It's been a while since I covered the topic of compulsive hoarding, because the last time I did I posted photos of my nut collection and book pile, and the next thing I knew I was being contacted by Discovery Disney to be "fixed" on some hoarding special. Seems like that's kind of a pattern, now that I think about it. I go public with my stuff ... I get invited onto shows!
Well, anyway, I was reading an article in the Fall 2007 issue of The Johns Hopkins Depression & Anxiety Bulletin, an interview with Gerald Nestadt, M.D., M.P.H, Director of the Johns Hopkins Obsessive-Compulsive Disorder Clinic, and Jack Samuels, Ph.D., an assistant professor with a joint appointment in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine and the Department of Mental Health at the Bloomberg School of Public Health at Johns Hopkins. Wow. That's a lot of school.
I found out that even though most folks lump compulsive hoarding into the same illness umbrella as obsessive-compulsive disorder, hoarders actually have different brains. The brain-imaging research shows that people with compulsive hoarding have distinct abnormalities in brain function compared with people with non-hoarding OCD and those with no psychiatric problem.
According to Dr. Samuels, "[w]hat causes those brain abnormalities (besides genetics) is still not clear, but compulsive hoarding can begin after damage from stroke, surgery, injuries, or infections. In addition, psychology and environmental factors (e.g. traumatic family experiences) appear to contribute to abnormal brain development and function."
Samuels says that hoarding belongs to a syndrome that also includes:
- Avoidance behaviors
- Difficulty organizing tasks
And here are some interesting stats: hoarding obsessions and compulsions are present in approximately 30 percent of OCD cases. However, as a group, says Samuels, OCD-affected individuals with hoarding symptoms have a more severe illness, a greater prevalence of anxiety disorders and a greater prevalence of personality disorders than people with OCD who don't have hoarding symptoms. Hoarders are often less responsive to treatment than non-hoarding OCD patients.
Dr. Nestadt offers six anti-clutter strategies for compulsive hoarders:
- Make immediate decisions about mail and newspapers. Go through mail and newspapers on the day you receive them, and throw away unwanted materials immediately. Don't leave anything to be decided on later.
- Think twice about what you allow into your home. Wait a couple of days after seeing a new item before you buy it. And when you do purchase something new, discard another item you own to make room for it.
- Set aside 15 minutes a day to declutter. Start small -- with a table, perhaps, or a chair -- rather than tackling the entire, overwhelming house at once. If you start to feel anxious, take a break and do some deep-breathing or relaxation exercises.
- Dispose of anything you have not used in a year. That means old clothes, broken items and craft projects you'll never finish. Remind yourself that many items are easily replaceable if you need them later.
- Follow the OHIO rule (which apparently doesn't work in Ohio, because I'm from there): Only Handle It Once. If you pick something up, make a decision then and there about it, and either put it where it belongs or discard it. Don't fall into the trap of moving things from one pile to another, again and again.
- Ask for help if you can't do it on your own. If you feel these strategies are impossible to carry out and you cannot cope with the problem on your own, seek out a mental health professional.
This piece was originally published on Psych Central.
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