What Causes Hoarding Behavior, and How Do You Treat It?

You might be familiar with the reality TV show “Hoarders.” It shows people in their most vulnerable moments as they try to get help for hoarding disorder. Shows like this may be entertaining, but they put struggling people in the spotlight. This may contribute to the stigma associated with this mental health condition. 

Hoarding is much more common than reality TV may have you believe. About 4% of Americans hoard or can’t stop collecting items. If you or a loved one hoards, you are not alone, and help is available. 

Here, we’ll cover what hoarding is, what can cause it, and how to treat it.

What is hoarding?

Hoarding disorder is a mental health condition that can make it hard to throw out items. If you have hoarding disorder, you may: 

• Have extreme difficulty getting rid of items, regardless of their value

• Think you need to save everything

• Experience great distress at the thought of getting rid of things

• Gather items to the point where you can’t use living areas in your home — for example, having so much excessive clutter in your bedroom that you can’t sleep on your bed 

• Experience a lot of emotional distress from hoarding or have trouble participating in daily life because hoarding gets in the way

Hoarding disorder can sometimes make your home unsafe — both for you and your loved ones. In some cases, hoarding can make it hard to get out of your house quickly in an emergency. It can also create unsanitary conditions.

Just having some clutter or being messy does not mean you’re hoarding. Hoarding is a clinical disorder that can cause significant distress and disruption in your daily life. 

Are there different types of hoarding?

Officially, there aren’t different types of hoarding. But there do seem to be common themes. For example: 

• Animal hoarding is getting very large numbers (dozens or hundreds) of animals. This can create unhealthy and unsafe conditions for both you and your animals.

• Shopping hoarding can happen if you buy things compulsively. It leads you to buy and keep things that you don’t need or can’t afford. It can also cause unsafe clutter at home due to unopened packages.

• Garbage hoarding, also known as Diogenes syndrome, causes severe issues with hygiene and cleanliness at home. Diogenes syndrome is a little different than hoarding disorder. It typically appears after you receive news of a life-threatening illness. In addition to poor personal hygiene, you may also have a buildup of garbage, rotting food, or body waste.  

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What is the difference between collecting and hoarding?

Collectors gather many items that are like each other. They do this out of an interest or love for the item. For example, a baseball fan might collect baseball cards. Someone who loves dolls may collect dolls from different parts of the world. Collectors usually feel proud of their items and may display them in an organized manner.

Those who hoard, on the other hand, feel like they have to collect objects and find it difficult to stop. Some people hoard items that don’t reflect their interests, have no value, or are considered trash. They may feel embarrassed by their behavior and not let others see their hoarding. 

If you hoard, you may know that it’s a problem but feel out of control or like you can’t change. The thought of no longer hoarding might cause a lot of fear.

What causes a person to hoard?

Signs of hoarding usually first appear around age 16. The symptoms tend to worsen with age if you don’t get treatment. There is not any one cause of hoarding that we know of. However, various factors may make you more likely to develop hoarding behaviors. 

The main risk factors include:

• Genetics: One of the strongest known factors for hoarding behavior is genetics. This means that you have a greater chance of hoarding if you have a relative who hoards. 

• Personality traits: Characteristics like perfectionism, indecision, and procrastination often go along with hoarding. If you hoard, you may feel a strong need to make the right choice on whether or not to keep something. You may feel that it’s easier just to keep the item than try to decide. 

• Cognitive difficulties: Another potential cause of hoarding is differences in mental (cognitive) functioning. Studies found that those with hoarding disorder are more likely to have trouble with learning, memory, attention, and problem solving.

How is hoarding connected to trauma?

Having a history of trauma can also lead to hoarding. Hoarding symptoms typically begin after the trauma happens. Your hoarding symptoms may be worse if you have experienced more than one trauma.

If you’re a trauma survivor, you may hoard because it makes you feel safe. For example, maybe you experienced emotional abuse or physical neglect in childhood. Now, you may find it difficult to trust other people. This may cause you to get attached to objects rather than people. 

You may start hoarding after a trauma if you feel responsible for keeping your loved ones’ belongings. For instance, the sudden death of a spouse or parent could worsen your hoarding behavior because you feel like you have to keep all of their things. 

Hoarding may also be related to an intense need to be prepared for — or stay safe from — more trauma. For example, if you survived a sexual assault, you may feel the need to collect as many objects as you can for self-defense. 

How do you treat hoarding behavior?

If you have hoarding disorder, you may not know where to start. If you have a loved one who hoards, it may be tempting to do a massive cleanup by getting a dumpster and throwing everything out. 

However, a quick cleanout doesn’t address the underlying causes of hoarding. It can also be very distressing for the person with hoarding disorder. That’s why it is important to get help from specialized mental health providers. 

Psychotherapy for hoarding

Cognitive behavioral therapy (CBT) can help with hoarding symptoms. CBT is a type of psychotherapy that helps you learn how your thoughts, feelings, and behaviors influence each other. 

For hoarding, CBT involves changing your thoughts about saving items. You’ll also practice getting rid of objects, stopping your collecting behaviors, and learning organizational skills. 

Your provider may also suggest other types of psychotherapy depending on your symptoms. For example, you may want to consider trauma therapy.

Clean-up home visits for hoarding

Decluttering support may also be a part of treatment. This might involve professionals visiting your home to help you sort your belongings. 

For example, when treating older adults, therapists may visit their homes and teach them how to problem solve and categorize. Together, they go through their belongings item by item and decide what to keep and what to discard. Over time, it gets easier to tolerate the distress they feel when throwing out unnecessary items.

CBT and home visits can help people with hoarding disorder. In one study, nearly 80% of those who participated in CBT had fewer hoarding symptoms a year after treatment. 

Medication for hoarding disorder

Medication can also help treat hoarding disorder. Your provider may recommend medication on its own or with therapy. 

There is limited research on medications for hoarding disorder. Providers typically start with medications for obsessive-compulsive disorder (OCD), since the conditions are similar. They most commonly prescribe selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant. 

Medication for hoarding may make it easier to do therapy. It can also help with other mental health conditions like anxiety and depression.

Support groups

Support groups can give you support from others who also hoard. Being part of a support group may make you feel less alone. You can get tips on how to cope from other people who can relate to you.

You can search for an online hoarding support group through Hoarding Cleanup. Your treatment providers may also have recommendations if you prefer to try a local support group. 

Why trust our experts?

Written by:

Mona Bapat, PhD, HSPP

Mona Bapat, PhD, HSPP, has 15 years of clinical experience providing therapy. She is a licensed clinical psychologist in Indiana and Illinois with treatment experience in individual, couples, family, and group therapy modalities.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

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