Hoarding Disorder

Hoarding disorder is associated with three key features:

1. Ongoing and significant difficulty getting rid of possessions (i.e., throwing away, recycling, selling, etc.), regardless of their value; and strong urges to save and/or acquire new, often non-essential, items, that if prevented leads to extreme distress. Non-essentialincludes items that are both useless (i.e., broken), as well as those with limited value (e.g., 10 skirts in every color but never worn)
2. Living space becomes severely compromised with extreme clutter, preventing one from using that space for its intended purpose.
3. Significant impairment in social, occupational, and other important areas of functioning as evidenced by:
   • Impaired physical health
   • Missed work and compromised employment
   • Financial problems
   • Housing instability including threat of, or actual, eviction
   • Social isolation
   • Emotional distress
   • Family stress

Two additional specifications include:

1. Whether the individual is also engaged in excessive acquisition (It is currently estimated that upwards of 80-90% of individuals with hoarding also experience excessive acquisition of items through collecting, buying, and even theft.), and,
2. Whether the individual has any insight or awareness that their behaviour is problematic.

• Acquiring and/or having trouble discarding items that have little to no value (e.g., broken lamps, a new fondue set when you already own 2, stacks of expired coupons, etc.). This is distinct from a hobby such as stamp collecting and owning thousands of stamps, or an interest in car restoration and having a garage full of parts and equipment.
• Commonly saved items include:
  • Newspapers
  • Magazines
  • Old clothing
  • Bags
  • Books
  • Mail
  • Paperwork
• Items take on special significance such as an emotional connection, being part of one’s identity, or offering a sense of safety and security.
• Clutter results from items being kept in unrelated groupings or piles, and in locations designed for other purposes.  For example, important bills and paperwork are kept with expired advertisement mailings, on a pile in the bathtub.
• Striving for perfection, including a sense of responsibility to fulfill the potential of an item or not to be wasteful.
• Feeling good not bad. Individuals with hoarding report positive feelings when they acquire items, and/or relief from fear, sadness, grief, and other negative emotions, that would occur were they made to discard items.
• Living space becomes severely hampered or impossible to use. For example, the oven or bath are filled with items preventing one from cooking or bathing, or a bedroom is filled to capacity so one cannot sleep in the bed.
• Problems with thought processes are well documented, including:
  • Challenges in sustaining attention to important tasks
  • Disorganization, and difficulties sorting and categorizing items
  • Poor decision making- what to keep and what to remove
  • Too many ideas of how to re-use/fix a discarded item
  • Memory difficulties-use of visual cues to aid memory that goes awry
• All of the above features contribute to significant functional impairment and /or emotional distress.
• Less common features involve the hoarding of animals, hoarding in the elderly, and the role of theft in item acquisition.

My Anxiety Plan (MAPs)

MAP is designed to provide adults struggling with anxiety with practical strategies and tools to manage anxiety. To find out more, visit our My Anxiety Plan website.