Unlike collectors, whose items tend to be neatly organized and who thin their collections periodically, hoarders closely resemble pack rats, says Randy O. Frost, a psychology professor at Smith College who pioneered the study of hoarding in the early 1990s. Frost, who has coauthored several books on the subject, the latest of which is Stuff: Compulsive Hoarding and the Meaning of Things, says hoarders' collections are wildly chaotic: yellowing newspapers, old junk mail, bags of cat hair and rotten food may be mixed with valuables such as stock certificates.
Psychologist Charles Mansueto, director of the Behavior Therapy Center of Greater Washington, has treated people who hoarded dust bunnies, bicycles, even garbage. Other hoarders prefer animals, typically cats, including an 82-year-old woman who was barred by a judge from owning cats after authorities found 488 of them, many sick or dead, in two townhouses she owned in Fairfax County, Va.
Hoarders think you're the problem
Although hoarding can coexist with dementia, obsessive-compulsive disorder (OCD) and depression, experts believe it is a distinct psychiatric disorder best treated through intense behavioral therapy and sometimes medications, including antidepressants, says Catherine Ayers, an assistant professor of psychiatry at the University of California, San Diego, who studies older hoarders.
Denying the problem and resisting change are common, says social worker Henriette Kellum, who adds, "To them, you're the problem." Kellum helped found one of the country's first hoarding task forces in Arlington, Va., bringing together officials from the fire department, housing division and human services to contend with a problem that, in extreme cases, can result in eviction and even homelessness.
"It tends to be a lifelong problem that gets worse with age," says Maryland psychologist Elspeth N. Bell, who heads the Behavior Therapy Center's hoarding program and is a consultant to the Montgomery County Hoarding Task Force in Maryland. Both sexes are equally affected, but more women seek treatment, Bell says. Some of her patients are compulsive collectors, scooping up dozens of free newspapers, rummaging through dumpsters or haunting thrift shops. They loathe discarding things like empty milk cartons and tend to be paralyzed by indecision, perfectionism and procrastination. Many hoarders feel sentimental attachments to possessions, which they regard as extensions of themselves.