Hoarding Disorder – Diagnosis and Treatment

ByJanis Updated

Diagnosis

A mental health expert confirms hoarding disorder. The process usually involves a careful mental health checkup, which asks about thoughts, feelings, and how daily life is affected by keeping things.

Professionals ask about habits and attitudes toward saving items and how much clutter is in the home.

Questions often focus on:

  • Why items are saved
  • How hard it is to let go of things
  • Effects on living spaces and routines

Sometimes, pictures or videos of cluttered areas help show the problem more clearly. Specialists may also speak with close family members or friends to better understand the person’s situation.

They check for other mental health issues, like depression or anxiety, that sometimes appear along with hoarding.

Treatment

Talking Therapy (CBT)

Cognitive Behavioral Therapy (CBT) serves as the main help for hoarding disorder. This therapy teaches people new skills to manage their thoughts and actions related to keeping too many things.

In CBT, a person might:

  • Figure out why they feel like they need to keep or collect things.
  • Learn how to fight the urge to collect more stuff.
  • Practice organizing items and making choices about what to keep, toss, or donate.
  • Work on making better decisions and handling stress.
  • Get help from a therapist or organizer at home to clear away clutter.
  • Find ways to feel less alone and join social activities.
  • Participate in family or group therapy sessions.

Family, friends, or community agencies often provide extra help. This support especially benefits older adults or those with health problems. Regular check-ins or additional sessions help people maintain good habits and reduce the risk of clutter returning.

CBT Activities Table

CBT Skill How It Helps
New ways of thinking Handles urges to keep things.
Organizing practice Makes it easier to let go of stuff.
Stress coping Reduces anxiety when decluttering.
Social support Prevents feeling alone.

Helping Children Who Hoard

When children have hoarding disorder, their parents should join the treatment process. Sometimes, parents allow the child to collect many objects to prevent arguments or lower the child’s stress. This is called “family accommodation.”

Letting these behaviors continue often strengthens the child’s habits and makes it harder to change. Instead, therapy for the child should include guidance for parents.

Parents can learn helpful ways to support their child and respond to hoarding behaviors. This builds a healthier environment for change.

Tips for Parents:

  • Get guidance from a mental health expert.
  • Set clear rules and limits about collecting items.
  • Use positive encouragement to support progress.
  • Avoid handling the problem alone—teamwork is important.

Medicine Options

While cognitive behavioral therapy is the top choice for care, sometimes medicines can help. Right now, the Food and Drug Administration (FDA) has not approved any medicines just for hoarding disorder.

Doctors may prescribe medicines for other problems people often have along with hoarding, such as anxiety or depression.

The most common type used for these are called selective serotonin reuptake inhibitors (SSRIs), which are a group of antidepressants. Research continues to find the best ways to use medicines for hoarding disorder.

Key Points about Medicines:

  • No FDA-approved drug is specifically for hoarding disorder.
  • Medicine may be used if the person also has anxiety or depression.
  • SSRIs are often the first type tried for these symptoms.

Lifestyle and Home Tips

Managing daily habits can help make a home safer and more comfortable for someone who struggles with hoarding. Simple routines support progress and recovery along with any professional treatment.

Here are some practical strategies:

Stick to a Routine

  • Keeping to a written plan each day helps with reducing clutter.
  • Work at times when energy levels are high.
  • A calendar or checklist can keep track of small tasks.

Get Support from Others

  • Friends, family, or local helpers can assist with organizing spaces.
  • Support helps with making decisions or moving items.
  • Staying connected with others can prevent loneliness.

Connect with Community

  • Support groups provide understanding and practical advice.
  • Visiting friends or family outside the home can reduce feelings of isolation.
  • Sharing experiences helps motivate continued progress.

Promote Cleanliness and Safety

  • Remove items from bathrooms and other key areas to keep clean.
  • Clear the tub or shower to allow regular bathing.
  • Basic cleanliness supports both mental and physical health.

Eat Well

  • Make sure food areas like the kitchen and refrigerator are easy to access.
  • Healthy meals are easier to prepare when the kitchen is uncluttered.
  • Clear pathways to essential appliances to help maintain proper nutrition.

Look After Yourself

  • Remind yourself that a calm, organized space is achievable to boost motivation.
  • Set simple, specific goals to keep actions focused.
  • Notice and celebrate small changes over time.

Work on Small Steps

  • Tackle one small area at a time for effective progress.
  • Slow progress is still helpful; patience is key.
  • Consistency brings improvement, even if changes seem minor at first.

Care for Pets

Pet Needs Tips
Proper Nutrition Make sure pets have regular access to food and water.
Clean Living Space Remove clutter in areas where pets stay.
Veterinary Care Ensure pets get needed check-ups and medical care.

Pets deserve a safe home and good care. If the number of animals becomes too hard to handle, seek help for their health and safety.

Getting Ready for Your Visit

Steps You Can Take Before the Visit

Preparing for your first meeting with a mental health specialist about hoarding behaviors can help you feel more confident and organized. Simple steps before the appointment can make the session go more smoothly.

  • Make a List:
    • Symptoms you notice and how long they have lasted
    • Problems you have faced when trying to handle clutter
    • Important personal events or losses (like a divorce or death)
    • Any health conditions, both physical and mental
    • Medications, vitamins, or supplements you take and their doses
    • Questions you want to ask
  • Document Your Experience: Snap photos or record short videos of rooms or areas where clutter has built up. Bringing pictures can help the provider understand what daily life looks like. This is useful for people who may worry about letting others into their homes.
  • Bring Support: Bring along a close friend or family member. This person can give support, help you explain your struggles, and remember details from the discussion.
  • Prepare Your Questions: Here are some ideas for questions you can ask during your session, shown in the table below:
Suggested Question Purpose
Are my symptoms something to worry about? Understand seriousness
Do you believe I need some type of treatment? Know if care is needed
What treatments could help? Learn about treatment options
Will I get better? How long might it take? Set realistic expectations
How many sessions will I need? Plan for future appointments
Are there medicines that might help? Find out about medications

Add other questions that are important to you. Keeping notes or bringing a written list can make it easier to remember everything you need to discuss.

What Might Happen During the Appointment

When you meet with the mental health provider, they will ask about your thoughts, habits, and daily challenges to understand how hoarding affects your life.

Topics the Provider May Cover:

  • Types of items you find hard to get rid of or feel you must save
  • Whether you find it difficult to make decisions about your belongings
  • Feelings or worries you experience when faced with discarding things
  • If clutter prevents you from using your living spaces for their normal purpose
  • If you avoid having guests because of too much clutter
  • How you care for any pets and whether clutter gets in the way
  • Any previous attempts you made to clean up and whether they worked

The provider will also ask about any other health or mental health concerns you have. They may ask if friends or family have shared concerns about your situation.

What to Expect:

  • Open Conversation: Providers ask gentle questions to learn about your habits and feelings.
  • No Surprise Visits or Forced Clean-Outs: Providers aim to offer help, not to judge or take away belongings.
  • Private and Respectful Care: Providers keep all information private and take your concerns seriously.
  • Information About Next Steps: The provider will likely discuss possible treatments and what results you might expect.

The provider may also discuss options for therapy, support groups, and whether medications could be useful in your situation.


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Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.