Hoarding disorder is a mental health condition that is defined by the excessive accumulation and saving of physical items. People with hoarding disorder can accumulate huge amounts of possessions to the point where the clutter completely overtakes their homes, significantly impacting their quality of life and even their safety. While many people may safely collect certain items and have difficulty getting rid of them due to their value and sentimentality, hoarding disorder is a diagnosable mental health condition that has very real consequences on people’s lives and well-being.
Unsurprisingly, the resulting extreme clutter can wreak havoc on a hoarder’s home and make it difficult to live in. But hoarding doesn’t just affect the hoarder themselves; it can also have huge emotional and physical tolls on their family and loved ones, and cause tension with neighbors or landlords.
Dr. Nicholas Farrell, licensed clinical psychologist and Regional Clinical Director at NOCD, explains, “I think one of the underappreciated negative outcomes of hoarding is that it presents massive health risks.” He gives an example of a client currently being treated for hoarding, who has accumulated so many items that their family can’t access the toilet in the bathroom and has resorted to going to the bathroom in inappropriate places like bags and buckets. Others can even develop sepsis from wounds that become infected due to extremely unsanitary living conditions.
“Additionally, hoarding also is responsible for a significant emotional toll on family members,” he continues. “There’s a very high amount of tension and friction between the hoarding family member and the family members that are negatively impacted by the hoarding.”
Finally, there are also very real consequences when it comes to social isolation and loneliness, both for the hoarder and for anyone who might live with them. Dealing with hoarding can be a lonely and isolating experience. Family members of hoarders are often embarrassed by the state of their homes, or feel unsafe entering them, and they might stop inviting friends or other family members over as a result. The hoarder themselves may feel deep shame and not want anyone, including professionals, to see their home, making it even harder to get help for this significant problem.
At the end of the day, hoarding disorder is very serious—not only for the person suffering, but for their loved ones as well. If someone you love has hoarding disorder, you might feel anxious, angry, helpless, and alone. But your feelings are valid, and there is help out there for both you and your loved one—and you can play a role in getting them the help they deserve. I spoke with Dr. Farrell to understand more about the experiences of people with hoarding disorder, and to determine what your next steps look like while you support them through their recovery.
5 ways to offer support to a loved one who is hoarding
Seeing someone you love accumulating enormous piles of possessions can be difficult—especially when it has a severe impact on their overall well-being.
However, a good support system is crucial if they want to get help and proper treatment. Here’s how you can offer them support and show that you are there for them, no matter how difficult it is.
1. Recognize that your loved one is experiencing a problem. Hoarding disorder is a serious and debilitating mental health condition. Someone who hoards may not even recognize that they have a problem to begin with. If you want to support a friend or family with a hoarding disorder, it’s important to recognize that they have a legitimate mental health problem and that they need support and understanding to get through it. It can also be helpful to research more about what hoarding disorder is and how it can affect your loved one, as well as to reach out to a mental health professional to understand the options that your loved one has.
2. Approach the topic with love and care. In addition to understanding the connection between their hoarding and their mental health, it’s also important to approach the issue from a place of compassion and understanding. Listen to their concerns and try to understand their point of view without judgment. By framing your concerns from a place of love, rather than anger or accusation that can make them resistant to change, you may be able to have more productive conversations.
3. Be gentle, but firm. With that said, it’s also important for friends and family members to establish their boundaries in a way that is empathetic but still firm. This is especially true when it comes to expressing how the hoarding is affecting you and others in your home so that you can have meaningful conversations. As Dr. Farrell puts it, “The person who is hoarding may not be able to fully appreciate that you no longer have a workplace because of the clutter in the office.” Having those hard conversations from a place of love and caring can help them realize how far the consequences of their hoarding are spreading, and it can also help you establish boundaries yourself.
4. Let them know that there is hope. Having a hoarding disorder can feel overwhelming and scary. A good way to support your loved one is to let them know that evidence-based treatments exist and are available that can help them cope with their distress and ultimately create a more habitable home for themselves and you. Be supportive by helping them research and reach out for help when they’re ready.
5. Work together as a team. When it comes to treatment, it’s also highly effective to let your loved one know that they don’t have to do it alone. “It’s not: ‘You need to get treatment,’” says Dr. Farrell. “It’s: ‘We can do this together as a team and a family. We’re going to work together to overcome this problem. I’m going to be with you every step of the way, both supporting you and holding you accountable as needed.’”
Dos and Don’ts of helping a loved one declutter when they have a hoarding problem
If a loved one with hoarding disorder decides that it’s time to start throwing things away, you can play an integral role in helping them declutter and determining which items should be tossed. However, the process of throwing things out tends to be incredibly difficult for someone with hoarding disorder, so it’s important to approach the process with the utmost care.
Do: Challenge them when necessary to get rid of something, even if they really don’t want to.
Getting rid of items is hugely distressing to someone with hoarding disorder, since even seemingly valueless items often hold emotional meaning to them that others might not understand. Throwing out even apparently worthless items can become an extremely distressing event, since hoarders often fear that they might one day need that item.
So when it comes to decluttering, a huge part of providing support and encouragement in this situation involves gently encouraging them to get rid of things, even if they feel intensely resistant. Challenging them to get rid of those things can be uncomfortable, but it is often necessary to get the ball rolling.
Don’t: Try to hide that you’re throwing things out, unbeknownst to the hoarder.
It’s easy to get frustrated with people suffering from hoarding disorder, especially if you feel that the decluttering is not happening as quickly as it should. But no matter how frustrated you get, resist the temptation to throw things out in secret. “While this might be understandable in most cases, in my experience, it badly backfires,” warns Dr. Farrell. “There’s a loss of trust and also a ‘cooling’ of a hoarder’s motivation.” Instead, allow your loved one to make those decisions themselves, and always give them the final say. Don’t try to force the issue yourself, which can often make matters worse.
Do: Understand that hoarding is not just a problem of saving—it’s also a problem with acquiring things.
In addition to having a hard time throwing things away, many people with hoarding disorder also have a problem with bringing new things into the house. “What research has shown is that people who hoard actually discard stuff at close to the same rate that you and I would,” says Dr. Farrell. “So it’s not as though a hoarder never throws anything out. They occasionally throw things out, but there’s a whole lot coming in that doesn’t need to be coming in.” It’s important to understand both sides of the issue when it comes to decluttering the house so you can address your loved one’s struggle from all angles.
What to do when someone is in denial about their hoarding
The extent to which people recognize their own hoarding disorder as an issue can vary. In fact, in some cases, people with hoarding disorder might not recognize it as a problem at all. In cases like these, convincing them to get the appropriate treatment can be especially challenging for their loved ones.
Trying to convince someone that they have a problem can be very difficult, especially when it comes to mental health conditions like hoarding disorder. If this is something that you are struggling with, Dr. Farrell recommends changing the narrative and approaching the issue from a more practical standpoint.
“Ask open-ended questions about how, in general, life might improve if the hoarding behavior were to be reduced,” he suggests.
To demonstrate this, he presents a hypothetical example in which someone with hoarding disorder has accumulated so much stuff that their living room is no longer usable. Rather than aggressively confronting the hoarder about all the stuff they have in the living room and how it is preventing the family from being able to sit down, he instead suggests asking questions like “How do you think our family’s use of this room might improve if there was less stuff laying around?”
Framing issues this way might help them see a different perspective and understand more about how their condition is affecting both themselves and those around them.
Learn to spot the signs of mental health issues like OCD
Hoarding disorder is a mental health condition on its own. However, hoarding behaviors are also commonly associated with obsessive-compulsive disorder (OCD), so it’s helpful to understand the connection as you support your loved one, so you can recognize any additional or related issues they may be facing.
OCD is a condition in which people experience distressing and unwanted intrusive thoughts, urges, feelings, or images. They then try to cope with the resulting discomfort with compulsions, which are actions that are done to alleviate the anxiety or prevent a bad thing from happening.
Hoarding and OCD can look very similar. In fact, hoarding used to be considered a subtype of OCD, and it’s still listed among “obsessive-compulsive and related disorders” in the current version of the DSM (the manual for diagnosing mental health conditions). Research suggests that 1 in 4 people with OCD also experiences compulsive hoarding, while 1 in 5 hoarders have additional OCD symptoms. Both conditions are marked by excessive and intense anxiety about perceived negative consequences. However, the core nature of that anxiety is different.
“Someone with OCD may be extremely anxious about potentially being responsible for a catastrophe, whereas someone with hoarding might be anxious over what consequence they may experience if they discard an item that they’ll really need at a later time,” Dr. Farrell explains. “That being said, it’s fair to say that both hoarding and OCD are characterized by a perceived inability to tolerate distressing emotional experiences—and it’s fairly common for people to suffer from both conditions.”
Practical tips for living with someone who is hoarding
Supporting your friend or family member is integral to their success. However, it can be extremely hard in the meantime to share a home with them and all of their possessions, so it’s also important to claim your own space and set boundaries so that you can live under the same roof in spite of their collection.
Dr. Farrell’s biggest suggestion here: don’t accommodate. In other words, if you notice that your loved one is acquiring things at a high rate, don’t clear more of your own stuff away in order to accommodate all of their excess belongings. If someone accommodates hoarding in this way, “they’re essentially making more space, both literally and figuratively, for the hoarding problem to fester.” Instead, set clear boundaries and establish that your space and your possessions are equally important in your home.
It’s also well worth acknowledging how hard someone else’s hoarding can be on your own mental health. Start by acknowledging that it is hard and distressing—and that there is nothing wrong with getting frustrated over such a serious issue. “There’s a lot of emotional and even physical burdens to living with a hoarder,” says Dr. Farrell. “Sometimes we hear from family members that they feel guilty for communicating with their loved ones in a way that upsets them. In other words, ‘the fact that their hoarding bothers me makes me feel guilty.’”
Where to find help for your loved one’s hoarding
At the end of the day, recovering from hoarding disorder can be a long road for everyone involved. Support your loved one with their treatment as much as possible, and approach the issue as a united front. It’s a family effort, and both you and your loved one will benefit from working through it all as a team.
If you’re ready to take concrete steps to helping your loved one recover from hoarding, effective treatment is accessible to you. I recommend learning more about NOCD’s evidence-based approach to treating OCD and related disorders, including hoarding disorder. Many of NOCD’s licensed therapists have received intensive, specialized training in treatment for hoarding and have experience helping people like your loved one recover from the condition. The International OCD Foundation (IOCDF) also provides excellent resources on helping people with hoarding disorder. By taking initiative to reach out for expert help, you can make a life-changing difference for your loved one’s mental health.