While the stockpiling of stuff is often pinned on America’s culture of mass consumption, hoarding is nothing new. But it’s only in recent years that the subject has received the attention of researchers, social workers, psychologists, fire marshals and public-health officials.
They call it an emerging issue that is certain to grow with an aging population. That’s because, while the first signs often arise in adolescence, they typically worsen with age, usually after a divorce, the death of a spouse or another crisis.
Hoarding is different from merely living amid clutter, experts note. It’s possible to have a messy house and be a pack rat without qualifying for a diagnosis of hoarding behavior. The difference is one of degree. Hoarding disorder is present when the behavior causes distress to the individual or interferes with emotional, physical, social, financial or legal well-being.“If you aren’t able to use the stove and your refrigerator is stockpiled with expired items, if you’re so disorganized you aren’t able to file for Medicare or make a primary-care appointment, [hoarding] becomes a major problem,” says Catherine Ayers, a geriatric psychologist at the University of California at San Diego who has developed a cognitive behavior therapy for older people with the disorder.
Studies show that compulsive hoarding affects up to 6 percent of the population, or 19 million Americans, and it has been found to run in families. The rate is twice that of obsessive-compulsive disorder, the condition under which hoarding was listed until 2013 in the Diagnostic and Statistical Manual of Mental Disorders, the bible of the American Psychiatric Association. The DSM’s latest version now categorizes it as a separate mental illness.
Brain-imaging studies of hoarders have revealed abnormally low activity in the anterior cingulate cortex, which governs thinking and emotion. When these people are shown trigger images — such as pictures of objects being shredded and discarded — that area of their brain lights up and turns hyperactive.