Nature of Disorder

A person with hoarding disorder feels a strong need to acquire objects and they are unable or unwilling to part with them without experiencing great distress.

The main diagnostic characteristics are extreme difficulty parting with possessions regardless of actual value and a cluttered living space due to abundance of possessions leading to severe distress or impairment.

How do you differentiate between hoarding and collecting? One thing to consider is the quantity of the items. Collectors usually feel pride and joy acquiring, organizing and curating their collectables. Hoarders feel shame and a lack of control over their acquisitions. They do not want others to see their clutter and may make excuses to keep people from coming into their home or room. Some may go into debt due to inability to control spending.

Hoarding is classified as an obsessive-compulsive disorder; approximately 1 in 4 people suffering with OCD are compulsive hoarders. However, studies have shown that hoarders have unique patterns of brain activity, distinct from people with typical OCD in areas related to risk assessment and emotional decisions. Those with hoarding disorder report greater anxiety and indecisiveness during decision-making than those with OCD.

A person can have a genetic predisposition for hoarding disorder or may experience a traumatic event that propels them into hoarding behavior to cope. Hoarding tendencies usually begin in the teenage years and begin with saving outdated papers, old outgrown clothes, broken toys, or other items that are not needed or have limited functional value.

Hoarders may feel they risk making the wrong decision and therefore avoid decision-making altogether. They fear discarding something that may be valuable believing it’s “a great bargain” or thinking they will find some future use for it. They may believe it has sentimental value and is irreplaceable, fearing that without the items they will forget the memories associated with them. Commonly-hoarded items include reading materials like magazines, newspapers, bags, boxes, photos, supplies for the home, clothing, and food.


Hoarding among children tends to be more contained than adults due to lack of resources (money) to purchase items and developmental age (i.e. parental oversight of their belongings and whereabouts).

Oftentimes children are not able to accumulate large amounts of clutter as parents will limit the items that are saved or brought into the home. Hoarding may go unnoticed or excused as normal disorganized child behavior. In children, the most notable sign of hoarding is the emotional reaction to their possessions. They may show extreme worry about their belongings to a degree that it interferes with their daily functioning. Parents may try to throw items away (while the child is asleep or out of the house) or despite the child’s objection, often resulting in family conflict.

Due to the limitations in acquiring items, children generally hoard items that are free (e.g. notes from friends, school papers, ticket stubs), items that they already own (e.g. broken toys, trinkets, outgrown clothes) or items that are easily found (e.g. sticks, rocks, trash).


Hoarders often struggle with:

  • Severe indecisiveness and anxiety when attempting to throw away items
  • Social isolation – the more hoarders accumulate, the more separate they feel from others.
  • Difficulty and indecision on how to organize possessions.
  • Wary of others touching their belongings.
  • Fear of running out of something or not having an item when they need it.
  • Cluttered physical environment, as items take over home space.
  • Financial difficulties over time.
  • Conflict with others who live in the home over clutter.


Cognitive behavioral therapy (CBT) has been proven to be helpful in treating hoarding disorder.

For younger children, a behavioral plan may be developed to create new habits, keep the child from acquiring new items, and learn decision-making and distress management skills to use when discarding objects.


Anxiety and Depression Association of America (ADAA);

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