Hoarding, or hoarding disorder, is defined as a persistent or profound difficulty in discarding, eliminating, or parting with possessions, according to the Mayo Clinic. A person is unable to part with certain possessions, even those with no value, because they strongly feel a perceived need to keep and maintain these items.
Over time, an excessive accumulation of possessions, including items of no value whatsoever, even trash, results. The net effect of hoarding can be that living conditions become cramped, even unsafe. Indeed, severe hoarding can result in a residence becoming virtually inhabitable.
The severity of hoarding does range from mild to severe. A mild case of hoarding has very little impact on a person’s life. However, more serious hoarding can hugely impact a person’s ability to function on a day-to-day basis. Hoarding nearly always worsens over time.
Clinical Diagnosis of Hoarding
Historically, hoarding was considered to be a type of OCD, or obsessive-compulsive disorder. More recently, hoarding disorder has received its own DSM-5 classification, according to the Mayo Clinic.
Oftentimes, a diagnosis of hoarding disorder is made in conjunction with other diagnoses. For example, a person with hoarding disorder may also be afflicted with depression or social anxiety disorder.
A considerable about of discussion has occurred regarding which condition precedes the other. For example, does someone hoard because they are depressed, or is someone depressed because they hoard.
What is certain in the event a person is diagnosed with hoarding disorder and another condition is that one problem feeds into the other. The combination of hoarding with another mental health issue creates what can fairly be described as a vicious circle, with one condition aggravating the other, no matter which one developed in a patient’s life initially.
The Prevalence of Hoarding Disorder
A study of individuals selected from the general population focused on determining the incidence of clinical hoarding among that broad cohort in the United States. The results of the study concluded that the incidence rate of clinical hoarding among the population of the United States was approximately 1.5 percent.
Despite the due diligence exercised by the researchers in this study, the individuals who designed and pursued the research made clear that the 1.5 percent figure likely was not accurate. They maintained that the number of people afflicted with chronic hoarding is likely to be higher than what is reported by the study. Indeed, these researchers stated that the actual number of clinical hoarders in the United States could be significantly higher than what was reported via the study. They maintain that the existence of a great many individuals with hoarding disorder simply is now known.
Undisclosed and Undiscovered Hoarding
Although research suggests that the rate of people afflicted with hoarding disorder is at about 1.5 percent, psychologists and researchers are uniform in their belief that the actual number of men and women afflicted with this condition is significantly higher.
Very few individuals admit that they hoard. More significantly, a vast majority of individuals with hoarding disorder do not even recognize that they have a problem. They believe that hoarding is a perfectly normal activity.
The reality that people who recognize they have a problem with hoarding but do not disclose their situation, coupled with the number of people who do not even concede they have a problem, skews data associated with tracking the number of clinical hoarders in the United States, and elsewhere. Although this involves a tremendous amount of guesswork, estimating the actual number of people afflicted with hoarding disorder at three or even four times above the 1.5 percent might not be completely unrealistic.
A surprising number of hoarding discoveries are made under two common sets of circumstances. First, a person, usually an elderly individual, develops a health malady that requires long-term hospitalization or case. Through this process, a residential hoard is discovered.
The second common situation in which hoarding is discovered is when a person passes on. At that juncture, family members, or other loved ones, are called upon to get that individual’s property or affairs in order. At this juncture, these men and women find themselves surprised to discover that their deceased loved one had been hoarding.
Identifying a Hoarder
As noted, more certain statistics could be gleaned if so many hoarders did not operate in proverbial darkness. There are a few telltale signs that a loved one may be having an issue with severe clutter or even actual hoarding. One of the primary signs that a family member or friend may have chronic clutter or hoarding issues is if he or she doesn’t permit others into his or her residence.
If a once social individual becomes less and less involved with other people, that can be indicative of a range of different issues, one of them being hoarding. If items begin to accumulate on the outside of a person’s residence that generally are not found out of doors, severe clutter or hoarding may be an issue.
An important fact needs to be stressed when it comes to identifying a hoarder. Clutter and chronic disorganization does not necessarily mean a person is afflicted with hoarding disorder. With that noted, excessive clutter and profound organizational issues could prove to be a precursor for clinical hoarding disorder in some instance.
When Does Collecting Become Clutter Become Hoarding?
Calculating the number of people afflicted with hoarding disorder is further complicated by actually classifying people as compulsive hoarders. Historically, experts in the field have had some difficulty drawing lines to define what truly represents hoarding disorder.
The Institute for Challenging Organization, or ICD, developed what it calls an observational guideline tool to aid in the assessment of residential environment to ascertain whether it is the scene of hoarding or merely extensive clutter. Using these guidelines, which ICD calls the Clutter–Hoarding Scale, is proving a useful tool in an effort to properly classify individuals who are afflicted with hoarding disorder.
The classification capabilities permitted through the use of the Clutter–Hoarding Scale serve a valuable purpose. A person who merely has serious organizational issues requires different types of assistance with their dilemma than does an individual with hoarding disorder.
The Clutter–Hoarding Scale utilizes a five-tiered system to rate the level of clutter or hoarding at a residential premise. The five levels are based on how professionals in the field of organization, together with other types of professional, would evaluate the condition of a home at a particular point in time.
The level system included in the Clutter–Hoarding Scale is progressive, with Level I indicative of organizational issues, but far from hoarding. Level III represents a pivot point on the Clutter–Hoarding Scale at which an individual may require some fairly serious professional assistance and remediation to prevent the situation from progressing. Level V represents a person who clearly suffers from profound hoarding disorder.
Through the use of this schematic, a better understanding of the nature and extent of the hoarding problem can be realized. Again, by better identifying the exact circumstances of an individual, be it severe organizational deficiencies or profound clinical hoarding, best ensures that proper intervention and remediation can be established.