What Are The 5 Levels of Hoarding?

Hoarding is a complex mental health disorder that can be difficult to understand. It’s more than just a tendency to collect or hold on to items. Instead, it’s a condition that can have a profound impact on a person’s life, affecting their daily activities, relationships and overall well-being.
To better understand this disorder, it’s helpful to know that hoarding is categorized into five levels. Each level represents a different degree of severity, with level 1 being the least severe and level 5 the most extreme.
Our goal is to highlight and explore the characteristics of each hoarding level. We aim to provide a clear understanding of what each level entails, from the early signs of hoarding to the most severe manifestations.
Whether you’re seeking information for yourself or a loved one, this guide will offer valuable insights. It’s a step towards understanding and addressing hoarding behaviors effectively.
Understanding Hoarding as a Mental Health Disorder
Hoarding is recognized as a mental health disorder by the American Psychiatric Association. It’s characterized by persistent difficulty discarding or parting with possessions, regardless of their actual value.
This behavior often results in clutter that disrupts the individual’s ability to use their living or work spaces. It’s not just about being messy or disorganized. Hoarding can cause significant distress or impairment in social, occupational or other important areas of functioning.
Level 1 Hoarder: The Beginning Signs
At level 1, hoarding symptoms are less noticeable. The home of a level 1 hoarder may appear well-organized. There might be light clutter and no noticeable odors.
All doors and stairways of the home are accessible. There are no signs of animal waste, pests or other problematic conditions.
However, the individual may already be experiencing difficulty discarding items. They may also show signs of excessive acquisition, often buying or acquiring items they don’t need.
Key characteristics of a level 1 hoarder include:
- Light clutter
- The home is still accessible
- Difficulty discarding items
- Excessive acquisition of items
Level 2 Hoarder: Clutter Begins to Accumulate
As we move to level 2, the signs of hoarding become more apparent. Clutter begins to accumulate, and at least one room or area is unusable due to hoarding.
There may be mild odors present, and the home may be in need of minor repairs. The person may also start to withdraw from friends and family, avoiding inviting others into their home.
At this stage, the hoarder may also neglect their personal hygiene and cleanliness of the home. This can lead to an increase in clutter, dirt and pests.
Key characteristics of a level 2 hoarder include:
- Clutter in several rooms
- At least one room or area is unusable
- Mild odors and need for minor home repairs
- Withdrawal from social interactions
- Neglect of personal hygiene and home cleanliness
Level 3 Hoarder: Noticeable Impact on Lifestyle
At level 3, hoarding starts to have a noticeable impact on a person’s lifestyle. Clutter is visible in most areas of the home, and several rooms may be unusable.
There may be visible clutter outside the home as well. Odors become stronger, and there may be evidence of pests. The person’s personal hygiene may deteriorate further, and the home may be in need of significant repairs.
The hoarder may also start to experience negative effects on their relationships and social life. They may feel embarrassed about the state of their home and avoid having guests over.
Key characteristics of a level 3 hoarder include:
- Clutter visible in most areas of the home
- Several rooms are unusable
- Visible clutter outside the home
- Strong odors and evidence of pests
- Deteriorating personal hygiene and home in need of significant repairs
- Negative impact on relationships and social life
Level 4 Hoarder: Severe Clutter and Health Concerns
When hoarding reaches level 4, the situation becomes more severe. The clutter is now excessive, and most rooms in the home are unusable. There may be structural damage to the home, and essential utilities like water, electricity or gas may be disconnected.
Health hazards become a significant concern at this level. There may be mold, mildew and pests, and the home may be in a state of disrepair. The person’s personal hygiene may be severely compromised, and they may have difficulty maintaining a healthy lifestyle.
The hoarder’s social life and relationships are likely to be significantly affected. They may become increasingly isolated and avoid social interactions due to embarrassment or fear of judgment.
Key characteristics of a level 4 hoarder include:
- Excessive clutter and most rooms in the home are unusable
- Possible structural damage to the home
- Significant health hazards
- Severe compromise of personal hygiene
- Significant impact on social life and relationships
- Increased isolation
Level 5 Hoarder: Extreme Hoarding and Safety Risks
At level 5, hoarding reaches its most extreme state. The home is typically filled to capacity, with pathways carved out of the clutter. The living conditions are unsanitary, and there may be a severe rodent or insect infestation.
The individual’s health is at serious risk due to the unsanitary conditions and potential for injury. They may be unable to care for themselves properly, and their mental health is likely to be severely affected.
At this level, the hoarder may face legal issues, such as eviction or child custody loss. They may also be at risk of losing their home due to structural damage or fire hazards.
Key characteristics of a level 5 hoarder include:
- Home filled to capacity
- Unsanitary living conditions
- Serious health risks
- Possible legal issues
- Risk of losing home due to structural damage or fire hazards
Approaching a Loved One About Their Hoarding
Approaching a loved one about their hoarding can be a delicate task. It’s important to approach the conversation with empathy, understanding and patience.
Remember, hoarding is a mental health disorder. It’s not simply a matter of being messy or disorganized. And most importantly, it should not be seen as a personal failing.
There is still a lot of stigma surrounding hoarding disorders, which is why it remains important to offer support and refrain from passing judgment.
Treatment Options and Support for Hoarding Disorder
There are several treatment options available for hoarding disorder. Cognitive-behavioral therapy (CBT) is often the first line of treatment. It helps people understand their hoarding behaviors and develop healthy coping strategies that enable them to part with items they no longer need.
In some cases, medication may be used to treat underlying mental health conditions that may be exacerbating hoarding behavior. This can be particularly helpful if the person is also dealing with anxiety, trauma or depression.
Support groups can also be beneficial. They provide a safe space for those with hoarding disorder to share their experiences and learn from others who are facing similar challenges.
The Journey Ahead: Hoarding Recovery is Possible
The journey to recovery from hoarding disorder is often long and challenging. However, with the right support and treatment, people can regain control of their lives and look forward to a healthier future.
It’s important to remember that recovery is a process, and it’s okay to ask for help.
If you or a loved one is showing signs of hoarding disorder, Sierra Vista Hospital, located in Sacramento, California, is here to help. 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.
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.