Hoarding Disorder Basics

In this guide you’ll learn the signs and symptoms of hoarding disorder, how it’s diagnosed and how it’s treated.

Hoarding: What Is It?

Hoarding is a disorder characterized by a person’s not only acquiring objects in great excess, but also being unable or unwilling to part with them, causing great personal and family distress. Children who hoard develop overpowering emotional attachments to their possessions, resulting in cluttered rooms and contributing to tension in the family, especially when a parent tries to clean away some of the mess. Children diagnosed with the disorder are so worried about their possessions that it interferes with their functioning.

Hoarding: What to Look For

Signs your child might have hoarding disorder:

  • A bedroom floor that can’t be seen because of the clutter
  • A closet so packed that nothing can be put in or taken out
  • A bed that is used more for storage than for sleeping
  • A desk covered with so much stuff that it can’t be used for homework

Having a messy room isn’t unusual for children. But while most children don’t get upset if someone occasionally cleans up and throws things away, children who hoard do.

Hoarders tend to acquire and hold onto objects that most people consider useless (rocks, toilet paper tubes, paper, Happy Meal boxes, food). Children might also hoard toy boxes and toys. The objects may or may not have typically sentimental value, but hoarders have a strong emotional attachment to them. Whereas a rock or stamp collector will search out specific items for his collection, a hoarder will acquire items seemingly at random and then struggle when asked to part with them. Collector also show pride in their collections, organizing them, sharing them, and talking about them; hoarders often feel embarrassed or uncomfortable letting others see or touch their things.

Adult hoarders are often identified by the clutter they accumulate, which results in complete disorganization and unlivable spaces. Children’s hoarding tends to be more contained — for example, under their bed or in areas of their bedroom — and might not be immediately obvious to an observer because disorganization is common among kids. For children the most notable sign of hoarding is the emotional reaction to their possessions. Children will be constantly worried about them, so much so that it becomes impairing and creates a major source of tension with their parents. Kids who develop hoarding disorder may become severely anxious and distressed if things are taken away; they may cry, yell, have tantrums, even kick or hit parents or break things.

Hoarding: Risk Factors

Approximately half of all people who hoard also have a relative who hoards, making this a behavior that runs in families. Anxiety, as well as experiencing stressful and traumatic events, may also be factors.

Hoarding: Diagnosis

When diagnosing hoarding, mental health providers check for three principal characteristics: persistent difficulty discarding or parting with possessions, regardless of their actual value; cluttered living spaces from having so many possessions; and significant distress or functional impairment.

Hoarding: Treatment

How hoarding is treated depends on the age of the child. For children eight and younger, psychologists often work with parents to set up a behavioral plan, to first stop a child from acquiring new things and then use incentives to work on gradually getting rid of some of her hoarded objects. For older children, cognitive behavior therapy (CBT) with a therapist who has experience treating hoarding is helpful. CBT helps children understand why they feel compelled to hoard and teaches them how to decide which possessions are worth keeping and which should be discarded.

Despite what appears on misleading hoarding shows on television, an important aspect of treatment is not to judge the value of what patients collect; they already know that what they believe about their possessions is not what other people believe, and shaming is not going to help.

The medications most often used in a treatment plan for hoarding are a selective serotonin reuptake inhibitors, or SSRIs. Not all children respond to medications.

Hoarding: Risk For Other Disorders

Many people with hoarding disorder also have depression, OCD, or an anxiety disorder, including social anxiety disorder and general anxiety disorder.