Helping Someone with Hoarding Disorder

How hoarding disorder affects family and friends

People with hoarding disorder have an excessive attachment to their belongings, even seemingly worthless or unusable ones. They feel comforted buying and accumulating things, but greatly distressed if they ever try to discard them. This can lead to a cluttered, unsanitary, and unsafe living environment, and take a heavy toll on their close relationships, especially with family and friends who struggle to help them.

If you have a loved one with hoarding disorder, it’s easy to feel emotionally overwhelmed. You may be frustrated at your continued failure to get the hoarder to change their behavior, upset at how they live, or stressed by all the conflict it creates in your relationship. You may worry about the financial implications of their excessive shopping, the health problems created by unhygienic living conditions, or the risk of fires and injuries from all the clutter in their home.

If you have to share a living space with the hoarder, things can feel even worse. As the mess continues to mount, you may be angry at the loss of livable area, exasperated by the hoarder’s unwillingness to clear out any of their stuff, or offended by how they’ve claimed certain parts of the home as solely their own. You may even feel that the hoarder cares more about their possessions than they do about you.

While no one should have to live in cramped or unsanitary conditions, it’s important to remember that your loved one hasn’t chosen to become a hoarder. Hoarding disorder is a complex mental health issue and helping someone goes beyond cleaning out their clutter. In fact, if it’s done without their consent, discarding the hoarder’s possessions usually does more harm than good. The hoarder will likely be angry and resentful—damaging the relationship between you—and their process of accumulation will simply begin all over again.

Instead, these guidelines can help you address the emotional aspects of hoarding as well as the practical challenges. While recovery tends to be gradual, with your support, empathy, and patience, your loved one can regain control over their life.

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Recognizing hoarding disorder in a loved one

Many of us struggle with “pack rat” tendencies or clutter in our homes, especially as we get older. It’s also common for people to resist parting with old possessions that carry a sentimental value. However, hoarding disorder goes beyond untidiness and disorganization.

If someone has hoarding disorder:

• They overestimate the importance of possessions, perceiving the need to amass things and then experiencing emotional distress when trying to discard them.
• Their accumulated clutter can block doors and stairways in their home, make it difficult to access rooms or carry out household repairs, and increase the risk of injury, accident, or fire.
• Dust, mold, mildew, and even bug or rodent infestations in the home can have serious health implications.
• In the case of animal hoarding, those implications stretch to pets not having the necessary space, food, or veterinary care to stay healthy.

[Read: Hoarding Disorder: Help for Hoarders]

People with hoarding disorder may feel ashamed about how they live or friends and family may shy away from visiting them at home. This can take a toll on the hoarder’s social life, causing them to feel isolated and lonely, and making your support even more important.

Clutter, collecting, and hoarding: What’s the difference?

In the early stages or in less extreme cases, it isn’t always easy for family or friends to differentiate hoarding disorder from being messy and disorganized or just having too much stuff. So, at what point does being a “pack rat” cross the line?

People who are messy or prone to clutter usually still feel comfortable inviting others into their home. Despite the untidiness, their rooms remain accessible and can be used for their original purpose. A hoarder, on the other hand, may use the bathroom, bedroom, or kitchen to store piles of newspapers, boxes, plastic bags, or other worthless items, making it hard to use the toilet, get to bed, or cook.

People who collect tend to proudly keep their items on display and derive pleasure from their collections, rather than the guilt, shame, or anxiety associated with hoarding. A collector’s items usually have an obvious monetary or personal value and while their home may be crowded, it’s not disorganized like a hoarder’s where items are often difficult to find.

People who hoard tend to do so with an intensity that distinguishes them from collectors and messy people. Their need to acquire and retain even worthless items is compulsive and they have a real difficulty getting rid of things.

Why is my loved one hoarding?

People hoard for a number of reasons, but it usually stems from having irrational beliefs about objects that make it so distressing to get rid of things. It may be that your loved one feels that even an every-day or worthless item has great sentimental value, that it will help them to remember an important event or person they may otherwise forget, or they see the use or uniqueness in things that other people would consider junk.

Some hoarders fear running out of things, have a compulsive need to accumulate free items, or find it impossible to pass up a bargain or deal. Others simply view disposing of things as being wasteful.

Hoarding disorder is most commonly diagnosed in older adults with a family history of hoarding. Some display symptoms following a stressful or traumatic life event, such as a divorce, accident, or the death of someone close. Others find that hoarding accompanies another mental health problem, such as OCD, other anxiety disorders, depression, PTSD, or ADHD.

How to talk to someone about their hoarding

Despite their disordered and sometimes unsanitary living conditions, some people with hoarding disorder may not identify their behavior as problematic. Therefore, it can take multiple attempts to begin a conversation about changing their habits.

Whether you’re broaching the subject for the first time or have tried and failed to engage your loved one in a conversation about their hoarding before, how you approach the problem can make a big difference. Pushing your loved one to make major changes at once, trying to take charge, or cleaning away their possessions behind their back will only alienate the person, destroy their trust, and add to the family conflict.

[Read: Effective Communication]

Rather, it’s important to show that you empathize with the hoarder’s struggle and want to support and assist them as they work to change their behaviors.

Examine your own behavior

When you’re dealing with someone who hoards, it’s easy to lose patience at their behavior, feel stressed at your lack of influence over their living conditions, or even experience burnout from the struggle of trying to help.

While you can’t control the hoarder’s behavior, though, you can manage your own responses. That starts with taking a step back and exploring how your own actions—or those of other friends or family members—may be contributing to the hoarding problem.

Don’t enable your loved one’s hoarding. While they may seem like helpful fixes in the short-term, don’t offer to store items for the hoarder or pay for extra storage space. In the long run, you’ll just make the problem worse. Similarly, don’t go shopping or scavenging with the hoarder, gift items that will only add to their hoarding problem, or bail them out of debts incurred by excessive shopping.

Don’t clean up after the hoarder. While you’ll always want to assist your loved one to clean and organize when they request help, don’t take on all the duties yourself. The more you clean up after the hoarder, the less they’ll be motivated to address the problem themselves and tackle the real issue—the beliefs and behaviors that fuel their hoarding.

Keep your expectations realistic. Expecting your loved one to become perfectly neat and organized is setting yourself up for disappointment. Changes tend to happen gradually and there will likely be setbacks along the way where the person reverts to old patterns of behavior. Unrealistic expectations can fuel family stress and conflict, so instead of targeting a perfectly neat, clutter-free home, aim at reducing the dangers in your loved one’s home. Can you settle for having your loved one live in a cluttered but safe environment, for example?

Manage stress. Dealing with someone who has hoarding disorder can cause a lot of stress, anxiety, and tension—and that can rub off on the hoarder. The more stressed and anxious they become, the more likely they are to revert to negative behaviors. Try to make time to relieve stress and regain your inner calm through exercise, meditation, or other relaxation techniques.

[Listen: Deep Breathing Meditation]

Resolve conflict in a positive way.While conflict is a normal part of every relationship, dealing with a loved one who hoards can trigger strong emotions in anyone. But reacting with angry or hurtful comments, refusing to compromise, or rejecting the things that are important to the hoarder will only push you apart. Instead, you can learn to resolve your differences in healthier ways that can bring you closer together.

Focus on the person, not the possessions

Whether the hoarder is a close friend, partner, or family member, you may forget that the disorder is just one aspect of their identity, not the only thing that defines them as a person. Try to look beyond their accumulation of stuff (or animals) and find other ways of relating. Bonding over other interests or hobbies can help nurture an atmosphere of trust and cooperation.

Don’t make everything about hoarding. Spend time talking about other issues and interests. Go for a walk, visit a museum, attend a concert, or take up a new hobby together. People with hoarding disorder are often socially isolated, so your non-judgmental support can be crucial in helping them change their behaviors.

Highlight your loved one’s strengths. We all have our strengths and weaknesses. Instead of focusing solely on your loved one’s hoarding problem, acknowledge and validate their areas of strength and the things they do well.

Address any underlying conditions. Mental health problems such as depression, anxiety, or OCD may be contributing to your loved one’s hoarding. Encouraging them to treat the underlying condition may help improve their hoarding symptoms.

[Read: Anxiety Disorders and Anxiety Attacks]

Help motivate your loved one

One of the toughest aspects of helping someone with hoarding disorder is motivating them to start and stick with the process of changing how they accumulate items. The prospect of discarding existing possessions and resisting the urge to purchase more can be emotionally harrowing for the hoarder. Motivating them can take patience, understanding, and lots of encouragement.

Make harm reduction the focus. When setting goals with your loved one about organizing their living space, emphasize reducing the risk of accidents and injuries rather than eliminating clutter. To keep the hoarder motivated, make it clear that the aim is only to get rid of enough items to keep the person safe. As you move ahead with the process, your loved one may become more comfortable making decisions about things to discard.

Set achievable goals. When decluttering, aim to tackle just a small pile or a single drawer at first. Start with items that your loved one finds easiest to throw away—old bills may be less distressing to discard than letters or photographs, for example. Getting rid of just one or two items can be emotionally exhausting for someone with hoarding disorder, so by keeping goals manageable, you’ll allow the person to develop a tolerance to the decluttering process and gradually build momentum.

Don’t make decisions for them. When helping your loved one organize their things, encourage them to assign possessions to “keep” or “discard” piles rather than any kind of “decide later” category. While you want to avoid them delaying decisions, the final say should always be theirs.

Identify your loved one’s shopping habits. What triggers the person to acquire more things? Perhaps they’re unable to pass up a bargain or they shop when they’re bored, lonely, or stressed. Once you identify what triggers them to accumulate more possessions, you can find healthier ways to deal with the urges.

Celebrate even small victories. Clearing away just a few things is reason to praise your loved one—and yourself. Don’t underestimate the importance of small steps and how your efforts are making a difference.

Encourage your loved one to seek treatment and support

While medication may help for underlying issues such as anxiety or depression, cognitive behavioral therapy (CBT) is the primary treatment for hoarding disorder. Whether in a group or one-on-one setting, CBT can address the negative thoughts that contribute to hoarding disorder and help the hoarder develop new patterns of behavior.

Working with the right therapist can help your loved one to:

• Challenge the unhelpful thoughts and beliefs that contribute to their hoarding.
• Resist the urges to acquire more possessions.
• Improve their decision-making and organizational skills.
• Bolster their motivation to declutter.
• Prevent relapse into negative patterns of coping.

[Read: Therapy for Anxiety Disorders]

Help your loved one to research therapy options, make and keep appointments, and stay on schedule.

Additional sources of support

For your loved one. In addition to therapy, talking regularly to others facing the same challenges can help your loved one to feel less isolated and alone. Find online or in-person support groups for people with hoarding disorder using the resources listed below.

For yourself. While helping your loved one, it’s important not to let their hoarding take over your whole life. To keep your mood up and your stress levels down, don’t neglect your own health needs and other relationships. Joining a support group for family members of hoarders can also help you find support, discover local resources, and learn new coping tips.