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Almost all of us accumulate clutter in our homes, but some people may hold onto clutter more than is typical – those with a hoarding disorder.

Hoarding is “a mental health condition characterized by a compulsive need to acquire and keep possessions, even when they’re not needed” (Harvard Health Publishing). People who hoard experience significant distress when faced with the idea of decluttering.

What is Hoarding Disorder?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is an authoritative guide to mental disorder diagnosis that is used by healthcare professionals in the U.S. and much of the world. Hoarding was first recognized as a unique disorder in the DSM in 2013 and is part of a class of obsessive-compulsive and related disorders.

According to the DSM-5, hoarding disorder is characterized by the following:

Persistent difficulty discarding or parting with possessions, regardless of their actual value. This difficulty is due to a perceived need to save the items and to the distress associated with discarding them.

The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, or the authorities).

The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment safe for oneself or others).

Hoarding disorder affects two to six percent of Americans, or six to 15 million people in the U.S. (Stanford University). Symptoms for hoarding disorder typically start in childhood and adolescence and become more severe when adults are in their 50s (Stanford University). Because Serene Transitions specializes in compassionate organizing and move management for seniors, we are prepared to provide support for individuals who may struggle to declutter for whatever reason, whether they are experiencing hoarding disorder or are simply reluctant to let go of sentimental items.

What to do if someone if your life has a hoarding disorder

It can be extremely difficult to watch a loved one deal with the distress caused by hoarding. If someone you know is experiencing hoarding disorder, the following steps can be helpful:

  • Educate yourself about hoarding disorder (some resources are linked below).

  • Without being critical or judgmental, ask your loved one about their experience — why are they accumulating things? Is there a reason that they’re having difficulty letting go? Do they think the amount of clutter is causing them distress or negatively impacting their life?

  • Look into therapists, clinics, and support groups in the area so your loved one can get guidance from a professional and make progress at their own pace. Finding a community through a support group or online can also be helpful — having a mental health condition can be isolating, and it can be valuable to talk with people who understand.

  • In a non-judgmental and compassionate way, share your findings about hoarding, treatment, and support.

  • If your loved one is prepared to declutter, contact a decluttering and move management company like Serene Transitions to see what services would be the most beneficial.

Please note: This is not a replacement for a recommendation from a psychological professional, and each case varies.

Working with Serene Transitions

Each Serene Transitions service is customized to the client, and compassion is central to our operation model. We know that, especially for individuals who experience hoarding disorder, organizing and getting rid of possessions may be emotional. We approach our work from a place of care and non-judgment. If you are interested in discussing how Serene Transitions can help you and your loved ones reduce clutter and accommodate specific needs, please reach out — we’re just a phone call or email away.

Although it is not stratified as such in the DSM, some organizations classify hoarding in five levels. The Institute for Challenging Disorganization has a Clutter-Hoarding Scale as follows: Level 1 – Low: Household environment is considered standard. No special knowledge in working with the chronically disorganized is necessary.

Level 2 – Guarded: Household environment requires professional organizers or related professionals who have additional knowledge and understanding of chronic disorganization.

Level 3 – Elevated: Pivot point between a cluttered household environment and a potential hoarding environment. Those working with Level III household environments should have significant training in chronic disorganization and will require a community network or resources, especially mental health professionals.

Level 4 – High: Household environment requires a coordinated collaborative team of service providers in addition to professional organizers and family: mental health professionals, social workers, financial counselors, pest and animal control officers, crime scene cleaners, and licensed contractors and handypersons.

Level 5 – Severe: Professional organizers should not work alone in a Level V environment. Requires a collaborative team, potentially including family, mental health professionals, social workers, building manager, zoning, fire, and/or safety agents. Formal written agreements among the parties should be in place before proceeding.

At Serene Transitions, we are equipped to support the first three levels. Levels four and five require medical professionals and protective cleaning equipment. If you or someone you know has a severe hoarding disorder in the upper levels, contact a medical professional for guidance.

Advice beyond a diagnosis

If you don’t fit the criteria for hoarding disorder but are still unhappy with the amount of clutter you’ve accumulated, you’re not alone! Check out our blog posts on downsizing and decluttering, and get in touch about how we can support your path to less clutter and cleaner living.

Sources & resources

The following resources may be helpful if you or someone you know is struggling with hoarding disorder. If you’re able to, speak with a medical professional or someone you trust about the best course of treatment and support.

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