The disorder is identified by five characteristics, the first three being:

A. Persistent difficulty discarding or parting with personal possessions, even those of apparently useless or limited value, due to strong urges to save items, distress, and/or indecision associated with discarding.

B. The symptoms result in the accumulation of a large number of possessions that fill up and clutter the active living areas of the home, workplace, or other personal surroundings (e.g., office, vehicle, yard) and prevent normal use of the space. If all living areas are uncluttered, it is only because of others’ efforts (e.g., family members, authorities) to keep these areas free of possessions.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment for self and others).

The third point, that the hoarder is incapable of “maintaining a safe environment for self and others,” seems to be the dividing line between hoarding and chronic disorganization.

Hoarding also appears in multiple places in the document as a symptom of other disorders. According to the Hoarding Disorder entry in the DSM-V draft, hoarding can also be a symptom of Obsessive-Compulsive Disorder, Major Depressive Disorder, delusions in Schizophrenia or another Psychotic Disorder, cognitive deficits in Dementia, restricted interests in Autistic Disorder, and food storing in the Prader-Willi Syndrome.

I’m interested in following this topic to see if the proposed Hoarding Disorder ends up as a separate diagnosis in the final version of the DSM-V. Hoarding has appeared in previous versions of the DSM, but only as a symptom of other disorders. If it does make the final version, I hope that it helps people who are hoarders to get the quality treatment they need.

I am hoping that you can give my brother and I some advice. Our mom is getting worse each year and refuses to believe she has a problem. In addition to her bringing other people’s garbage into the house, she also has a number of cats who use the house as one large litter box. When my brother and I attempt to clean, she yells and screams, and takes the rubbish back in when we put it out for the garbage truck. Unless we physically rent a truck to take it to the dump ourselves, it never leaves the house. We are so worried because it’s getting worse and she is approaching 70 and are at our wit’s end. She won’t go to counseling and when we clean anything it just gets disgusting again. There is food rotting as she doesn’t have a working fridge anymore and when she buys food she forgets about it and it gets compacted with stuff she puts on top of it. The piles of garbage are growing and we can barely get the front door open now. We have threatened not to come and visit and she said fine don’t. Nothing seems to work or get through to her. What can we do as we don’t want to see her die in this. Please, can you help us? Please don’t publish my name.

Only a doctor can give an official diagnosis as someone being a hoarder, but, since your mother is refusing to seek treatment at this point, that diagnosis is going to be difficult to acquire. I think that you will be okay if you function under the assumption that she is one, however, as it definitely won’t hurt her or you if you do.

Hoarding is a psychological illness. Your mother is not a bad person or a bad homemaker, she’s suffering from a mental health condition similar to obsessive-compulsive disorder or clinical depression. As much as she doesn’t want treatment for her condition, she desperately needs it. You and your brother can clean her house a million times, but it will always return to its current state if she does not get the medical care she needs. Cleaning her house against her will might also lead to her cutting off communication with you — and that is not something you want to happen. Keeping the lines open with your mother is extremely important.

Start by learning as much as you can about hoarding. There are many resources available to those who love and care about people who suffer from this condition. The Children of Hoarders website may be specifically helpful to you, and I recommend checking out their resources section.

Unless you believe your mother is endangering herself or others, you cannot force help upon her or commit her against her will to a mental health facility. Nagging, negative and judgmental statements, and disrespecting her stuff will only exacerbate her hoarding behavior. Learn as much as you can about her condition, be supportive and encouraging, and find non-threatening ways to encourage her to seek help. Best case scenario: She decides to seek treatment and finds a healthy way to live with her condition in a safe home environment.

Thank you, Anonymous, for submitting your question for our Ask Unclutterer column. My thoughts are with you and your family. It is admirable that you and your brother are worried and care so much about your mother.

Do you have a question relating to organizing, cleaning, home and office projects, productivity, or any problems you think the Unclutterer team could help you solve? To submit your questions to Ask Unclutterer, go to our contact page and type your question in the content field. Please list the subject of your e-mail as “Ask Unclutterer.” If you feel comfortable sharing images of the spaces that trouble you, let us know about them. The more information we have about your specific issue, the better.

When firefighters arrived, they found flames coming from the west side of the home, said [Evanston Fire Department Division Chief Tom] Janetske. When they tried to enter the front door, they were unable, so went around to a side door, Janetske said.

When they were able to begin their search of the home, firefighters, including some who were able to force their way in the front door, found the man under about 3 feet of debris in the home’s living room, about 10 feet from the front door, Janetske said.

If you know of someone who is a hoarder and whose life might be in danger, please help them to find medical assistance. The Hoarders television website has an excellent resource page that lists many programs and organizations.

We’ve heard from a number of people associated with the show that the second season is going to talk more about treatment options and look more closely at the psychological aspects of the disorder than was the case in season one. I truly hope this is accurate because I believe the hoarders on the show deserve to be treated with dignity and respect. I’m not saying that they weren’t in season one — I know from first-hand accounts that they were given excellent help behind the scenes during the filming of the episodes — but what translated onto the screen didn’t always reflect the entire process. I’m looking forward to tonight’s episode and seeing how the changes are implemented.

After the episode airs, feel welcome to jump onto our Unclutterer Forums and talk about it in our second season Hoarders thread. If you don’t get A&E, check out the official Hoarders website in a couple days where they will post the full episode online.

When working with a hoarder on this series, I have asked each client to commit to working with a therapist (counselor, psychologist, psychiatrist) and/or a professional organizer after I leave. (The organizing-filming only lasts 2 days and there are a lot of stops and starts for the film crew to change batteries, etc.) While it’s OK with me if the therapist isn’t on site at the same time I’m working with the client, I always stress the importance of the therapist-client-organizer relationship. There will be no lasting change if the hoarder is not willing to also work with a mental health professional for some period of time.

I was surprised to learn that filming only occurred over two days, and I think this explains why viewers don’t get to see anything other than the purging process. Geralin is an amazing individual and a highly skilled and trained professional organizer. Her insights into her experience are definitely worth reading and I’m glad she took the time to write her post.

On a recent episode of A&E’s Hoarders a key concept was brought to light by my dear friend and hoarding expert Dorothy Breininger. The important concept is stuff versus relationships. It’s so sad to see individuals choose their stuff over the people in their lives. To those of us watching the show at home, the hoarder’s behavior doesn’t initially seem to make sense.

In my industry, I often encounter clients who have a history of choosing stuff over people. It’s not just hoarders who do it, either. People often choose the comfort of stuff over relationships because relationships can be scary. People can reject you. People are sometimes critical and judgmental. People can be mean, insensitive, and heartless. People can leave you, abandon you, and disappoint you. But your stuff never will.

That is, until your stuff chokes the life out of you.

It could be easy to watch the television show Hoarders and lose sight of the humanity of the people featured. But we shouldn’t. All of us can empathize with the anxiety that the hoarders feel — we’ve all felt abandoned, disappointed, and ridiculed by others. We can understand how someone stopped focusing on the people in their life and turned to their stuff. Hopefully, with time, treatment, and assistance, the hoarders featured on the show can turn again to people and let go of so much of their stuff. I also hope that you continue to make the same choice.

I didn’t write about it beforehand because I was nervous about how the show was going to treat the subject matter. Hoarding is a psychological disorder and compulsive hoarders should be under the treatment of a licensed medical professional, and I was afraid that the mental health issues would be pushed aside for the shock and awe of the homes.

After watching the first episode, I have to say that they did go for shock and awe — the show actually began like an episode of the fictional drama “Law and Order” and the music added during editing makes the show sound like a horror film — but, they did mention some of the underlying issues of the psychological disorder. And, in the show’s favor, they used trained professionals to help the hoarders on the show. One of the professional organizers in the first episode is NSGCD-certified Geralin Thomas, whose writing you have seen here on Unclutterer and whose work I greatly admire. So, even though you might not have seen it in the episode, I feel confident that the hoarders were treated with respect off camera and at least in Jill and Ron’s case the hoarders are receiving continuing help.

Unfortunately, I followed the Twitter streams of people responding to the show as they were watching it and was horrified by what some people were saying. Many people were judging the hoarders as being “bad” and “disgusting” instead of individuals, real people, who are suffering from a psychological disorder. I hope that in the coming episodes the show works more diligently to educate viewers about the mental health issues that hoarders experience and treat the issue with more respect (less horror film sound effects and shock-and-awe editing). I also hope that they provide more information about what happens after the initial cleanup and medical treatment that is available for hoarders. As it is now, it seemed that most viewers were just interested in looking at piles of stuff and A&E definitely catered to them.

Instead of the link at the beginning of the episode that referred hoarders to InterventionTV (I’m not kidding, they directed people to a site about how they can be on a reality television show), we at Unclutterer recommend the following resources:

• OC Foundation
• Squalor Survivors
• Children of Hoarders

The cats and or dogs are then put into cages and hauled off to an animal shelter. Many of the animals are diseased, malnourished, and unfortunately euthanized. This is a peculiar form of hoarding that accounts for roughly 1,500 cases per year. 

Hoarding is a type of obsessive compulsive disorder that takes hold of people’s lives. Hoarders want to hold on to just about everything they come in contact with. Animal hoarders are usually lonely, older individuals that accumulate a large number of animals to protect them from harm. In doing so, the conditions in the home deteriorate over time. This leads to a very unhealthy environment for the animals as well as the hoarder. From AnimalHoarding.com:

Hoarders justify their behavior with the view that the animals are surrogate children and that no one else can care for them. They harbor a fear that if they seek help the animals will be euthanized.

More recently, in a publication from the Hoarding of Animals Research Consortium, Animal Hoarding: Structuring interdisciplinary responses to help people, animals and communities at risk, Patronek and his cohorts list four key characteristics:

• Failure to provide minimal standards of sanitation, space, nutrition, and veterinary care for the animals
• Inability to recognize the effects of this failure on the welfare of the animals, human members of the household, and the environment
• Obsessive attempts to accumulate or maintain a collection of animals in the face of progressively deteriorating conditions
• Denial or minimization of problems and living conditions for people and animals

For more information on animal hoarding, go to AnimalHoarding.com or the Animal Hoarding News and Info blog.

For more information on hoarding in general, check out these resources:

• OC Foundation
• Squalor Survivors
• Children of Hoarders

The other day, I discovered the website Hoardhouse. It is a project being assembled by a group of journalism students at Columbia University. From the their website:

All three of the authors are very curious about the issue of hoarding and how it impacts the lives of New York City residents.

This project will explore the hoarders, psychologists, social workers, and cleanup specialists for whom hoarding is a defining phenomenon.

The final version of the site will be live by March 23, 2009.

While readers of Unclutterer may be familiar with hoarding, it is a psychological ailment that still isn’t understood by much of the general public. It is encouraging to see these journalism students working to increase public awareness about the disorder’s damaging effects.

If you or someone you know struggles with compulsive hoarding, please try and get help from the following resources:

• OC Foundation
• Squalor Survivors
• Children of Hoarders

Once again, hoarding is a disorder that should be treated by a licensed medical professional.

The magazine Psychology Today approximates that 2 million U.S. residents suffer from compulsive hoarding disorder. This diagnosis is usually made based on results to one or more of the following tests: The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Scale (Ham-A), the Global Assessment Scale (GAS), or the Clinical Global Impression/Improvement (CGI) scale. Psychiatrists and medical doctors make the official diagnosis, but, unfortunately, too many cases go undiagnosed.

A report published in June of 2006 in the Journal of Psychiatric Research found evidence that “SRI [serotonin reuptake inhibitors] medications are effective for compulsive hoarding,” and so many compulsive hoarders are finding help for their disorder with a combination of psychotherapy and SRIs. If you know someone who is a compulsive hoarder, I strongly recommend that you encourage them to seek medical treatment so that they can find some relief from this debilitating disorder.

If you’re interested in learning more about compulsive hoarding, the TLC network has a special called, “Help! I’m a Hoarder!” that will air again on August 10, at 9:00 p.m. Eastern. The show explores the symptoms and treatments of compulsive hoarding disorder. From the TLC’s website:

“More than a million Americans suffer from disposophobia – the fear of throwing anything away. Meet three individuals who face the devastating effects of compulsive hoarding. You’ll never look at your clutter in the same way again.”

This special aired last September, and my understanding is the August 10 episode is a re-broadcast of last year’s program. I can’t find documentation on TLC’s website to know for certain. So, if you missed the show last year, let me definitely recommend that you tune in this year to learn more about this paralyzing condition.

From the article:

Nationally, an estimated 1 million to 2 million people are compulsive hoarders. And while statistics aren’t available for just how many people in San Francisco suffer from the condition, experts say the city has become the center for study of the problem and might have more hoarders per capita than other areas.

The compact, expensive city has many SRO hotels and other small living spaces as well as an aging population that has had years to collect clutter. Dementia also can contribute to hoarding.

The nonprofit Mental Health Association of San Francisco and the city’s Department of Aging and Adult Services have teamed up to create the Institute on Hoarding and Cluttering. That group conducts training of professionals such as nurses and in-home care providers, and last summer officials launched an effort to enhance communication among city agencies that work with hoarders.

The association sees about 250 new hoarding patients a year and runs a support group for them. The Department of Public Health has two inspectors, including Oblena, who visit SRO hotels that are run by nonprofits contracted by the city to provide housing.

If you or someone you know struggles with compulsive hoarding, try and get help from the following resources:

• OC Foundation
• Squalor Survivors
• Children of Hoarders

For those of you in the San Francisco area, there will be a 16-week hoarding and cluttering treatment group that will be held starting Monday, April 28, 2008.

To see these people talking about their problem puts a personal perspective on this condition. The subjects of this documentary obviously know they have a problem, but find themselves powerless to overcome their addiction to accumulation.

For more on hoarding, here is an article that was recently featured on MSNBC.

When clutter becomes serious hoarding, though, dwellings become difficult to navigate. It raises mental health and public health issues and becomes a potential nightmare for firefighters.

“We do encounter hoarding on occasion,” Giles said, “and it may not be evident from the street,” where the fire crew assesses the location of the flames and rescue needs.

A fire blamed on faulty wiring killed three people in Fremont, Neb., last week. And clutter hampered firefighters from the moment they arrived, just minutes after receiving the alarm.

Hoarding has negative effects on a person’s emotional well-being, but it may also wind up having a very dire physical toll. Not only to the hoarder, but to firefighters trying to navigate through a maze of trash. The hoarded mess also adds fuel to the fire. Boxes stacked to the ceiling packed full of clothes aren’t exactly deterrents for a spreading inferno.

Succumbing to a fiery end in the middle of a hoarded mess of clutter, may be one of the worst ways to leave this world. If you know of anyone who has a hoarding problem, please try and get them professional psychological treatment. You may very well be saving their life.

Excessive clutter and disorganization are often symptoms of a bigger health problem. People who have suffered an emotional trauma or a brain injury often find housecleaning an insurmountable task. Attention deficit disorder, depression, chronic pain and grief can prevent people from getting organized or lead to a buildup of clutter. At its most extreme, chronic disorganization is called hoarding, a condition many experts believe is a mental illness in its own right, although psychiatrists have yet to formally recognize it.

Adding more storage to a home will not remedy the problem. The added storage just becomes a clutter safety net, like we discussed here. More on this from the article:

…the problem with all this is that many people are going about it in the wrong way. Too often they approach clutter and disorganization as a space problem that can be solved by acquiring bins and organizers.

Measures like these “are based on the concept that this is a house problem,” said David F. Tolin, director of the anxiety disorders center at the Institute of Living in Hartford and an adjunct associate professor of psychiatry at Yale.

“It isn’t a house problem,” he went on. “It’s a person problem. The person needs to fundamentally change their behavior.”

Thursday’s episode, “Inside the Lives of Hoarders, Part I,” introduced viewers to Sharyn and Marvin’s 3,000 square foot home filled to capacity with clutter. In addition to Peter Walsh helping the family discover their home from under the mess, Oprah brought in Dr. David Tolin to help with the psychological issues of hoarding. Oprah’s site provides additional resources on the subject of hoarding, which can be found here.

Today’s episode follows the family as they continue to work on cleaning and repairing the home. This project, initially scheduled to be a two-week process, ended up taking eight weeks and required more than 100 people to staff its undertaking.

Check your local listings for today’s show times.

My parents have a compulsive hoarding problem. I don’t mean that they’re “a little disorganized” or “let the housekeeping get the best of them.” They’ve had this problem since I can remember–and it’s affected me for much the worse.

In high school, there was no free horizontal space in the house–no tables, no desks, no countertops–clear of junk. I had to do my homework on my bed or go to the library. (And, yes, I had the same problem as them, too!)

The photos [which appear below] were taken almost a year ago. In the ensuing time, the house has gotten much, much worse. This is pretty organized for them.

For those of you with children, keep in mind that you aren’t just getting rid of clutter for yourself–your organization has a direct effect on your child, whether or not they can articulate it. If you or your spouse has a problem with hoarding, take care of it sooner rather than later. My mom was the one with the clutter problem and it drove my dad crazy–but he didn’t do anything about it. If he had, even if she hadn’t liked it in the short term, we all might have had a happier life.

If you or someone you love has a problem with hoarding, please seek help. As Elizabeth has so accurately explained, hoarding affects more than just the person with the problem.

The researchers have found that subjects are quite accurate in their self assessments and that anyone who chooses picture #4 or above may be eligible for hoarding studies and/or treatment.

Which brings me to the story of a 90 year old man who was rescued from his mountain of clutter in Norton, MA. Local residents were very aware of all the junk in his yard, but had no idea how bad it was inside the elderly man’s home.

After someone called authorities Friday concerned that Halko had not been seen for a couple of days, an ambulance responded.

It took paramedics more than 10 minutes to locate him amid the piles of furniture, boxes, magazines, appliances, and trash that he’d accumulated over several decades.

Be aware that hoarding usually takes a hold of an individual when they reach middle age and progressively gets worse. By the time a person reaches their golden years hoarding may consume their whole life and my become a danger to themselves and others. The researchers from the Boston University/Smith College study estimate that 1 to 2 percent of adults suffer from a hoarding disorder.

The discovery of just how bad the Collyer brothers’ hoarding was came to light in March 1947 when an anonymous person reported there was a dead body in the Collyer residence.

The authorities did not have an easy time gaining entrance to the home. They started by trying to remove tons of garbage from the front foyer, which consisted of newspapers, phonebooks, furniture, boxes, and other miscellaneous debris. Unsuccessful in their attempts, a patrolman broke a window on the second floor in order to gain entry. After climbing through junk for two hours, he found the body of the elder brother Homer among the boxes and trash. Missing from the home, however, was Langley, the younger of the two recluses.

The hunt for Langley began, and authorities searched for him as far away as Atlantic City. A disturbing realization took place three weeks later, unfortunately, when Langley’s body was was found ten feet from his older brother’s. Because of the vast amount of garbage in the house, his body wasn’t unearthed until then. Langley had been crushed to death by one of his many booby-traps that he had made to deter people’s entry into their palace of junk. Langley actually had died first. He was crushed while bringing food to his elder brother, who was blind. Langley fed Homer a diet of one hundred oranges per week to try and restore his sight. Believing that the diet of oranges would restore Homer’s vision, Langley also saved every newspaper so that Homer could eventually read them when his sight returned.

Authorities eventually removed more than 100 tons of trash from the Collyer brothers’ house. Some of the more unusual items included human pickled organs, the chassis of an old Model T, fourteen pianos (both grand and upright), hundreds of yards of unused silks and fabric, the folding top of a horse-drawn carriage, and more than 25,000 books.

To learn more about the Collyer brothers, read Frank Lidz’s famous account in Ghosty Men: The Strange but True Story of the Collyer Brothers.