Hoarding disorder

A hoarding disorder is when a person has strong urges to keep a large number of items, even when they are not needed or useful. These items are often stored in a way that causes clutter and is difficult to manage.

Hoarding can be a significant problem if:

• the clutter stops someone living safely or comfortably in their home
• it is causing distress or affecting the quality of life of the person or those around them

The difference between hoarding and collecting

Many people collect items such as books or stamps. This is not considered a problem. The difference between a 'hoard' and a 'collection' is how they are kept.

A collection is usually well ordered and the items are accessible.

A hoard is usually very disorganised. It can take up a lot of room and you cannot get to or reach the items.

Why someone might experience hoarding difficulties

The reasons behind hoarding are not fully understood. They can vary from person to person.

Possible causes include:

• mental health difficulties, such as severe depression, anxiety, obsessive compulsive disorder (OCD), dementia or schizophrenia
• mobility (movement) difficulties - they may find it hard to clear large amounts of clutter
• learning disabilities - they may find it hard to sort or make decisions about their belongings
• neurodivergence, for example attention deficit hyperactivity disorder (ADHD) or autism - they may find it hard to organise, order or let go of items
• a difficult or traumatic life event, such as the death of someone close

In some cases, hoarding is a mental health difficulty in itself and is connected with self-neglect.

Some people who hoard may:

• have had negative childhood experiences
• have a family history of hoarding
• have grown up in a cluttered home
• live alone
• have little social contact

Many people who experience hoarding difficulties hold strong beliefs about the need to keep items. They may have a fear of wasting something they might need in the future.

Trying to throw things away can cause strong emotions for the person who has hoarding difficulties. This can lead to avoiding decisions altogether.

Signs of a hoarding disorder

You might have a hoarding disorder if you:

• keep or collect items that may have little or no use
• find it hard to sort, organise, or throw away items
• have difficulties making decisions
• struggle to manage everyday tasks, such as cooking, cleaning and paying bills
• feel emotionally attached to items and do not want others to touch or borrow them
• have difficult relationships with family or friends

Common items that people may hoard include:

• newspapers and magazines
• books
• clothes
• leaflets and letters, including junk mail
• bills and receipts
• containers, including plastic bags and cardboard boxes
• household supplies
• animals
• digital information, such as emails, files, or photos

Why hoarding disorders are a problem

Hoarding can cause serious problems, such as:

• making your home difficult for you to live in and get around
• making your home unsafe
• affecting your work, personal hygiene, and relationships
• leading to loneliness and isolation
• creating health and fire risks for yourself and others who live in or visit your home
• creating unhygienic conditions and encouraging rodent or insect infestations

Helping someone who is experiencing hoarding difficulties

If someone you know is experiencing hoarding difficulties:

• encourage them to talk to their GP or a health professional
• do not judge or pressure them
• be sensitive
• tell them you're concerned for their health and wellbeing
• reassure them that nobody will go into their home and throw everything out
• share non-judgmental resources with them, such as leaflets, videos or stories of recovery

When they talk to their GP, their GP will decide what treatment or support is best. They may refer the person to trained therapists or their local community mental health team (CMHT). The CMHT may have a therapist who is familiar with hoarding difficulties.

What not to do

Do not get extra storage space or call a service to clear the clutter away.

Doing this:

• will not solve the problem
• may cause intense distress for the person with hoarding difficulties
• can worsen the situation
• cause conflict
• does not stop what causes them to hoard
• means clutter will likely soon reappear and begin to build again
• results in frustration, hopelessness, and often anger for the person and their families and friends

Helping people who hoard (video)

Supporting someone who refuses help

If the person refuses help, talk to their GP. A GP can assess them and refer them to mental health services if needed.

If the person is elderly or has a disability, the GP or another professional may refer them to the HSE Vulnerable Adult Safeguarding Team for support.

Getting help for hoarding difficulties

Treatment can help, but may take time.

Many people:

• do not see hoarding as a problem
• may not be aware of how it is affecting their life or the lives of others
• feel ashamed or anxious about asking for help
• are afraid of losing control or being judged

It is important that support is respectful and based on building trust over time.

With the right support, many people can learn new ways to many their things and feel more in control.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is the recommended talk therapy for hoarding.

A psychologist or therapist can provide talk therapy and emotional support.

Together with your therapist, CBT can help you:

• explore your beliefs about needing to keep things
• understand why it is hard for you to get rid of things
• learn skills to help you cope with difficult feelings

CBT may include practical support, goal setting, and working step-by-step with a therapist.

You can find information about accessing mental health support from your GP.

Talk therapy