Mind Matters - February 2006
Written by Ron Sterling, M.D. and Published in Northwest Prime Time Magazine

This Full House
by Ron Sterling, M.D. -- February 2006


    Dear Dr. Ron:

      I saw you on television recently when KIRO in Seattle did a report on a Shelton-area 62 year-old woman who died from suffocation after she fell into collected clothing in her home. I would really like more information on hoarding disorders. Is it true that hoarding disorders are more common in older adults? -- Signed: Wondering About Hoarding.

    Dear Wondering:

      Thank you for writing! I welcome the opportunity to write more about abnormal hoarding. Not only was the KIRO report very brief, but it also gave the impression that abnormal hoarding is primarily related to obsessive compulsive disorder. It is not.

      Although the Shelton case is an obvious example of abnormal hoarding, the question for most of us is "When does collecting things cross the line and become a hoarding disorder?" The other question most often asked is "Is abnormal hoarding a disorganization problem or a collecting problem?" The main question for mental health professionals is "Is abnormal hoarding primarily a learned behavior or is it a more biologically-based disorder?"

      The Webster's dictionary definition of hoarding -- "to store up beyond one's needs" -- does not describe abnormal hoarding. There is no official medical "hoarding disorder" diagnosis since the behavior is almost always a part of a more pervasive problem. Abnormal hoarding is defined as "the accumulation of so many possessions that the storage of the items significantly affects the health and welfare of the resident(s) living in the same space as the stored items." To me, this definition begs the issue. Wealthy hoarders, for instance, may be able to purchase storage space that excludes the stored items from becoming a safety or welfare concern. Does that mean they are not experiencing a hoarding disorder?

      In a very real sense, we each have to decide when our hoarding or someone else's hoarding is crossing the line into causing significant problems. For wealthier individuals, there may be no need to worry, but for the rest of us, hoarding can lead to safety hazards or financial problems. Wealthier individuals can get in trouble in other ways with a hoarding disorder that compels them to shoplift, burglarize, or scout through garbage in dumpsters to collect items.

      Although many of the news reports of dramatic cases of abnormal hoarding have involved older adults, not enough good data has been collected to know whether abnormal hoarding is more common among older adults. However, older adults who have hoarded for years and become more frail or disorganized as they age may be more subject to safety hazards than younger hoarders.

      Hoarding behavior can be part of obsessive compulsive disorder, post-traumatic stress disorder, attention deficit hyperactivity disorder, major depressive disorder, schizotypal, schizoid or obsessive compulsive personality disorder, psychosis or dementia. How a professional attempts to assist a person who is abnormally hoarding depends a lot on whether one of these disorders is part of what is taking place in the person's life. It is difficult to help someone with their hoarding behavior until you have addressed the underlying disorder of which it may be a part.

      If you are aware of someone who is involved in abnormal hoarding, try to make non-confrontational contact with them in some way. If they are a friend or relative, provide support, and ask if you can help to clean up or organize. If the hoarding behavior appears to be a safety hazard or it is a neighborhood nuisance, you may need to call the your local Department of Health. Clutterers Anonymous is a good resource for support and recovery from abnormal hoarding.

      I hope that is helpful. Since this is such a complex subject, I recommend visiting some of the links listed below for more information about abnormal hoarding. -- Best wishes, Dr. Ron.

      Links to More Information About Hoarding

        Thank You for Stopping By!

      Have a great day!


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RON STERLING, M.D.
General Psychiatry with Specialization in Adult Attention Deficit Disorder
SeniorMentalHealth.org
Phone: 206-784-7842
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