This particular column isn’t for everyone. Then again, it might be. You may not immediately identify with the subject matter but hopefully, you might take away a helpful morsel of some sort, even if it’s only a broader understanding of the disorder known as hoarding. The affliction is real, is often shameful to those so affected, and can be difficult to treat.

With such programs as “Hoarders” and “Hoarding: Buried Alive,” reality television showcases what we assume are true, extreme cases that may lead us to believe that surely no one we know, no one we’re related to, and certainly not we ourselves are that bad. Those programs have sensationalized and trivialized hoarding. People are more complex than they’re represented, yet some hoarders have been helped into treatment by the shows.

You may be aware of someone who has this disorder, perhaps a family member or close friend. As it comes with a stigma and those afflicted generally rarely discuss it, someone you know may suffer from hoarding, but is secretive about it. You may be a hoarder yourself.

According to the Association for Behavioral and Cognitive Studies, it’s likely that hoarding problems are present in at least one in 50 people but may be as many as one in 20, or some two-and-a-half to three percent of the population. Though the propensity for hoarding may begin as early as the teen years, the average person seeking treatment for this disorder is about 50, and the prime age range for hoarding is 55 to 94.

“Hoarding is a chromosomal abnormality and not just someone being stubborn or lazy,” says Julie Pike, licensed psychologist and expert in treatment of anxiety disorders. “Eighty percent of people with hoarding disorder have a first-degree relative with it also. They have a difficult time staying focused and being linear. Especially with later-onset hoarding, people may have a trauma history or an addiction of some sort.”

Hoarding disorder is marked by three major characteristics:

  • Difficulty letting go of material possessions, many of which seem of little value to others.
  • Obsessive or compulsive acquisition of new items that keep the person from using their spaces as intended.
  • Disorganization and the inability to prevent clutter.

Hoarding differs from collecting in that people who collect usually display their collections proudly and keep them well organized, while those that hoard rarely seek to display their possessions, which are usually in disarray.

Most frequently, people hoard common possessions, such as paper (especially mail, newspapers), books, clothing, and containers, i.e. boxes and plastic bags. Some people hoard garbage or rotten food, or more rarely, animals. Enter, the “crazy cat lady.”

During my childhood years in Western Kentucky, our family had a neighbor who lived alone and was a hoarder. All the neighbors knew this because at night, her lights illuminated one room through filmy lace curtains, where scores of newspapers were stacked from floor to ceiling.

For years, hoarding was considered a type of OCD (obsessive compulsive disorder). Some experts estimate that as many as one in four people with OCD are also hoarders. However, in 2013 the American Psychiatric Association (APA) established hoarding as a separate disorder in the Diagnostic and Statistical Manual (DSM-V), the bible of the APA. It’s now labeled hoarding disorder.

Signs of this disorder can include:

  • Reams of clutter in the office, home, car, or storage unit that make it hard to use furniture or appliances or move around easily.
  • Difficulty getting rid of items, even those no longer useful.
  • Loss of important items, such as money or bills in the clutter.
  • Feeling overwhelmed by the volume of possessions that have “taken over” the space.
  • Being unable to cease taking free items, such as ad flyers or sugar packets from eateries.
  • Buying things because they are a “bargain” or to “stock up.”
  • Not inviting family or friends into the house due to embarrassment.
  • Refusing to let repairmen into the home to fix needed repairs.

People who hoard are often intelligent, well-educated, and creative, and they don’t want to be “fixed.” They may feel ashamed, anxious, and sad. Many are perfectionists that don’t want to make a mistake and get rid of the wrong thing. Their stuff is precious to them and makes them feel dug-in and safe, yet they feel shame from being asked frequently why they can’t just get rid of their “junk.” Even if their stuff is taken away, they’ll start acquiring stacks again. Hoarding can cause arguments, suffering, and rifts between hoarders and loved ones.

“There’s still a lot to learn about what treatments work, for whom, and why,” says psychologist David Tolin, PhD. “What we don’t know about hoarding disorder could fill a book.”

Some hoarders respond well to CBT (Cognitive Behavioral Therapy), ACT (Acceptance and Commitment Therapy), or exposure therapy (people facing what they fear under the guidance of a therapist), while others do not. Though it may help reduce the symptoms, medicine alone doesn’t appear to reduce hoarding behavior. The presence of conditions such as depression and anxiety that may make hoarding worse can be treated by medicines. An industry that has sprung up around hoarding includes psychotherapists, social workers, public health workers, professional organizers, fire marshals, biohazard cleanup companies, and haulers.

Should you be able to talk to, or perhaps help, a hoarder, look to these guidelines when a person seems willing to talk about the problem:

  • Be respectful. Accept the fact that the person has the right to make their own decisions at their own pace.
  • Be compassionate. Try to understand the importance to them of their things.
  • Discover ways to make their home safer, such as moving clutter from doorways and halls.
  • Team up with them. Never argue about whether to keep or throw away an item; instead, find out what might help the person become motivated to discard or organize.
  • Assist the person in seeing how hoarding interferes with the person’s goals or values. For instance, by de-cluttering their home, they may host gatherings that may lead to a richer social life.
  • To develop trust, always ask their permission before throwing anything away.

The journey may be frustrating at times. Dealing with someone who suffers from this disorder requires patience and understanding. Realize that the life you want for the hoarder might not work for him or her. If you try to force the issue, you may damage trust between you. Above all, love them for themselves.

Known for her life wisdom, Indian author Ritu Ghatourey states it well: “Our days are happier when we give people a piece of our heart rather than a piece of our mind.”