Hoarding is often the most obvious outward sign of a an OCD (Obsessive Compulsive Disorder) that has a strangle hold on a persons life. One of the misconceptions about OCD is that the suffer is compulsively neat, and germ phobic. Though perfectionism underlies hoarding, it does not manifest itself in the stereotypical hand washing, sock folding character we see on television. Think Adrian Monk. It has been suggested that hoarders may be suffering from a chemical imbalance that may be prompting their compulsion to save things seemingly worthless most of society. It is widely accepted that the hoarder suffers form a constellation of symptoms and compulsions that has made this disorder difficult to diagnose and very hard to treat clinically. If you know some one suffering from this problem be it a family member or friend you know that there is an obvious problem that needs attention.
Hording is characterized by an over valuation of objects. Each thing has some value whether real or imagined. The person hording these things, newspapers swizzle sticks gum wrappers, has an over whelming sense of duty to keep and save these thing either for later use or for later generation to cherish as they have. There is an element of a hero complex involved, that if I save this now, later when some one needs it they will see that I was right and my actions (hording) where not wrong, but valuable.
Hoarders have such attachment to each belonging that they see them as one of a kind and can not organize their ever increasing stuff into categories. Even the most similar things such as magazines though stacked neatly and chronologically exist for the hoarder as unique and separate each with its own special value. This disorganization lead to the acquisition of shelving, boxes and other organizational hardware that often becomes one more hoarded item, or at best a flat surface to pile more stuff on. The hoarder my have hundreds of empty Tupperware vessels all empty all taking up more precious space. The hoarder wants to find the right thing to put in to his or her Tupperware and not "waste" it on the wrong thing.
Most times the hoarder is putting off paying bills, shopping, and doing many day to day activities because the overwhelming burden of hoarded material is a constant source of concern, moving this thing here and that thing there. Making space for something new. The stove maybe filled with material that would catch fire if turned on, and the sink is full of not dishes but magazines. This often leads the individual to go out to eat to avoid the problem of shopping and cooking all together. Financial burdens also pile up as storage units additional apartments, and garages are also acquired.
Often hoarders has compulsive spending habits. When faced with the choice of buying one book, say on how to draw cartoons the hoarding personality will ignore all budgetary limitations and put all the books on drawing cartoons on a credit card or on layaway. Which of course put more financial strain on things. Putting off payment and even picking up the books becomes a strategy itself for the hoarder. Storage is temporary solved if the books are put on layaway, acquisition is at least partly achieved in partial ownership. Bills though unseen tend to pile up for the hoarder along with possessions.
For the hoarder a social life is very difficult. They have an impossible limit on the level of intimacy they can allow into their lives. The stigma of hoarding is much like that of substance abuse, that the person has no self control, or is lazy or dirty. These feelings of social isolation create more problems for the hoarder. Resentments can rage in some hoarders, the fact that the world can not see that they are saving things for use that they are being responsible for the planet. These feelings of responsibility and stewardship accompany mush of the compulsion to save. Even when recycling is available the hoarder will hold on to empty water bottle, coffee cans, newspapers out of feeling of responsible reuse, someday.
This brings us to some of the differences between classic OCD and hoarding. Most hoarders have less anxiety then most people with OCD. It seems that because the agitation arises from thoughts of future need such as, "I might need this book one day" that the act of getting that book right then and there dispenses with the anxiety. Hoarder do not see there ritual of hoarding as ridiculous or extreme, but perfectly logical, and right. Most people with OCD know touching the stove fifty time before leaving is not reasonable, but do it to dispel their anxiety. Most concerns arise from disorganization and guilt over procrastination. For the hoarder it is not the act of hoarding that causes distress but the treat of being forced to get rid of things because a spouse, relative or landlord views it as unreasonable.
The main and most pronounced difference is the seeking of treatment and how the treatment works. Most hoarder do not seek treatment out for themselves, probably because their anxiety never reaches the levels that people suffering from other types of OCD do. The two methods of treatment most discussed are using anti-depressants, particularly selective serotonin reuptake inhibitors (SSRIs) as well as cognitive behavioral therapy. Because anxiety is not a large part of the hoarder dynamic the medication does not really help reduce anxiety and allow for normal behavior to take place, which is the typical out come for other OCD related conditions. The medication does not help with the disorganization because it is the over valuing of objects that creates the confusion in the first place. With out a more realistic value system in place medication is useless. If the hoarder is not sufficiently dismayed by their behavior they are not going to seek any treatment. Behavior therapy works for those who have have hit bottom and are motivated to change. To that end there are self help groups and a growing awareness of the problem, message boards and websites dedicated to the problem of hording also for friend and relatives: Friends of Hoarders. The first step for the hoarder seems to be the classic admission that a problem exists.