Hoarding a distinct disorder

Over the past couple of years, hoarding has captured the fascination of many. First it was featured on several major talk shows and then of course a television series dedicated entirely to the strange behaviour of hoarding.

Video footage of rooms piled to the ceiling with old newspapers, food boxes, balls of wool and scraps of virtually any sort makes us cringe. We wonder what compels these people to collect so much seemingly worthless stuff that it literally takes over entire homes and makes it nearly impossible to function normally?

Hoarding is the persistent difficulty in discarding or parting with possessions regardless of their worth.

Until recently, hoarding was officially classified as a sub-criteria or symptom of obsessive compulsive disorder (OCD) – but it is now recognized as a distinct condition in the recently released DSM V.

Hoarding affects between two and five percent of adults – meaning more than one million Canadians experience this troubling condition that is quite difficult to treat.

Although it shares some similarities with OCD, it is distinct because hoarders don’t typically experience intrusive thoughts or impulses as in classic OCD. Also, drug and behaviour therapies used in OCD have very little effect on hoarding behaviour.

Critics of the new distinction worry about labeling eccentricity as illness and question who will decide when collecting or saving crosses the line into pathological behaviour.

In my opinion, the line between simple or even eccentric collecting and hoarding is relatively easy to distinguish. An individual with no disorder does not feel distress about collecting and the collection does not interfere negatively with every day life.

Hoarders experience intense anxiety when attempting to discard even small items. In fact, the hoarding behaviour is usually done in order to combat the anxiety produced by questions that arise when considering organizing or discarding any items. Very often, these individuals are crippled by indecisiveness, perfectionism, procrastination and avoidance behaviour.

Not only do hoarders experience significant distress surrounding their hoarding, but the compulsive behaviour greatly impacts daily activity.

Hoarders become increasingly socially isolated as their hoarding becomes impossible to hide. Very often they stop wanting people to come to their homes because they are ashamed of the extent of the clutter.

When a collection becomes so extensive that it is impossible to use furniture, rooms or entire homes because of the space taken up by piles of saved material, it has often crossed the line into hoarding.

Unfortunately, the lack of space tends to lead to a complete breakdown in the ability to keep a house clean. It doesn’t take long before infestations of insects, rodents or mold become serious problems.

Homes are often lost and legal problems arise when neighbours complain and relationships with loved ones are often destroyed as hoarded material increasingly takes over.

While many hoarders save up inanimate objects, there are also some who hoard animals. We have likely all heard media reports of places with dozens of cats, dogs or other pets living in cramped quarters. Often animal hoarders believe they are saving these pets while their numbers actually lead to their neglect.

One of the goals of including hoarding as a distinct disorder in the DSM is to help increase public awareness of this condition, identify sufferers and spur research into treatments to help those affected.

If hoarding is ruining your life, don’t be afraid to seek help. Change is possible.

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About the Author

Paul Latimer has over 25 years experience in clinical practice, research, and administration.

After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar.

Since 1983 he has been practicing psychiatry in Kelowna, BC, where he has held many administrative positions and conducted numerous clinical trials.

He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders.

He is an avid photographer, skier and outdoorsman.

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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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