Hoarding is a complex and often misunderstood condition affecting between 2% and 6% of the population. It is characterized by the excessive accumulation of items and the inability to discard them, leading to cluttered living spaces, unsafe living environments and difficulty functioning in daily life.

While hoarding may seem like a simple issue of clutter, it is actually deeply interconnected with mental health. Understanding hoarding and developing empathy for this condition is crucial to help more people get the help they need. As a result, Sierra Vista Hospital is here to explore the connections between hoarding and mental health, including the symptoms, causes and treatment options for hoarding disorder.

What is Hoarding Disorder?

Hoarding disorder is characterized by the persistent difficulty in discarding or parting with possessions, regardless of their actual value or utility. People with hoarding disorder often have an intense emotional attachment to their possessions and may experience extreme distress at the thought of getting rid of them. This leads to the accumulation of items, often resulting in cluttered living spaces that can be difficult if not impossible to navigate.

Hoarding disorder can also make one’s home a hazardous environment. The accumulation of items can lead to fire hazards and prevent proper trash disposal. Furthermore, it may contribute to structural damage and veil underlying issues, such as rodent infestations or bed bugs.

As a result, seeking help for hoarding disorder as soon as possible is critical to ensure your or your loved one’s mental and physical health.

Is hoarding a mental disorder?

Yes. Hoarding disorder is indeed classified as a mental health condition. Specifically, it is categorized as a type of obsessive-compulsive disorder (OCD). It is also recognized in the Diagnostic Statistical Manual of Mental Disorders (DSM-5), emphasizing the emotional attachment and challenges associated with discarding items.

Hoarding disorder levels

There are five stages of hoarding. They include:

  • Level 1: Minimal clutter: The home is organized and cleanly.
  • Level 2: Mild clutter: The home has cluttered heaps in common living areas.
  • Level 3: Moderate clutter: The home is difficult to navigate as a result of clutter. Appliances may be broken and exits blocked.
  • Level 4: Severe clutter: The home is almost impossible to navigate as a result of overflowing clutter. Home is unsafe due to fire hazards, mold and deteriorating materials.
  • Level 5: Extreme Clutter: The home is an unlivable environment with clutter blocking major passageways. Home is unsafe due to biohazard waste, fire hazards, structural damage, rodent/insect infestations and more.

If you or your loved one’s home is at or above a level 3, it is time to seek professional help immediately.

Hoarding Disorder Symptoms

The DSM-5 outlines the following criteria for diagnosing mental and behavioral health disorders. Hoarding disorder DSM-5 criteria include:

  • Persistent difficulty discarding or parting with possessions, regardless of their actual value.
  • The difficulty is due to a perceived need to save the items and distress associated with discarding them.
  • The difficulty results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use.
  • The hoarding causes clinically significant distress or impairment in social, occupational or other important areas of functioning.

In addition to these criteria, other signs of a hoarding disorder may include:

  • Difficulty making decisions
  • Perfectionism
  • Avoidance of situations that involve discarding possessions
  • Difficulty organizing possessions
  • Difficulty managing daily tasks
  • Difficulty with time management
  • Difficulty with planning and problem-solving
  • Difficulty with attention and focus
  • Difficulty with emotional regulation

The Interconnections Between Hoarding & Mental Health

As previously mentioned, hoarding disorder is classified as a type of OCD. However, this is not the only way hoarding is connected to mental health. Other common connections include:

Hoarding disorder & anxiety

Hoarding disorder is closely linked to anxiety disorders. People with hoarding disorder may experience intense anxiety and fear when faced with the thought of discarding their possessions. This can lead to avoidance dealing with the clutter and difficulty managing daily tasks.

In addition, the cluttered living spaces that result from hoarding can also contribute to feelings of anxiety and overwhelm. This can create a vicious cycle, as the clutter makes it difficult to manage daily tasks, leading to more anxiety and avoidance of decluttering.

Hoarding disorder & depression

Depression is another mental health condition that is commonly associated with hoarding disorder. People with hoarding disorder may experience feelings of hopelessness, low self-esteem and guilt due to their inability to manage their possessions and living spaces.

In addition, the cluttered living spaces can also contribute to feelings of isolation and shame, which are common symptoms of depression. People with hoarding disorder may find it difficult to socialize, as they may feel ashamed or afraid to invite people into their homes due to fear of judgment. This can make it difficult for people with hoarding disorder to seek help and support, further exacerbating their symptoms.

Hoarding disorder & trauma

Hoarding can also be connected to past trauma. Trauma, including the loss of a loved one, abuse or other distressing life experiences, can act as a trigger for hoarding tendencies. People in these scenarios use hoarding as a coping mechanism, seeking comfort and security in the items they collect.

What Causes Hoarding Disorder?

The exact cause of hoarding disorder is not fully understood, but common causes include a combination of genetic, environmental and psychological factors.

Genetic Factors

Studies have shown that hoarding disorder may run in families, suggesting a genetic component. However, more research is needed to fully determine the role of genetics in the development of hoarding disorder.

Environmental Factors

As previously mentioned, traumatic life events such as the loss of a loved one or a significant change in living situation can trigger hoarding behaviors. In addition, growing up in a cluttered or chaotic environment may also contribute to the development of hoarding disorder.

Psychological Factors

People with hoarding disorder may struggle with other mental or behavioral health issues. They may have difficulty regulating their emotions, leading to a reliance on possessions for comfort and security. In addition, perfectionism and difficulty making decisions may also contribute to hoarding behaviors.

Treatment Options for Hoarding Disorder

Seeking treatment for hoarding disorder is an important step in achieving recovery and long-term wellness. However, the journey is not always as simple as often desired. Overcoming hoarding disorder is often a long-term commitment, with treatment varying based on the specific needs of each patient. Common treatment options for hoarding disorder include:

Psychiatric treatment

Psychiatric treatment, such as cognitive-behavioral therapy (CBT), can be an extremely effective hoarding disorder treatment option. CBT helps people identify and challenge the thoughts and behaviors that contribute to hoarding and develop healthier coping strategies.

In addition, structured behavioral health programs and services can also help people with hoarding disorder address any underlying mental health conditions that may be contributing to their hoarding behaviors, such as anxiety, depression and trauma.


While there is no specific medication for hoarding disorder, antidepressants and anti-anxiety medications may be prescribed to help manage symptoms of co-occurring mental health conditions.

Support Groups

Support groups, such as Clutterers Anonymous, can provide a sense of community and understanding for people with hoarding disorder. These groups offer a safe space for people to share their experiences, receive support and learn from others who are going through similar struggles.

Seeking Help for Hoarding Disorder

If you or a loved one is struggling with hoarding disorder, it is important to seek help from a licensed mental health professional as soon as possible. They can provide a proper diagnosis and develop a treatment plan tailored to your specific needs.

In addition, it is important to have a support system in place, whether it be through therapy, support groups or loved ones. Hoarding disorder can be a difficult and overwhelming disorder to manage, but with the right support and treatment, recovery is possible.

Help Is Available at Sierra Vista Hospital

Those suffering with hoarding disorder may feel helpless and hopeless in their condition. However, achieving renewed well-being and happiness is possible.

Sierra Vista Hospital, located in Sacramento, California, is here for your mental and behavioral health needs. We provide inpatient and outpatient psychiatric services to adults and adolescents seeking improved mental well-being. Our individualized treatment plans aim to meet each person’s needs and challenges are met.

Learn more about how we can help by giving us a call at 916-273-4300 or get in contact with us by using this form.

About Sierra Vista Hospital

Sierra Vista Hospital is a private behavioral health facility that provides psychiatric and chemical dependency treatment through inpatient and outpatient programming. We also provide inpatient alcohol detox and outpatient chemical dependency services. With a team of licensed professionals committed to giving the highest quality care, we pride ourselves on having a compassionate and nurturing environment.

We offer care to adults and adolescents in the Sacramento area and also serve those through the northern and central California area. Some of our services include inpatient treatment for adults and adolescents and as well as our outpatient treatment for adults and adolescents. Our facility has been providing support for our patients and their families since 1986.

To schedule a no-cost assessment or for more information, please call 916-273-4300.