Hoarding disorder is a compulsive behavior disorder characterized by the inability to part with personal belongings due to severe anxiety at the thought of getting rid of something and/or having thoughts that the items are still needed in some way. Compulsive hoarding may lead to social isolation, distress and embarrassment, relationship problems, unsanitary or dangerous living conditions, and financial difficulties.

While compulsive hoarders often understand that their behavior is irrational, the intense emotional attachment they feel toward their belongings far outweighs the motive to discard any items. Compulsive hoarding can become so severe that a person is unable to throw away used, broken or useless items such as junk mail, old newspapers or a burned-out candle. This results in the extreme accumulation of items in one’s living space that tends to cause great distress and functional impairment.

The build-up of accumulated items in the sufferer’s home can eventually hinder movement from room to room and make daily activities, such as cooking and sleeping, enormously difficult. When severe, compulsive hoarding may result in extremely unsanitary living conditions and even pose a fire hazard.

It is estimated that approximately 2-5% of adults suffer from compulsive hoarding. It is more common in people with other types of mental illness, such as schizotypal personality disorder (STPD), obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), depression and anxiety.

Previously, hoarding was thought to be a subtype of OCD, but brain scan studies have shown that the brain activity of hoarders is very different from those with OCD. In particular, hoarders exhibit higher activity in the anterior cingulate cortex, a brain region involved with decision-making, especially when it involves uncertainty or indecisiveness.

Example: Kristie was too embarrassed to invite friends over to the house after school, as her mother’s compulsive hoarding had filled every room with useless items, including old newspapers, bags, boxes and empty bottles.