Estimated reading time: 4 minutes
Rajeev’s hoarding disorder
Rajeev* is a 70-year-old, first-generation retired immigrant from India who came to the US in 1990 with his wife, Shobha*. They live in a four-bedroom house on the outskirts of Dallas. They have two adult children who live in other cities. Lately, Shobha has been thinking of relocating to be closer to one of their children.
Over the years, Rajeev has accumulated a lot of things he no longer needs, but does not want to dispose of them either. He has a hard time parting with material possessions regardless of their actual value, and gets upset even with the idea of parting with items such as old books and magazines, or an old, rusty motorbike in his garage that no longer works. They have no space for these items, either at home or in the rented storage they use. His hoarding habits are making it difficult to live at home due to a lack of space. Due to these issues, Shobha reached out to us for guidance.
Q: Does Rajeev suffer from a problem?
Dr. Sharma: Shobha, from what you are describing, Rajeev seems to have a hoarding disorder. It is a mental health condition characterized by continuing difficulty in discarding possessions regardless of their value, excessive accumulation leading to extreme clutter, and an impact on living spaces. It impairs daily functioning and causes distress to the self and others. According to a recent US Senate Special Committee on Aging Report, it is a growing problem in the US, and this disorder affects approximately 2% of the overall population, but up to 6% of all people who are older than 70 years.
Q: What are the causes of hoarding disorder?
Dr. Sharma: Shobha, hoarding disorder was considered a symptom of obsessive-compulsive disorder (OCD), but since the introduction of the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) in 2010, it has been identified as a distinct disorder. The exact cause of this disorder is unknown, but it is known to begin in adolescence and is a progressive condition with genetics and trauma playing some role.
The person exhibits a high emotional attachment to material possessions, which provides some subconscious or conscious relief in overcoming the memory of trauma they may have experienced. Hoarding is different from collecting; with the latter, people accumulate things that have some value and are organized.
Q: What are the dangers of hoarding?
Dr. Sharma: Hoarding can be a health risk for individuals and their family members. They put limitations on living space due to the clutter of objects. They can also expose people at home to a greater risk of injuries or other illnesses caused by a lack of cleanliness. There are implications for social life as one avoids people in the home. This causes loneliness and social isolation. Hoarding is also a fire hazard. It can also lead to legal problems, especially for those renting properties. Finally, as in your case, it will be a nightmare to relocate with so many possessions.
Q: Does he need professional help?
Dr. Sharma: A structured interview for hoarding disorder (SIHD) is available online, but the diagnosis must ideally be done by a clinician. With the resources provided here, you believe that Rajeev does have a hoarding disorder, it may be worth persuading him to seek professional help. Consult your primary care provider or a mental health provider. If the hoarding problem poses a health or safety risk, you may take the help of local police, fire, or public health agencies.
Cognitive-behavioral therapy (CBT), in which the beliefs about hoarding are questioned and altered, is the most suitable intervention for hoarding disorder. Some medications have also shown benefit and must be taken under psychiatric care.
Q: Can he change for the better permanently?
Dr. Sharma: Shobha, it is always good to be optimistic in life, and that is my philosophy. Some people show significant improvement after treatment. However, you must understand that hoarding disorder is difficult to treat. Hence, coping with this chronic condition is very important for the person and the family members.
Q: Can Indian philosophy and techniques help in this condition?
Dr. Sharma: While Indian philosophy cannot directly treat hoarding disorder, it has a rich tradition through its scriptures, yoga, and meditation – all of which can help with this condition. Some studies show that yoga, with its focus on mindfulness and breath work, is quite helpful in hoarding disorder. Yoga also specifies the discipline of Aparigraha (non-hoarding), which can be adopted by practicing charity (Dāna).
Additional resources
Here are some additional resources to cope with hoarding disorder:
- American Psychiatric Association’s website on hoarding disorder
- Cleveland Clinic’s website on hoarding disorder
- Mayo Clinic’s website on hoarding disorder
- Treating people with hoarding disorder
- Stress management book with individual chapters on coping and managing stress while living with a person suffering from a hoarding disorder.
If you have further questions, reach out to Dr. Sharma at editor@indiacurrents.com.
*Names changed upon request.