Compulsive hoarding is a condition whereby seemingly useless items are accumulated to an excessive degree and never thrown away potentially causing cramped living conditions, squalor, disease, not to mention health and fire hazards. Hoarders tend to be reclusive, hiding their amassed useless possessions from the rest of the world, too embarrassed to let anyone in for fear they might take it all away. Clutter is a different animal in that there is just might not be enough storage space to put everything. The difference is that while clutter might also be excessive, rooms can still be used for what they were intended for. Hoarders have whole rooms that are inaccessible due to the accumulation of meaningless items, often having to tunnel to get to other rooms. Collectors typically are hobbyists who collect certain things, like cars, figurines, or salt-and-pepper shakers. These people are proud of what they have, generally keep it well maintained, and frequently use it to form relationships with other collectors of the same item or items.
There are several types of hoarding. The first, and most common is hoarding in the elderly. It usually begins early in life, becoming increasingly worse as age and mental incapacitation increases. It tends to get more severe with worsening dementia. Another type, animal hoarding is described as having an extreme number of animals in poor living conditions with resultant neglect and suffering of the animals as well as the hoarders. It is thought to be similar to those with the obsessive-compulsive disorder (OCD) based type. In this type, hoarding is driven by the OCD tendencies of ritualistic behavior, need for order, or fears of contamination. With all of these types, there is increased danger of fire, disease, infestations, and neglect of basic human needs. Sometimes, the hoarding is so extreme that homes are condemned as unfit to live in, affecting entire neighborhoods especially if there are infestations or fires. Some communities have taken action and created task forces for those determined at risk.
Diagnosis of this disorder can be difficult, especially if the person is reclusive. Research has indicated that hoarders have usually had some form of mental disorder prior to the hoarding diagnosis. For example, those who keep too many animals have usually been abused or neglected in childhood. Other disorders associated with hoarding include schizophrenia, mental retardation, attention deficit hyperactivity disorder (ADHD), eating disorders, and autism. Each of these conditions is treated differently. If the hoarding is a result of dementia or decreased mental capacity, retraining in basic organizational skills and problem solving often proves effective in this age group. These people will usually have to have constant monitoring to address those issues as they come up. Those who hoard animals and/or have OCD typically benefit from a specialized form of cognitive-behavioral therapy, which teaches alternative ways of thinking in incremental baby steps. This coupled with anxiety/depression medications has been found to decrease the likelihood of a recurrence.
Two famous hoarders were the Collyer brothers, Homer and Langley. They lived in Manhattan and collected newspapers, furniture, books, broken junk, and other miscellany, which were all booby-trapped to keep intruders out. In March 1947, neighbors complained of a stench emanating from their home. Investigation revealed that Homer had died, but Langley was nowhere to be found. They located him a couple of weeks after some of the 130 tons of junk were removed from the house. He died trying to get to his brother when one of the booby traps crushed him. While the Collyer brothers are an extreme example, prevalence is on the rise with an estimated 1.4 million Americans afflicted to varying degrees. Individualized therapies including the use of cognitive behavioral strategies, pharmaceuticals, alternative thinking processes, and constant monitoring for relapse have been found to be effective in the long term. Prognosis is excellent if the problem is discovered before it is too late.
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