It generally starts small—keeping items for sentimental reasons, letting clutter pile up, or avoiding cleaning out storage. But when saving things becomes overwhelming and begins to interfere with your ability to function in your home, it may be a sign of a hoarding disorder.

Many people wonder why they or someone they care about is holding on to things they no longer need, often at great emotional and physical cost. According to the International OCD Foundation, hoarding disorder affects approximately 2–6% of the U.S. population. While hoarding can be a symptom of obsessive-compulsive disorder (OCD), it is also recognized as a separate diagnosis. Given the overlapping symptoms, individuals experiencing hoarding disorder may benefit from targeted OCD treatment.

What causes hoarding disorder?

Hoarding disorder is more than disorganization or messiness. It’s a persistent difficulty parting with possessions, regardless of their value, and a tendency to accumulate so much that living areas become unusable. People with hoarding disorder may be unable to use certain areas of their home due to the amount of stored items in the space. They often experience deep emotional attachment to their belongings and anxiety at the thought of discarding them, which is why a simple suggestion of throwing items away is often met with resistance.

The onset of this condition is typically in adolescence or early adulthood and can worsen over time, especially without treatment. While the causes can vary, hoarding often leads to distress, impaired functioning, and safety concerns in the home.

Multiple factors contribute to hoarding

There isn’t a single cause of hoarding. Instead, it results from a combination of psychological, emotional, and neurological factors. Some of the most common contributors include:

• Trauma or grief: Losing a loved one or going through a divorce can sometimes make it difficult to let go of objects associated with the past or a person you remember fondly. This trauma can also be elicited by eviction from a prior home.
• Cognitive difficulties: Someone who struggles with decision-making, categorization, and memory can also experience hoarding tendencies. These characteristics are often seen in individuals with hoarding disorder.
• Co-occurring conditions: Hoarding can exist alongside mental health concerns like anxiety, depression, or OCD.
• Emotional regulation challenges: Belongings may provide comfort and security for someone who’s experienced long-term emotional distress.
• Family history: Hoarding behavior may be genetic or influenced by others in the immediate environment.

Regardless of how or why an individual’s hoarding disorder developed, help is available. Columbia Mental Health offers compassionate, accessible care. You deserve a life free of hindrances, and we’re here to help you make that happen.

The emotional and social impact of hoarding disorder

Hoarding disorder can have a profound emotional impact on your life. You may feel:

• Embarrassed or ashamed about the state of your home, leading to never extending an invitation to friends or family.
• Anxious about unexpected visitors.
• Guilty for accumulating too much, but overwhelmed by the idea of letting anything go.
• Depressed due to social isolation or the physical state of your environment.

These emotional experiences don’t have to be permanent. You can begin to live more freely, one step at a time, with professional treatment. Reach out today and find healing.

How hoarding disorder may affect loved ones

Family and friends of someone with a hoarding disorder can feel caught in a difficult position. They’re concerned for their loved one’s safety and well-being, but they may be unsure of how to offer the best support. Repeated efforts to organize may also leave them feeling frustrated. If you love someone with a hoarding disorder and have felt powerless or even resentful, here are nonjudgmental ways to offer your support:

• Approach with empathy, not judgment: Let your loved one know you care about them, not just their living space.
• Focus on safety and health: Express concern about tripping hazards, fire risks, or blocked exits rather than the mess itself.
• Encourage professional help: Offer to help find and connect with a therapist or mental health provider experienced in treating hoarding disorder.
• Celebrate small victories: Acknowledge and affirm even minor progress, like sorting through a box or clearing one surface.
• Be consistent: Offer steady emotional support without pressuring or giving ultimatums.
• Set boundaries around shared spaces: If you live with the person, try to maintain clutter-free zones in common areas like the kitchen or bathroom. You can advocate for your own comfort while still showing them that you care.

Compassionate support from professionals can help family members learn how to offer help without enabling harmful behaviors.

What not to do

Just as there are ways to support, there are also things you might do or say that your loved one would not receive well. Some of these include:

• Decluttering without consent: Don’t remove items without permission. This can damage trust and worsen your loved one’s anxiety.
• Shaming or criticizing: Comments like “How can you live like this?” will likely reinforce secrecy and resistance. Don’t judge.
• Expecting things to change quickly: Hoarding is rarely solved with one deep clean—it’s a long-term mental health concern that requires professional support for healing.
• Ignore your own needs: Supporting someone through an emotionally taxing scenario can deplete your emotional storehouse as well. Set boundaries and seek support for yourself, too.

Being a good friend or family member means being willing to act in ways that are truly helpful to your loved one. Try to be a consistent source of reassurance and gently encourage them toward professional care.

How is hoarding disorder treated?

It’s important to remember that hoarding disorder is treatable, and change is possible with the right tools and support. While progress often takes time, many individuals experience significant improvements in their ability to manage clutter, part with items, and reclaim their living spaces.

Treatment for hoarding disorder may include:

• Cognitive-behavioral therapy (CBT): This helps individuals identify unhelpful beliefs about their possessions and build skills to reduce hoarding behaviors
• Medication: When co-occurring disorders like depression or OCD are present, medication can be helpful
• Skills training: Focuses on improving organization, categorization, and decision-making
• Family involvement: Therapy that includes loved ones can strengthen support systems and improve treatment outcomes

Call today for support at Columbia Mental Health

At Columbia Mental Health, our therapists offer personalized care for individuals experiencing hoarding and related disorders. We understand the unique emotional challenges that come with this condition and meet each client with empathy and clinical excellence. Whether you’re seeking help for OCD or hoarding disorder, we’re here to guide you toward a healthier, more manageable future. Call us today at 703.682.8208.

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