Friday, February 8, 2013

Understanding Hoarding Disorder

Dr. Melva Green, a board certified psychiatrist, appears on the popular reality TV show “Hoarders” to help those on the program suffering from Hoarding Disorder. Here she answers questions about this mental illness and shares about her experiences working on “Hoarders.”
How do you define “Hoarding Disorder?” What’s the difference between hoarding vs. collecting?
Hoarding is the compulsive need to hold on to things in excess that often have no actual marketplace value. When someone suffers from Hoarding Disorder, he/she can’t let go of these things even though the things are in the way of day-to-day functioning and even dangerous. For example, not being able to use vital areas of the home like the kitchen or bathroom, being unable to sleep in the bed or only a small area of the bed because of excess clutter. The difference has to do with the level of severity.

What are the signs of hoarding?
Obviously a major sign of hoarding is when the person is unable to get around his/her home safely because the things have taken over. Anxiety over these things – feeling anxious about others touching the things and a sense of paranoia that things are missing which often leads to accusing others of taking things that go missing under the piles are typical. In regards to interpersonal signs, a very common one is difficulty with relationships. Those suffering from Hoarding Disorder struggle with emotional connections to others, especially their own family members. They often describe feeling a deep connection to their things because they believe their things are safe and can’t hurt them as a human can. And animal hoarders describe a genuine strong bonding sense with their animals although in reality, they are often causing the animals harm in these unhealthy environments.

What causes Hoarding Disorder? What are the risk factors?
In every case I’ve seen, there is a painful traumatic event or loss that has triggered the hoarding behavior (like the death of a loved one, divorce, growing up poor). People suffering from Hoarding Disorder have often repressed and internalized their emotions. There's a grieving process that got stuck somewhere along the way. Hoarding is the behavior that keeps them from having to face the underlying pain. Isolation, advanced age, severe obesity or difficulty ambulating, and having a family member with the behavior are also risk factors.

What types of treatment are available for those suffering from Hoarding Disorder?
Cognitive behavioral therapy to change thoughts and behavior patterns. Medication would only be used in a short course if there are other conditions like severe anxiety, depression that are getting in the way of the therapy. But in the end, treatment for Hoarding Disorder is about getting to the heart of the trauma / pain / loss through deep therapy and mindfulness work, so that the patient no longer “hides” behind the things but properly grieves what needs to be grieved and learns to form emotional connections with others...not just things.

Why do you think reality TV shows on hoarding have become popular?
I would like to think that it's because we want to learn more about the human condition...that we want to see people succeed. But the truth is, I think people are fascinated with other people’s problems. On some level, “Hoarders” feeds that voyeuristic energy in today’s pop culture. It's like watching others’ mayhem so we don’t have to deal with our own issues, and we can say “at least my life isn’t that bad.” But for me, those who come on the show are brave souls who teach me about the miracle of recovery. They inspire me. They remind me of the power of the human spirit, the willingness to face what needs to be faced...the determination to live whole.

Do you feel shows like “Hoarders” have helped raise awareness for this mental illness?
ABSOLUTELY! I regularly receive feedback from viewers who say they know someone who may need help and are grateful for the show. What viewers may not know is that patients on “Hoarders” receive free after-care treatment from the show: six months of therapy and organizational skills training. The show has done amazing work in giving people who are close to becoming homeless a new chance at life.

What do you hope viewers learn from the show (“Hoarders”)?
I want viewers to know people do recover from Hoarding Disorder. I also hope “Hoarders” shows another image of psychiatry in terms of a holistic approach to treating the soul – using treatments like mindfulness.

What should someone do if they think they may have Hoarding Disorder? If you suspect you, or a loved one, are suffering from this mental illness, you should contact a mental health professional for diagnosis and treatment recommendations.

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