People with Hoarding Disorder have a conscious, ongoing urge to accumulate possessions, as well as corresponding feelings of anxiety or mental anguish whenever those possessions get thrown away. While some people affected by the disorder accumulate valuable items, most affected individuals accumulate things with limited or no real-world value, such as books, old magazines or newspapers, self-made notes, outdated clothing, or old mail. The result is an accumulation of possessions that congest and clutter active living or work areas and substantially compromise their intended use.


Hoarding disorder affects emotions, thoughts and behavior. Signs and symptoms may include:

  • Persistent inability to part with any possession, regardless of its value
  • Excessive attachment to possessions, including discomfort letting others touch or borrow them or distress at the idea of letting an item go
  • Cluttered living spaces, making areas of the home unusable for the intended purpose, such as not being able to cook in the kitchen or use the bathroom to bathe
  • Keeping stacks of newspapers, magazines or junk mail
  • Letting food or trash build up to unusually excessive, unsanitary levels
  • Acquiring unneeded or seemingly useless items, such as trash or napkins from a restaurant
  • Difficulty managing daily activities because of procrastination and trouble making decisions
  • Moving items from one pile to another, without discarding anything
  • Difficulty organizing items, sometimes losing important items in the clutter
  • Shame or embarrassment
  • Limited or no social interactions

People with hoarding disorder typically save items because:

  • They believe these items will be needed or have value in the future
  • The items have important emotional significance — serving as a reminder of happier times or representing beloved people or pets
  • They feel safer when surrounded by the things they save


What causes hoarding is not known. However there are some risk factors that have been identified such as:

  • Having a family member who is also a hoarder
  • Genetic research has begun to identify gene variants that may indicate a risk for hoarding
  • Sometimes a brain injury can cause hoarding symptoms
  • People who hoard often experience other psychological disorders like depression, anxiety, ADHD, or alcohol abuse
  • A stressful life event, such as the death of a loved one, can trigger hoarding

Symptoms of hoarding usually appear during the teen years, although there have been instances of children demonstrating symptoms as young as 3 years old. Hoarding is seen as chronic, becoming more severe over the years and causing more dysfunction


Treatment for hoarding disorder can be challenging because often the individual does not see the behavior as having a negative impact on their life and don’t believe they need treatment. This is especially true when the possessions or animals offer comfort and, if taken away, will just find more to meet their emotional needs.

Early recognition, diagnosis and treatment are crucial to improving outcomes. There are two types of treatment that is useful in treating hoarding disorder: therapy (cognitive-behavioral therapy or CBT) and medication. The therapy helps the individual learn how to discard unnecessary items with less distress and improve their decision-making and organizational skills. Some people find that anti-depressant medication is helpful and may produce more rapid improvement.