Understanding Hoarding: More Than Just Clutter
When most people think about hoarding, they picture homes filled with piles of belongings stacked from floor to ceiling. Television shows and sensational headlines have reinforced this image. But hoarding is far more complex than simply having too much “stuff.” It is a serious mental health condition that affects millions of people and can significantly impact individuals, families, and communities.
What Is Hoarding Disorder?
Hoarding disorder is characterized by persistent difficulty discarding possessions, regardless of their actual value. Individuals often experience intense distress at the thought of getting rid of items, leading to the accumulation of belongings that clutter living spaces and interfere with daily life.
These items can range from newspapers and clothing to mail, boxes, or even things others might consider trash. For the person struggling, however, these objects often hold strong emotional, practical, or symbolic meaning.
As Jeffrey Borenstein, M.D., President and CEO of the Brain & Behavior Research Foundation, explains, “Hoarding is not simply about clutter or collecting things—it reflects underlying mental health challenges that deserve understanding and care. Reducing stigma is an important step in helping people seek the support they need.”
The Impact on Health and Safety
Hoarding can have serious consequences beyond clutter.
In severe cases, accumulated items may block exits, create fire hazards, attract pests, and make homes unsafe or unsanitary. Everyday activities—such as cooking, bathing, or sleeping in a bed—can become difficult or even impossible.
The emotional impact can be just as significant. People living with hoarding disorder often experience shame, isolation, and strained relationships with family members or neighbors. Fear of judgment may prevent individuals from seeking help, allowing the condition to worsen.
Why Hoarding Happens
Hoarding behavior can stem from a range of psychological factors. Many individuals develop strong emotional attachments to objects, viewing them as tied to memories, identity, or security.
Others may struggle with decision-making, perfectionism, or fears of waste. In some cases, hoarding behaviors emerge after major life events such as the loss of a loved one, financial hardship, or trauma. Hoarding disorder also commonly occurs alongside conditions such as depression, anxiety, obsessive-compulsive disorder, and attention-deficit/hyperactivity disorder.
Treatment and Support
The good news is that help is available.
Treatment often includes cognitive behavioral therapy (CBT) tailored specifically for hoarding disorder. This approach helps individuals build skills for organizing, decision-making, and gradually reducing clutter while addressing the emotional attachment to possessions.
Medication may also be helpful, particularly when hoarding occurs alongside other mental health conditions.
Equally important is compassion. Forcing someone to discard belongings can increase distress and resistance. Effective support involves patience, trust, and professional guidance.
Moving the Conversation Forward
Hoarding disorder remains widely misunderstood, and stigma can make it harder for people to seek help. Increasing awareness and approaching the issue with empathy can help individuals feel more comfortable accessing care.
Hoarding is not about laziness or lack of willpower—it is a complex but treatable condition.
“Hoarding disorder is a treatable condition, and with the right support, individuals can make meaningful changes that improve their daily lives,” said Dr. Borenstein. “Increasing awareness and access to care can help more people take that first step toward recovery.”
To learn more about hoarding disorder and other mental health topics, tune in to Healthy Minds with Dr. Jeffrey Borenstein, available nationally on public television stations (check local listings) and streaming on PBS.org. A list of local airtimes can be found at https://www.bbrfoundation.org/healthy-minds-tv.
