group therapy sessions are available. In addition, intensive daily outpatient therapy may be recommended for certain individuals. 

Hoarding disorder may be difficult for families and friends to understand and manage, particularly if the person does not recognize that they have a problem with their hoarding. It may cause distress for families and present questions on how best to help. Some helpful ideas include

  • Encourage the person to seek professional treatment.
  • Try to learn as much as you can about the condition.
  • Avoid going into their home or personal space and throwing things away without discussing it with them first. This may cause great distress for the person. Try to discuss it with them first and, if no agreement is reached, do not take it upon yourself to clear their clutter.
  • Acknowledge their fears of losing their possessions and the changes they will have to make during treatment.
  • Be realistic with expectations. Don’t expect too much too quickly.
  • Seek support for yourself, whether speaking to a mental health professional or attending a support group.

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Medically Reviewed on 3/5/2021
References
Medscape Medical Reference

American Psychiatric Association