Hoarding disorder is characterized by an ongoing difficulty in parting with possessions due to the belief that they need to be saved. People with hoarding disorder experience distress at the thought of getting rid of items and gradually accumulate a vast number of possessions, regardless of their actual value.

Hoarding often results in extremely cluttered living conditions, with narrow pathways winding through stacks of belongings. Surfaces like countertops, sinks, and desks are piled with stuff, and the clutter may spread to other areas such as the garage, vehicles, yard, and storage spaces.

Hoarding can range from mild to severe, with varying degrees of impact on daily functioning. While some individuals may not perceive hoarding as a problem, intensive treatment can help them understand and change their beliefs and behaviors, leading to a safer and more enjoyable life.


The first symptoms of hoarding disorder typically appear during the teenage to early adult years. Individuals may acquire and save excessive items, gradually building up clutter in living spaces, and find it difficult to discard things.

As hoarding behaviors persist into middle age, the clutter becomes overwhelming, impacting daily functioning. Hoarding tendencies tend to be private behaviors, and major clutter may develop before others notice.

Symptoms of hoarding disorder include:

  • Getting and keeping too many items, regardless of immediate need and available space
  • Difficulty throwing out or parting with possessions, leading to distress
  • Building up clutter to the point of unusable rooms
  • Trying to be perfect and avoiding decisions
  • Problems with planning and organizing

When to See a Doctor

If you or a loved one exhibits symptoms of hoarding disorder, seeking help from a healthcare or mental health provider experienced in diagnosing and treating this disorder is essential. Some communities have agencies that can assist with hoarding problems, so it’s worth checking with local or county government for resources in your area.

If hoarding disorder poses a threat to health or safety, contacting local authorities, such as police, fire, public health, or protective services, may be necessary.


The exact cause of hoarding disorder is unclear, but factors like genetics, brain function, and stressful life events are being studied as potential contributors.

Risk Factors

Hoarding usually starts in the late teens or early adulthood and tends to worsen with age. Older adults are more commonly affected than younger adults. Risk factors include personality traits that involve difficulty making decisions, attention, organization, and problem-solving issues. Having a family member with hoarding disorder also increases the likelihood of developing the disorder. Additionally, stressful life events, such as the loss of a loved one or possessions in a fire, can trigger hoarding behaviors.


Hoarding disorder can lead to several complications, including an increased risk of falls and injuries due to clutter, family conflicts, loneliness, unsanitary living conditions, fire hazards, poor work performance, legal issues, and associations with other mental health disorders like depression, anxiety disorders, OCD, and ADHD.


As the specific cause of hoarding disorder is not known, there is no known way to prevent it. However, early treatment at the first sign of hoarding behaviors may help prevent the condition from worsening.

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People with hoarding disorder often seek treatment for other issues like depression, anxiety, or relationship problems rather than directly addressing the hoarding behavior. To diagnose hoarding disorder, it’s best to see a mental health provider experienced in this area.

The mental health exam will include questions about emotional well-being, beliefs and behaviors related to hoarding, and the impact of clutter on one’s quality of life. Relatives and friends may be involved, and pictures or videos of living spaces affected by clutter can be helpful in the assessment.

Diagnosis may involve ruling out symptoms of other mental health conditions as well.


Hoarding disorder treatment can be challenging but effective when individuals work on learning new skills. Some may not recognize the negative impact of hoarding or believe they need treatment, especially if possessions or animals provide comfort.

Cognitive behavioral therapy (CBT) is the main treatment for hoarding disorder. It involves:

  • Identifying and challenging thoughts and beliefs related to hoarding
  • Resisting the urge to acquire more items
  • Organizing and grouping belongings to decide what to get rid of, including donations
  • Improving decision-making and coping skills
  • In-home visits by a therapist or professional organizer to remove clutter
  • Reducing isolation and increasing participation in meaningful social activities
  • Attending family or group therapy
  • Occasional visits or ongoing treatment to maintain healthy habits

Family involvement and professional guidance for parents of children with hoarding disorder are also important.

Medications, particularly selective serotonin reuptake inhibitors (SSRIs), may be prescribed for anxiety or depression that accompanies hoarding disorder.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy is the main treatment for hoarding disorder. Seek a therapist or mental health provider experienced in treating hoarding disorder.

CBT includes:

  • Challenging thoughts and beliefs related to hoarding
  • Resisting the urge to acquire more items
  • Organizing belongings and deciding what to get rid of, including donations
  • Improving decision-making and coping skills
  • In-home visits to remove clutter
  • Reducing isolation and increasing social activities
  • Family or group therapy
  • Ongoing treatment to maintain progress


Cognitive behavioral therapy is the primary treatment for hoarding disorder, and there are no FDA-approved medications for this condition. However, medications like SSRIs may be used to treat accompanying anxiety or depression.

Research on the most effective use of medicines in hoarding disorder treatment continues.

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