Understanding Hoarding Disorder: Signs, Causes and Support

Spring cleaning is a time-honored tradition. As the weather warms up, many people feel motivated to declutter their homes, donate unused items and refresh their living spaces. But for some, the idea of cleaning and discarding items can feel overwhelming—almost impossible. If you have a loved one who fills their home with an excessive number of possessions, you may wonder if they are simply a collector or if they have a hoarding disorder.

Hoarding disorder is a mental health condition that can have a serious impact on a person’s daily life, relationships and well-being. Understanding the difference between collecting and hoarding, recognizing the signs and knowing how to offer help can make a meaningful difference in their quality of life.

What is hoarding disorder?

Hoarding disorder is recognized by the American Psychiatric Association as a distinct mental health condition. It was officially classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013.

Unlike collecting, which involves acquiring and organizing specific types of items, hoarding behaviors are characterized by:

An extreme difficulty discarding items, regardless of their actual value.
A strong emotional attachment to possessions, even if they are broken or unusable.
A belief that items might be needed in the future, leading to excessive saving.
Severe distress or anxiety at the thought of getting rid of items.

Hoarding disorder often worsens over time and can have a significant impact on daily functioning. People with hoarding disorders may find their homes filled with clutter to the point where rooms become unusable. This can create health and safety risks for the individual and their family members.

How common is hoarding disorder?

Research suggests that hoarding disorder affects approximately 2% to 6% of the population in the United States. It typically starts during the teenage years and becomes more severe with age. Studies show that adults between 55 and 94 years old are nearly three times more likely to experience hoarding problems than younger adults.

Hoarding disorder can occur on its own, but it is often linked to other mental health conditions, such as:

What causes hoarding?

There is no single cause of hoarding disorder. However, researchers believe that biological, psychological and environmental factors all play a role. Some common risk factors include:

Genetics – Hoarding tendencies often run in families.
Trauma or loss – A major life event, such as the death of a loved one, divorce, or financial struggles, may trigger hoarding behaviors.
Brain function differences – Studies suggest that people with hoarding disorder may have difficulty making decisions and processing emotions.
Perfectionism and anxiety – Many people with hoarding disorder struggle with fear of making the wrong decision about what to keep or discard.

Signs of hoarding disorder

Recognizing the signs of hoarding disorder is the first step in helping a loved one. Some of the most common symptoms of hoarding include:

Difficulty discarding items

Feeling intense distress or anxiety when asked to get rid of things.
Believing that all items have value, even if they are damaged or no longer useful.
Fearing they might need the items later.

Excessive accumulation of possessions

Filling rooms, hallways, and even bathrooms with clutter.
Acquiring items that are free, low-cost or unnecessary in large quantities.
Repeatedly bringing in new objects without organizing or discarding old ones.

Unsafe living conditions

Clutter blocking exits or creating fire hazards.
Structural damage to the home, such as mold growth, pest infestations or leaks.
Loss of functional living space—being unable to use the kitchen, bathroom or bedroom due to clutter.

Social withdrawal and isolation

Avoiding visitors out of embarrassment or fear of judgment.
Struggling with work or daily responsibilities due to hoarding behaviors.
Experiencing strained relationships with family and friends.

Health and safety risks of hoarding

Hoarding disorder doesn’t just affect mental health—it can also pose serious physical risks. Some of the most common dangers include:

Fire hazards – Stacks of newspapers, clothing or flammable materials increase fire risks.
Falls and injuries – Cluttered walkways make it difficult to move safely around the home.
Mold and mildew – Excessive items can trap moisture, leading to dangerous mold growth.
Pest infestations – Rodents and insects thrive in cluttered spaces, increasing health risks.
Respiratory issues – Dust, mold and mildew can make it harder to breathe, especially for those with asthma or allergies.

How to help a loved one with hoarding disorder

Talking to a loved one about hoarding can be challenging. Many people with hoarding disorders do not see their behavior as a problem and may become defensive or distressed when confronted.

Here are some ways to approach the conversation:

Express concern with compassion

Instead of criticizing their behavior, try to understand their feelings. Say something like:

"I’ve noticed that your home has become cluttered, and I’m worried about your safety. Can we talk about this?"

Avoid forcing them to throw things away

Sudden cleanouts can be traumatic. Instead, offer supportive and gradual solutions, like sorting one small area at a time.

Encourage professional help

Hoarding disorder is a mental health condition that often requires treatment. Cognitive behavioral therapy (CBT) is one of the most effective treatments for hoarding disorder. It helps individuals:

Understand why they feel the need to collect items.
Develop healthier decision-making skills.
Reduce anxiety about discarding items.

In some cases, medication may also be prescribed to treat coexisting conditions, such as OCD or depression.

Seek additional support

If your loved one’s living situation is unsafe, you may need to involve social services, home organizers or mental health professionals. There are also support groups that provide resources for people struggling with hoarding problems and their families.

When to seek professional help

If hoarding disorder is affecting a loved one’s quality of life, professional treatment may be necessary. The American Psychiatric Association recommends therapy and structured support for individuals experiencing severe distress.

Encourage your loved one to speak with a mental health professional or reach out to organizations specializing in hoarding disorders. With the right help, they can regain control of their living space and improve their well-being.

Final thoughts

Hoarding disorder is more than just excessive clutter—it is a mental health condition that requires understanding and support. If you have a loved one who struggles with hoarding behaviors, approach the conversation with patience and empathy. By encouraging them to seek help, you can play an important role in their journey toward a healthier, safer life.

If you or someone you know is struggling with hoarding disorder, Banner Health offers expert behavioral health services to help. Contact us today to learn more about treatment options.

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Hoarding Disorder: Signs, Risks and How to Help a Loved One