What do I need to know about hoarding disorder?

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This is the persistent difficulty in parting with possessions regardless of their actual value.

How would I know I have a hoarding disorder?
The following are symptoms of hoarding disorder;

  • Difficulty in discarding possessions; the main reasons for this difficulty are the perceived or delusional value of such possessions accompanied by the strong attachment to such items. Feeling responsible for the fate of possessions and going to great lengths to avoid being wasteful or losing important information. These possessions can be magazines, newspapers. Old clothing bag, books mail, and paperwork but virtually any item can be saved. Do these people come back for these items with the sole purpose of searching for information? Probably not but there is always that nagging “you never know” voice. 
  • Do you have those old school papers you can’t get rid of, why are you still keeping them?
Not all of these things are considered useless by other people some are very valuable but can be found mixed in piles with less valuable items.

  • Accumulation of a large number of items; may tend to fill up the place to the point of inconvenience. An individual may not be able to cook in the kitchen sleep in his or her bed or sit on the chair because or of these places are occupied by items due to cluttering. Clutter is defined as a large group of usually unrelated or marginally related objects piled together in a disorganized fashion for other purposes tabletops, floor hallway. If an individual with hoarding disorder is found without clutter is due to the intervening of a third party e.g. family member, the spouse who forces them to clear it and put it in appropriate places e.g. basement or a store.
  •  Animal hoarding; accumulation of large numbers of animals while failure to provide minimal standards of nutrition, sanitation, and veterinary care. the animals live in very deteriorating conditions while suffering from diseases starvation and poor living conditions. Animal hoarding maybe be a special manifestation of hoarding disorder
Other symptoms include indecisiveness, perfectionism, procrastination, difficulty in planning and organizing tasks, distractibility, and living in unsanitary conditions due to cluttering due to poor planning and organizing.

The major difference between animal hoarding and object hoarding is the extent of unsanitary conditions and the poorer insight into animal hoarding.

 Who is mostly affected by hoarding disorder? 

Symptoms of hoarding disorder first emerge as early as 11-15 years and start interfering with individual everyday activities around the mid-20s.

Pathological; hoarding in children can be easily distinguished from saving and collecting behaviors. However, this is hard in making a diagnosis because children do not control their living environments and discarding behaviors in the presence of parents and guardians.

Factors causing hoarding disorder

Genetic and physiological causes:
Hoarding behaviors is familial, about 50% of individual with hoards have reported having a family relative with hoarding disorder.

Environmental reasons; individuals with hoarding disorder have been through stressful and traumatic life events before the beginning of the disorder.

Temperamental reasons; indecisiveness is a prominent feature of individuals with hoarding disorder.

Other diagnoses with similar symptoms; 

Neurodevelopmental disorder hoarding disorder is not diagnosed if the symptoms are of a direct consequence of a neurodevelopmental disorder such as autism spectrum disorder or  intellectual disability 

Major depressive episode; if the accumulation of objects is due to the result of psychomotor retardation, fatigue, or loss of energy due to major depressive episode then hoarding disorder cannot be diagnosed.

Schizophrenia spectrum and other psychotic disorder hoarding disorder is not judged if the acquisition of objects in large quantities is due to delusions or negative symptoms of schizophrenia spectrum and other psychotic disorders.

Obsessive-compulsive disorder in OCD; the accumulation of objects is due to avoidance of onerous rituals (not getting rid of objects so as to avoid endless washing or checking rituals; however  OCD the behavior is distressing and the individual experiences no pleasure from it, unlike the hoarding disorder who feels a sense of accomplishment.

For OCD the excessive desire to acquire certain items is due to a certain obsession (the need to buy items that have been accidentally touched to avoid contaminating other people and not the genuine need to possess the items.

Imagine having both; when a person who hoards in the context of OCD while possessing bizarre items such as feces, urine, trash, nails, hair, used diapers, and rotten food though the accumulation of such items is very unusual for hoarding disorder alone. Although when hoarding disorder symptoms are diagnosed independently from  OCD both can be diagnosed.

Neurocognitive disorder; if the accumulation is judged based on the consequence of degenerative disorder such as neurocognitive disorder. The accumulation may be accompanied by self-neglect and severe domestic squalor along with other neuropsychiatric symptoms such as gambling and self-injurious behavior.

Effects of hoarding disorder

  • Clutter makes it difficult for basic activities such as e.g. cooking, cleaning personal hygiene, and even sleeping .when appliances are broken or utilities such as access to water broken repairing may prove difficult.
  • Risk of accidents  such as fire and falling especially for the elderly, poor sanitation  and other health risks which physical health
  • Social conflicts family relationships are frequently under strain. Conflicts with neighbors and local authorities  and some of the individuals are involved in the legal eviction 
  • Bankruptcy when they become shopaholics while everything ends up as clutter inside the house and due to difficulty in discarding possessions they can’t sell them.

Dsm v- American psychiatric association 

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