About this leaflet
- This leaflet is for anyone who is worried
about their hoarding, and for family or friends who want to know
- The leaflet describes hoarding, some of the
illnesses which might be connected with it, ways of helping and
What is hoarding?
Hoarding happens when you collect large
amounts of stuff and can't throw anything away. Unlike a
hobby, this sort of collection is usually very
disorganised. You can feel very attached to the things you
have collected and can get upset if someone tries to throw them
Other people may be bothered – but if you
hoard, you often won't be bothered yourself, even though it can
badly affect your life. You may not look after yourself very well,
pay bills, or bother to have repairs done at home. You may
collect so much stuff that you just can't use some of your rooms.
Your hoarding can also cause problems for any members of your
family who live with you.
How common is hoarding?
About 1 or 2 people in every 100 have a
problem which seriously affects their life.
What do people hoard?
It's usually objects which might be bought,
picked up off the street or out of a skip, or even stolen.
Some people hoard a large number of animals,
often believing they are rescuing them. But their animals are often
kept in poor conditions and suffer.
A more recent problem is data
hoarding. People find that they can't delete emails, which
keep building up.
Can hoarding be a normal part of life?
The difference is really between hoarding and
collecting. Many of us enjoy collecting things, but organise them
well. The items we collect are often seen as interesting or
valuable by other people.
People who hoard tend to collect things that
others see as useless or of little value.
Some people may have a large number of
possessions and live in cluttered, messy or neglected
conditions. However, such things would not usually be
considered a problem, unless they disrupt people's lives.
Is hoarding an illness?
Hoarding can be an illness in its own right,
known as hoarding disorder (see below).
Hoarding can also be part of another health
illness – can lead to tiredness and disorganisation.
- Dementia – memory problems can
interfere with someone’s ability to organise themselves and their
- Depression – can make you
lose interest in your normal activities, make it hard to
concentrate and make it hard to make decisions.
- Alcohol and drug
misuse – can affect your ability to look after
- Schizophrenia – unusual beliefs
and a lack of organisation can lead to hoarding.
- Bipolar disorder – can make
you shop too much, and will interfere with your organisation.
- Learning disability – can lead to
problems with thinking and memory.
- Autism and related
disorders – collecting things can be a source of
- Obsessive Compulsive Disorder
(OCD) – you don't feel attached to your hoarded
items, but you do fear what will happen if you throw them
away. About 1 in 20 people with OCD have a problem with
Hoarding disorder can be diagnosed when there
is no other illness to account for the problem. People with
hoarding disorder often strongly believe that their hoarded items
are valuable. They may call them a “collection”, even though
the large number of items and their disorganisation means that
individual things are inaccessible.
Until recently, hoarding disorder was thought
to be a form of OCD. As hoarding disorder has only recently
being recognised as a separate condition, there is not much
research into the problem.
Many people with hoarding disorder have had a
deprived childhood, but this is not always the case.
The average age when people with hoarding disorder come to that
attention of services is 50 years. By this time the problem
is usually well-established.
It is thought that some people are more likely
to become hoarders because of their personality. For example,
they might be perfectionist or reclusive. They may then start
to hoard after a major stress or change in their lives.
Is hoarding dangerous?
It can be dangerous in a number of ways:
- A home can become infested
with mice, rats or cockroaches, often as a result of hoarding
- Hoarded belongings might
- The sheer amount of
belongings can block your way out of the house – you can't
- It can make cooking or
eating at home difficult
- It can cause severe
structural damage to a house or flat.
- Piles of possessions can
collapse and crush you - perhaps even kill you.
So, severe hoarding can be a risk to others as
well to yourself.
Getting help for someone who hoards
Many people feel just too ashamed or
embarrassed to talk about it – but it's best to get help as soon as
you (or someone else) realise(s) that it is a problem.
It's often a relative or a neighbour who
notices that hoarding is problem. It can be a difficult issue
to ask someone about. Others can become quite critical of people
who hoard, but the hoarding is the problem, not the person. It can
be helped effectively, but also compassionately and
A number of organisations may be involved -
health, social services, the fire service. They will usually
visit the person’s home.
The person who is hoarding might refuse to let
anyone assess the situation properly. If this happens:
- mental health legislation can be used, if there is a
- public health legislation can be used, if there is a risk to
that person or other people.
When such legislation is used, there is always
a balance between someone’s individual rights and the public's
right to health and safety.
If it is a symptom of another illness, the
first thing to do is to start treatment for that illness.
If there is no other illness, there are two
main types of treatment for hoarding disorder: psychological
therapy and medication. Some people need both, others get
better with just psychological therapy.
behavioural therapy (CBT) is the most effective
psychological treatment. It can help you to change the thoughts and
feelings that drive you to hoard.
There are several stages:
- Getting to trust your
therapist. Things can be difficult to talk about, so it can take a
little time to open up to someone new.
- The therapist then helps you
to understand what makes it difficult for you to throw things
- You then agree to not hoard
more items during the treatment. There is no point clearing
things away if you replace them with others.
- You and your therapist start
clearing out items together. You will find that the longer you
spend thinking about it, the more difficult it becomes.
- The therapist helps you to
look at your thoughts and feelings about possessions.
As hoarding has often been going on for years,
treatment can take a long time. The aim is to use the 3 Rs –
Reduce, Recycle and Reuse.
Selective serotonin reuptake inhibitors
(SSRIs) are antidepressant
medications which are used to help anxiety and obsessional
problems. They also seem to help people who
hoard. Improvement usually happens slowly over weeks or even
Research continues into other medications
which might be helpful in hoarding disorder. One group of
drugs blocks the action of dopamine, a chemical in the
brain. They can be used with SSRI medication if the SSRI alone
does not seem to be helping enough.
George was in his 50s. He had been a
perfectionist since childhood. He was sent to boarding school
when he was 10 years old. He was unhappy and lonely and he
began to collect small items from home, like sweet wrappers.
On leaving school he successfully studied for a law degree.
Shortly afterwards his mother, Sarah, died. George found this
a very difficult time and was comforted by collecting things which
reminded him of his family home, or his mother - even newspapers
containing the name Sarah.
His hoarding gradually took over his life, and
finally stopped him from working. At times he could throw
items away, but they soon began to build up again. He lived
in a large house, every room of which became filled from floor to
ceiling. The living room ceiling was bent under the weight of
papers in the bath above. His bedroom was full, so he slept
in a chair in the living room. He moved around the house
through narrow passages between the piles of items. He could
not use the bath, so had to wash in the kitchen sink. He could only
get to one ring on his cooker and the house was infested with
insects, mice and rats.
George was encouraged by his family and GP to
seek help for his hoarding, and he was referred to the local mental
health service. He was anxious and ashamed at first, but over
a few weeks felt comfortable with his therapist. Because the
problem had been going on for so long, he started to take SSRI
medication. After a month he felt ready to allow the
therapist to visit his home and start work on helping him to get
rid of stuff. George continued to throw things out between
visits, and after 5 weeks felt that he could continue on his
own. He would visit the clinic from time to time when he ran
into problems. After a year he had cleared his house. He
organised repairs and hired a company to
clean the whole house and get rid of the vermin.
George was much happier. He was able to
take up voluntary work and returned to education to re-establish
his legal skills
- Compulsive Hoarding and OCD: two distinct
disorders? Saxena S. American Journal of Psychiatry,
- Hoarding behaviour: building up the ‘R
factor’. Gaston RL, Kiran-Imran F, Hassiem F, Vaughan
J. Advances in Psychiatric Treatment,
- Obsessive-compulsive disorder: Core
interventions in the treatment of obsessive-compulsive disorder and
body dysmorphic disorder CG31. National Institute for Health
and Care Excellence, 2005.
- Treatment of Compulsive Hoarding.
Saxena S, Maidment KM. Treatment of Compulsive Hoarding. Journal of
Clinical Psychology, 2004; 60:1143-54.
Hoarding and how to approach it – guidance for Environmental Health
Officers and others.
Holroyd S, Price H. Chartered Institute
of Environmental Health, revised 2012.
A review of hoarding and its impact from an
environmental health perspective.
OCD Action: A
charity that provides support and information for those with OCD
and hoarding, and their families and carers.
OCD-UK: A charity that
provides support and information for those with OCD and their
families and carers.
Triumph over OCD and
Phobia: A charity which runs a network of self-help
therapy groups for people with OCD and other anxiety disorders.
This leaflet was produced by the Royal College of Psychiatrists
Public Education Editorial Board.
Series Editor: Dr Philip Timms
Authors: Karen Smith, Dr Lynne Drummond, Dr Suhana Ahmed
and Dr Jim Bolton
This leaflet reflects the best available evidence available at
the time of writing.
© April 2016. Due for review: April 2019. Royal
College of Psychiatrists.
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