Hoarders

Hoarders are individuals who engage in hoarding behavior, characterized by a persistent difficulty discarding or parting with possessions, regardless of their actual value. This difficulty leads to the accumulation of items and clutter that disrupts the use of living spaces and causes distress or impairment. Hoarding disorder is recognized as a distinct mental health condition in the DSM-5-TR, separate from obsessive-compulsive disorder or simple collecting.

Symptoms commonly include excessive acquisition, distress at the thought of discarding items, strong attachment to possessions, and indecisiveness about what to keep. People may accumulate a wide range of objects, keep items for little or no use, and struggle with organization. The resulting clutter can make areas unhygienic or unsafe and can strain relationships, finances, and daily functioning. Hoarding can occur with or without coexisting disorders such as anxiety, depression, or attention-deficit/hyperactivity disorder.

Causes are multifactorial, involving genetic, neurobiological, cognitive, and environmental factors. Some individuals have information-processing or decision-making difficulties, and there may be an excessive emotional value placed on possessions. Onset often occurs in adolescence or early adulthood and tends to worsen over time. Animal hoarding is a related but separate phenomenon that raises additional welfare concerns.

Treatment typically relies on specialized cognitive-behavioral therapy tailored for hoarding, emphasizing gradual exposure to discarding and skills in organization, decision-making, and motivation. Pharmacotherapy is not specific for hoarding and evidence for medications is limited. Effective management often requires a multidisciplinary approach, including mental health services, social support, and, in some cases, housing or safety interventions.