Hoarding and its 5 Levels

All of us have one or more things in our life that we can’t let go of. And sometimes, when life pushes you to do so, you’re left with no choice. So you let go. Because things might not stay forever, but the memories do.

But there are these people who never want to give up their things or collection. It doesn’t matter if they’re valuable or not; they don’t want to give up their things. And sometimes, even if those things are no longer in use.

Is this some disease? Yes, it is.

This is called hoarding disorder.

So what is this hoarding disorder? As defined by APA, Hoarding disorder is the persistent difficulty to get rid of possessions due to the perception of a need to save them. People with hoarding disorder might feel distressed even upon attempting to part with their possessions.

This disorder might seem common, but it surely does affect one’s mental health. Many people would deem this behaviour to be normal. But if not taken certain preventive measures, the person with hoarding may act in a way that will disrupt their normal functioning.

Hoarding Disorder

Some might think that hoarding is a scientific name for collecting. But no, collecting and hoarding are not the same. Collecting happens systematically with an intention. Hoarding doesn’t involve a plan, and all their possessions are arranged in a disorganized way without a theme or objective.

The houses of these people are filled with stacks of messed-up clutter. They don’t hesitate to place the extra mess outside the house as in the garage. But the very thought of throwing them out distresses them.

As evident, they have problems with planning and organizing. This results in untidiness. Hoarding may also develop the idea that all those possessions are unique and thus have to be saved.

A few even think of hoarding as an obsessive-compulsive disorder. But the obsessive-compulsive disorder is more about recurring thoughts and behaviour that are meaningless. On the other hand, hoarding is all about compulsions to keep their stuff.

Animal hoarding and object hoarding are two types of hoarding that are widely known. Animal hoarding is when a person gets more pets than they can take care of. This might result in an unpleasant environment for all those pets.

Object hoarding is what we discussed earlier. They clutter their stuff as if they hold some meaning.

Levels of Hoarding

The national study group on compulsive disorganization has developed a scale to assess the hoarding level. Thus making it easy for a professional and family to understand the exact situation and relative treatment for the hoarder.

Let us look at what the national study group on compulsive disorganization developed to help us understand the levels of hoarding.

Essentially, there are 5 stages or levels of hoarding

1st Level of Hoarding

Hoarding might sometimes be confused with a messy house. That is one of the main reasons not to assess if a person is suffering from hoarding disorder.

The first level is the least severe and the most difficult one to identify. There is not much clutter one can observe in the house of a level 1 hoarder. The house might be accessible, but hoarders find it difficult to throw away and buy unnecessary items.

The common level 1 situation is that

  1. doors and stairs in the house are accessible
  2. less amount of clutter
  3. no noticeable odour

Even though there isn’t much sign that can identify a level 1 hoarder, the compulsive behaviour to collect things can still be observed.

2nd Level of Hoarding

This level holds a few characteristics that can help in identifying a hoarder. The odours are fairly low. The symptoms include

  1. overflowing garbage can
  2. expired food and used plates
  3. animal waste on the floor
  4. malfunctioning ventilation system
  5. household rodents
  6. clutter in the walkways
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Photo by Dim Hou on Unsplash

A few people at this level might also deny family members entering their house due to stress and anxiety1. The risk is relatively higher than of 1st level hoarding.

3rd Level of Hoarding

The symptoms of 2nd level hoarding will continue. And the odours become noticeable at this level. They maintain very poor personal hygiene. When asked about their lifestyle, they feel emotionally distressed. A few symptoms of 3rd level hoarding include

  1. at least one unusable bathroom or bedroom
  2. cluttered stuff or items outside of the house
  3. broken appliances for at least 6 months
  4. visible rodent and spider web infestation
  5. dirty clothing and soiled floor
  6. odour throughout the house

More a number of pets without space, if any.

4th Level of Hoarding

The symptoms become more severe in this stage. Hoarders at this stage maintain very poor hygiene. Their mental health also starts being affected. The symptoms one can observe in level 4 hoarding include

  1. more than one blocked exit
  2. bed bugs and insect manifestations
  3. rotten or spoiled food
  4. ageing animal waste, if any
  5. unusable rooms
  6. sewage issues
  7. blocked ways
  8. intense odours

Hoarders at this level are at a very high level of risk. Both mental health 2and physical health are affected. They might even stay for weeks without bathing.

5th Level of Hoarding

The worst hoarding conditions can be observed in level 5. Extreme unhygienic situations can be seen. The characteristics of a level 5 hoarder include

  1. structural damage in the home
  2. broken walls
  3. no electricity
  4. clutter everywhere
  5. the entire home is inaccessible
  6. noticeable human faeces
  7. rotting food, even in a non-working refrigerator
  8. pets may be left in degrading conditions

Hoarders might feel uncomfortable living in their homes. While these symptoms may differ from person to person, visiting a professional before hoarding becomes too severe is recommended.

Hoarding and Mental Health

Hoarding disorder might disrupt normal functioning in many ways. Many factors can cause hoarding disorder. They include

  1. having a relative with a hoarding disorder
  2. traumatic life event
  3. compulsive shopping
  4. mental disorders like OCD or depression.

Very few acknowledge that they have a problem with accumulating items.

To treat this disorder, professionals make use of two methods of treatment. They are medication and CBT.

Cognitive-behavioural therapy, or CBT in short, is the most common treatment method used for hoarding disorder. Professionals make the hoarder understand their behaviour and help them in making decisions. They also teach organizing so that they can manage their stuff or possessions.

Medications such as venlafaxine and paroxetine, along with antidepressants, are given by professionals. These medications are given along with CBT 3for their effectiveness in improving behaviour. Treatment helps humans with hoarding to manage their possessions and feel less anxiety. After treatment, hoarders might feel less need to save their stuff.

Few facts about the Hoarding Disorder

Research states that 1 in 50 people are affected with hoarding disorder. And according to NAMI, up to 5% of the world’s population would display symptoms of clinically diagnosable hoarding. There are a few signs of individuals with hoarding disorder, such as

  1. living alone
  2. obese person
  3. perfectionistic
  4. at least one relative with a hoarding disorder

Hoarding is not about saving items. It is more about the fear of throwing the stuff.

Key Takeaways

Hoarding might sometimes be accompanied by other mental disorders like depression, impulse control, and social anxiety. The onset of hoarding behaviour is mostly seen in teenagers. But it cannot be observed until the behaviour becomes severe.

Read more from us here.

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1. Is hoarding any good?

Ans. Hoarding will only take up your space, both in your house and also in your mind. Hoarding can also cause anger issues, depression and conflicts among family members. Thus hoarding is in no way good.

2. How would you define a hoarding disorder?

Ans. Hoarding disorder is a mental condition which makes a person save a large number of items whether it is of monetary value or not.

3. Is hoarding an OCD?

Ans. Hoarding is a type of OCD. Reports have found that 1 in 4 people have this hoarding OCD.

  1. Nochaiwong, Surapon, et al. “Global prevalence of mental health issues among the general population during the coronavirus disease-2019 pandemic: a systematic review and meta-analysis.” Scientific reports 11.1 (2021): 10173. ↩︎
  2. Moreno, Carmen, et al. “How mental health care should change as a consequence of the COVID-19 pandemic.” The lancet psychiatry 7.9 (2020): 813-824. ↩︎
  3. Atwood, Molly E., and Aliza Friedman. “A systematic review of enhanced cognitive behavioral therapy (CBT‐E) for eating disorders.” International Journal of Eating Disorders 53.3 (2020): 311-330. ↩︎

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Dhavala Sree

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