What Is Compulsive Hoarding Disorder?

People With Disposophobia Fear Throwing Anything Out:

article-0-165CCB8A000005DC-601_634x420Compulsive hoarding disorder goes by several different names. This has been an attempt to describe the unusual behaviors found in the disorder. Syllogomania, Collyer brothers syndrome and disposophobia are a few of the names that are also used. Compulsive hoarding is poorly understood and is thought to be at least in some part an (OCD) obsessive compulsive disorder. It progresses over time and manifests mostly in older people even though it is seen in the young and middle aged. It causes people to be self abusive in how they live. They amass huge amounts of items, junk or even animals. Some cannot get rid of anything including waste products and obvious garbage. Many of them become isolated afraid of letting anyone see how they live. Some are ashamed of their life style and try to hide it, others seem oblivious to the mess. They cannot stop themselves without some sort of intervention.

Disposophobia – Living With Clutter:

People might start out buying but end up hoarding. They can hoard anything or everything including animals and even garbage. These individuals don’t necessarily start off with giant piles of dusty mess. Some in the beginning are organized and do dust and clean their environment. As time goes on and as more things start to accumulate it gets harder to clean and keep things organized.

You can’t tell that some people have a compulsive hoarding problem because the ones that are still social make a point of hiding it. Their appearance is reasonably neat and clean but their home tells another story. These people still take care of themselves, get medical care but maybe not do anything that has to do with guests coming to their home. They will visit others but probably wont let others reciprocate.

Some people consider themselves collectors. They claim that the stuff they collect would be worth something some day. If they have family or friends sometimes they try to store some of their possessions with them. This can cause feuds if the items start taking over living space and if the friends want the things out. If the hoarder has money they may use paid storage facilities. This can eat into finances. They also fill up garages, tool sheds anywhere there is space. Some have even filled up vacant apartments or houses that either did or did not belong to them. They do not have people over and are too embarrassed to have repairmen fix anything broken which adds another level to the situation. Deferred maintenance can cause problems like mold and mildew from unfixed leaks . They keep the windows covered so that people can’t see inside the living area. It can becomes public if they run out of space and the stuff ends up outside the house in the back or front yard where others can witness the problem.

tumblr_inline_nk8lrm588I1t5updr1There comes a time with some of them that they are forced to have their place emptied and cleaned. Sometimes getting physically ill and having to be hospitalized due to the stress of losing some of their possessions. If left to their own devices it doesn’t take long for them to fill it up again. Family has to be careful in how they approach this.The hoarder might truly feel devastated at any decluttering attempt and place blame on the well meaning family member who is trying to help. They might try to isolate themselves more or shun that family member while continuing to hoard.

If, due to circumstances they end up living in a nursing home they cannot take many things. Depending on the room, there is only limited space available for what they really need much less to hoard things. Some do start to collect newspapers and items they find. They are monitored by the staff and even if involuntarily they will be made to declutter.

Medication Safety And Hoarding:

Health can suffer from living in such an environment. Compulsive hoarders will also hold onto their medications. Being disorganized they may put them in different locations and store them inappropriately. If medication is not stored properly it can lose its potency and not work. Putting medicines in different places means they will be lost or forgotten and maybe become expired. Hoarding them means the expired and badly stored medicines will still be used. It is not safe taking old medicines. The effect is unpredictable, it could be very weak and not helpful or very strong causing a overdose like reaction.

People With Syllogomania Can Be Artistic And Thrifty:

Is It Stockpiling Or Hoarding?

Watching some of the organization shows on TV demonstrates the thinking of hoarders. The bigger the house, the more junk that can fit it it. They are reduced to tears when confronted with throwing things out. A lot of them are artistic with many unfinished projects. The organizers point out that in four lifetimes they will never finish all those projects, so they need to donate their supplies of yarn, material, or scrap booking stuff.

Some hoarders consider themselves frugal or green. This type of person theoretically can find a use for everything. The operative word is “theoretically” because they don’t or can’t follow through. To them it seems wasteful to discard anything that can be reused. They go to rummage sales, auctions, liquidators or dumpster dive and stock up on things that are pretty much useless.They hoard food products that are way past their expiration date thinking that they are being thrifty.

Buying on sale or with coupons gives them a rush, but overbuying is a problem. Extreme couponing is interesting in that you will see some individuals buying things just because they have a coupon and not because they like the product. Claiming that someone else would want or could use it is just an excuse they use. They also put monetary value to their stockpile. But there is value only if it is used or sold.

One of the issues is a failure to make decisions. Keeping the stuff is a non decision while convincing themselves of their frugality. There are other non hoarders that are able to part with their goods without a problem and give to family, friends and charities. Hoarders have trouble with problem solving and are poor decision makers. It runs in families so it can be both nurture and nature.

A Sad Story Of Hoarding To Homeless:

While at work in a hospital I was interviewing an patient about his complaint of not breathing well. He started to tell me how he had a new landlord and he wanted to evict him from his apartment of 14 years. This landlord had made an inspection of his apartment and told him it was a fire hazard. He was told that if he didn’t get rid of his books he would have to leave. At that time I couldn’t imagine books being a safety hazard. I asked him how many books did he have. He said he loved books and picked them up from everywhere and he had many. It seemed like an easy answer, get rid of some of the books to show the landlord that he was cooperating. But he said he couldn’t.

It seemed inconceivable that facing eviction from his apartment and facing homelessness or life in a shelter he could not get rid of the books. His options were limited, obviously he couldn’t move anywhere with them and he said he didn’t have much money to rent a new apartment. It wasn’t easy, he was in the clinic because he was having breathing problems from the stress, but he didn’t want to get rid of the books. Even though the potential dust and mites from all the books was not helping his breathing. It was unlikely he was able to get to the dust with all the books. He said he had an appointment with the social worker to help him with the situation.

Is There Recovery From Compulsive Hoarding Disorder?

Since the disorder is poorly understood it makes it harder to treat. Considered by some to be a part of obsessive compulsive disorder, but maybe 30 to 40% of them don’t present with OCD. Also there is believed to be a difference in the brain activity of these individuals. Some are not even considered to have a mental disorder. There are those that do have dementia, depression, psychosis and attention deficit disorder. This of course makes it harder to treat. Take for instance dementia, where there is damage to the brain which makes the person act irrational and just gets worse as time goes on.

It would be easier to treat someone who is in the early stages and probably can be reasoned with. They would be better able to monitor their own hoarding behavior. Also if illness is a factor or isolation, then help with activities of daily living and companionship might make the situation some what better. They may never win the good housekeeping seal of approval but the point is to keep some control of the situation.

Cognitive behavior therapy (CBT) can be of some benefit. The first part of treatment is to have them admit that there is a problem. Some do not think they have a problem. And then to try to understand why they cannot throw things out and help them make the appropriate decisions about their lifestyle. The hoarder might not want an intervention and therefor can’t be made to change unless an emergency happens like they fall and get hurt or otherwise are a danger to themselves.

It seems to be a disorder that they are always recovering and not recovered because of the temptation to hoard. Some have been able to change their behavior with constant self assessment and help from professionals, friends and family. Others seem unable to. It seems to depend on how long they have been afflicted or how serious it is. If there is a mental illness component or another similar syndrome like squalor syndrome involved then it becomes more complicated.

There is no medication that can stop the behavior. The serotonin reuptake inhibitors (SRI’s) are beneficial for OCD behaviors, but have mixed results when it comes to compulsive hoarding. Some studies found them helpful others found they did not alter the behavior. It is stated that mixtures of different medications work on an individual basis.

The belief at this time that a combination of both medication and CBT have the best chance of working to some degree. More research and studies are being done to improve the outcome in the future.