A new understanding of hoarding disorder

| June 12, 2019

In August 2018, compulsive hoarding (more commonly known as hoarding disorder) was officially classified as a medical disorder by the World Health Organization, in a move hailed by both psychiatrists and hoarders themselves as “extremely significant.”

Recent studies estimate 6 percent of Americans – which is about 19 million people – have some form of hoarding disorder. Similar population percentages can be seen across European countries, with the UK topping the list at 5 percent. Even in Australia’s population of 24.6 million people, 1.2 million meet the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) criteria for hoarding disorder.

What characterizes does the World Health Organization (WHO) say about compulsive hoarding? Compulsive hoarding is characterized by “an accumulation of possessions due to excessive acquisition of or difficulty discarding possessions, regardless of their actual value.” Related symptoms range from Diogenes syndrome to mild misanthropy, and even resentment toward attempts at intervention from family members or loved ones.

Hoarding disorder was originally thought to be related to obsessive compulsive personality disorder (OCPD), but that categorization was ultimately reevaluated and revised in 2014. Hoarding is now considered by the Anxiety And Depression Association of America (AADA) to be one of several offshoot conditions resulting from anxiety disorders. In this post, we explore this connection and its effect on the millions of people suffering from compulsive hoarding around the world.

The Anxiety Connection

There is plenty of speculation as to why so many more people are suffering from hoarding disorder compared to previous generations. However, the recent AADA categorization linking hoarding to anxiety disorders could shed some light on this phenomenon.

Studies show that America is more stressed than ever before, with similar studies showing similar sentiments in Europe and Australia. This can likely be attributed to a variety of factors, not the least of which are climate change, declining birthrates and an overall higher cost of living. Public awareness of these trends are common across all three continents, which certainly isn’t the case in more industrialized and overpopulated areas of the world governed by leaders of developing countries.

It’s a logical position that populations particularly aware of issues such as climate change are also especially stressed in their daily lives. The resulting surge in anxiety disorders – particularly among younger generations – would naturally be accompanied by an increase in individuals suffering from some form of hoarding disorder.

What’s Changed?

While the WHO classification of compulsive hoarding as a medical disorder is certainly welcomed by psychiatrists and hoarders, actual life improvement is still difficult for those suffering from it. A recent Guardian article makes this point very well. Although it’s expected that the WHO classification will improve public understanding, the struggles involved in the disorder are largely personal in nature.

For hoarders, public empathy is nowhere near as large an issue as the chronic anxiety or past traumas that originated the disorder to begin with. Their self-awareness is also problematic, as they become hesitant to entertain guests, form relationships or even invite family into their homes.

Additionally, their natural apprehension at the prospect of relocating or leaving the house for extended periods of time understandably impacts the social and occupational opportunities available to them.

Future changes?

Over time, the recognition of compulsive hoarding as a medical disorder will improve the overall quality of life for hoarders, at least in terms of negative stereotypes and prejudices. An obvious next step is to provide resources – not just to help hoarders deal with their respective root causes, but for non-hoarders as well – in order to create a more cohesive and inclusive society for both parties.