There’s a difference between being a clutter bug and having a genuine hoarding disorder. There are actually five stages of hoarding, according to experts. Let’s talk about the five stages, how to recognize them, and how to know when you need to bring in professional help.
What is hoarding disorder?
Hoarding disorder is a mental health condition characterized by persistent difficulty discarding possessions, regardless of their actual value.
Hoarding disorder often precedes, follows, or acts in tandem with other disorders, such as anxiety, depression, obsessive compulsive disorder, post traumatic stress disorder, and agoraphobia.
Here are some of the main characteristics and signs of a hoarding disorder.
Extreme difficulty parting with items.
Even when those items have little (or no) objective value, individuals with hoarding disorder will have outwardly extreme reactions to the removal–or even the suggestion of removal–of their belongings. They experience intense emotional distress at the mere thought of it.
Accumulation.
A collection of items that congest living spaces. The items often have no obvious purpose, are broken or nonfunctional, and make the environment more difficult to move around in.
Unusable living space.
Living spaces become unusable for their intended purpose, causing significant impairment in daily functioning. Having to high-knee over things just to get across the room, not being able to find the things you need, no clear surfaces for cooking and other work. Traditional chores soon become impossible.
Social isolation.
Hoarding often comes with embarrassment or shame, causing individuals struggling with it to socially withdraw. They will stop inviting family members over and eventually make a real effort to keep others out entirely. The anxiety that comes with (or causes) hoarding disorder can be debilitating, growing into an agoraphobia that stops them from socializing at all, even outside of their house.
How hoarding affects your wellbeing.
Hoarding can have disastrous effects on a person. Here are only a few of the ways it does so.
Health hazards.
Hoarding spaces can be so severely cluttered that they create health hazards. Mold, rodent and bug infestation, expired food, animal waste, and human feces are common things to find in extreme hoarding situations.
Safety concerns.
Along with the health hazards, excess clutter can pose a physical threat as well. Blocked access to the home can prevent emergency services. Clutter presents a fire hazard, both in starting fires and in escaping one. Often, wild animals will move into hoarder homes and present a safety threat.
Family conflict.
It is incredibly hard to have a loved one with a hoarding disorder. Hoarding has a similar dynamic to substance abuse. The communication frustrations, the appearance that they are choosing this life over their family, and other commonalities make them feel interpersonally similar.
Financial complications.
Hoarders often have a problem controlling shopping impulses, which might result in consistent overspending.
Additionally, hoarders often have difficulty maintaining employment. This is for many reasons–shame or fear compelling them to hide in their home, time management issues due to a poorly functioning household, difficulty in keeping a clean wardrobe, mental illness, and poor hygiene.
The combination of extra spending with less time employed can drop a hoarder into significant debt relatively quickly.
Treatment for hoarding disorder.
I’m not a licensed medical professional, so please don’t take anything in this article as medical advice. That said, here are the most common treatments used for hoarding disorders.
Cognitive behavioral therapy.
CBT is a good first step for almost any mental disorder, so that might be where someone would start. A professional who specializes in the different levels of hoarding could be especially helpful.
Exposure therapy.
Exposure therapy for compulsive hoarding usually involves forcing yourself (with support) to face the fear and actually get rid of something. The more we do a thing that is uncomfortable, the better we tolerate it.
Skills training for organizing/decision-making.
Some people end up in a bad situation because they simply don’t have the skills required to keep themselves out of it. A professional can help with the cleanup, plus help in actually training the hoarder in how to keep a safe, clean home.
Medications.
In some cases, medication may be helpful. Treating an underlying issue, like anxiety, could have a great result and help a patient make progress toward a healthier lifestyle.
Family therapy.
Hoarding affects the whole family–not just the hoarder. Because of this, and because it is usually much easier to face hard challenges with a team behind you, family often gets involved in the treatment program.
5 different levels of hoarding disorder.
There are generally five stages of hoarding disorder, as defined by the National Study Group on Chronic Disorganization (NSGCD). Here they are with a clutter image rating scale. My graphic design skills aren’t top shelf, but hopefully these can give you a clearer idea of the intensity levels of hoarding.
Level 1: Mild
These are our casual hoarders. There’s light clutter, but doorways and stairs are easily accessible. There are no noticeable odors, and those who live there are able to clean regularly.
All appliances and home systems are functional.
If pets are present, they may have some maintenance issues, like accidents on the carpet that are left for long periods of time, but in general, the place is fairly clean.
Level 2: Moderate
In level two, we’ve got at least several rooms with notable clutter. One major exit is blocked, like that random door at the back of your kitchen that you can’t access for floor clutter.
You’ll have some light odors, possibly mold in the kitchen and bathrooms, overflowing trash cans, those beside-the-can garbage stacks.
With pets in level two hoarding, there will be tolerable pet odors and visible waste.
Another defining factor is one appliance not working for at least six months.
Level 3: Advanced
Advanced hoarding is where we really start to see quality of life issues.
One bedroom or bathroom is unusable. Strong odors throughout the house, excessive dust, cobwebs, and mold.
Again, overflowing garbage cans, multiple appliances out of order.
Advanced hoarding disorder is also where we start to see multiple pets that exceed local regulations. Commonly, a hoarded pet tends to be cats, as they reproduce rapidly, are somewhat self-sufficient, and are very easy to collect (there’s even a Cat Distribution System).
Level 4: Severe
Severe levels of hoarding brings in more damaging health threats. Hazardous living conditions with strong pet odors, rotting food, and other major health and safety concerns.
Severe hoarding also brings some structural damage to the dwelling itself, like partial ceiling collapse, electrical exposure, and a lack of utility access. Inhabitants may be sleeping on floors, couches, and other spaces due to clutter in the bedrooms.
Level 5: Extreme
Extreme hoarding disorder is the final and most severe stage of hoarding. In this case, the house is so uninhabitable that it will likely be condemned and demolished.
The house has structural damage, no utilities or running water, significant fire hazards, human feces, visible pests like roaches, rats, and bed bugs.
Level five hoarding disorder involves uninhabitable conditions and requires professional intervention as soon as possible.
Hoarding VS Collecting
“Collecting” is a common reason a hoarder may give for their hoard. There is a distinct difference between the two. Collectors will organize their items, display them attractively, focus on specific categories of items, feel positive about their collection, and maintain a functional living space.
That last point is crucial. That is what makes the difference between a hobby/lifestyle and a disorder. It’s all about how it affects you, your loved ones, and your environment.
When is clutter a mental health crisis?
Clutter is a mental health crisis sooner than you might think.
A cluttered environment begins affecting us immediately. Studies show that living in a cluttered space causes anxiety, depression, fatigue, and other issues that gradually worsen as time passes and clutter collects.
It can be hard to notice how much your home affects you, mentally and physically. If you think your clutter/hoard is negatively affecting you, it probably is.
We get into crisis territory when the area becomes hazardous. If the physical space is causing injury, illness, or the potential for either.
When to contact mental health professionals for hoarding disorder.
It can be difficult to spot when it’s time for professional intervention. If you or a loved one is suffering from the following things, it might be time to call someone.
1. Quality of life
Simply put, if hoarding affects their quality of life, you probably need to call someone. Professionals can help to effectively address issues like unpaid bills, injuries, or hazardous conditions.
2. Code enforcement
Severe hoarding may lead to complaints from neighbors about outdoor clutter, infestations, or seeping odors. Professionals can help intervene to avoid fines.
3. Facing eviction
Property management often considers eviction in hoarding situations, as hoarding can seriously threaten a home’s value–or even have it condemned. A professional can help streamline the cleanup and prevent the eviction.
4. Inaccessibility
Hoarding obviously can block entrances and exits to the home. This can lead to accidents, plus prevent emergency services from easily entering. Professionals may be required to restore safety.
5. Mental illness (depression, anxiety, PTSD, obsessive compulsive disorder)
Hoarding is often linked to various mental illnesses. Rather than being a “disorder” on its own, it exists in a complex network of complications. Professional help, including therapy, can help address these underlying issues and reduce the risk of relapse.
How to declutter your house.
If you or a loved one suffers from hoarding disorder, please try to be patient and empathetic. Do what you can to help them out of it without overextending yourself.
If you’re not at a level of clutter that requires professional intervention, you might still be looking for help. It’s hard to know where to start!
Here’s our ultimate decluttering guide to help you through every room of your house. You’ve got this!
