Types of Hoarding and Treatment Options

Hoarding is more than just having a lot of possessions. It's a specific type of behavior that can have a severe impact on a person's life. Although hoarding often occurs with obsessive-compulsive disorder, the two are not always linked.

Overview

Pathological or compulsive hoarding is a specific type of behavior marked by acquiring and failing to throw out a large number of items that would appear to have little or no value to others; severe cluttering of the person's home so that it is no longer a viable living space; and significant distress or impairment of a person's work or social life.

Types

Many people describe themselves as a "pack rat," that is, someone who enjoys collecting items and does not like to throw things away. Although many self-confessed pack rats lead normal lives, acquiring and failing to throw out a large number of items that seem to have little or no value to others could be a sign of compulsive hoarding, a behavior often associated with OCD. 

Animal Hoarding

Many people enjoy the company of pets. For example, according to the Humane Society of the United States, 35% of Americans own at least one dog, with another 33% owning at least one cat. While most pet owners provide excellent care to one or two animals at most, for some people, the desire to keep animals as pets crosses the line into a compulsive behavior called animal hoarding. 

Compulsive Shopping Disorder

Although it's not officially described in the Diagnostic and Statistical Manual of Mental Disorders (DSM), it has been suggested that compulsive shopping disorder, also known as compulsive buying disorder, is a type of impulse control disorder. The characteristics of compulsive shopping disorder include preoccupation with shopping for unneeded items; spending a great deal of time doing research on coveted items and/or shopping for unneeded items; difficulty resisting the purchase of unneeded items; financial difficulties because of uncontrolled shopping; and finally, problems at work, school or home because of uncontrolled shopping.

Treatment 

Hoarding, either alone or in the presence of OCD, usually does not respond well to medical or psychological treatments. A number of studies have examined the effectiveness of selective serotonin reuptake inhibitors (SSRIs) in the treatment of hoarding. Most investigations have found that only a third of patients who hoard show an adequate response to these medications. Results have been similar for other drugs affecting serotonin, such as the tricyclic antidepressant Anafranil (clomipramine).

However, a cognitive therapy protocol designed specifically for hoarding shows considerable promise.

Coping 

Although the clutter and squalor caused by hoarding often does not bother the hoarder themselves, it can be very frustrating and distressing for family members. Among the most distressing aspects of hoarding for family members is the lack of insight the hoarder often has into the consequences of their hoarding, even when threatened with legal action, eviction, or losing custody of their children.