Hoarding behavior may signal OCD

From The Indianapolis Star:

INDIANAPOLIS — The odd behavior has been thrust into the public eye on cable networks, with TLC's Hoarding: Buried Alive, A&E's Hoarders and Animal Planet's Confessions: Animal Hoarding. But it's more common than you might think.

"It's called a hidden epidemic," said Megan O'Bryan, an Indianapolis clinical psychologist who specializes in obsessive-compulsive disorder and hoarding. "Hoarders are reluctant to reveal it. They are embarrassed by it but don't want to seek treatment."

Hoarders shouldn't be confused with slobs or people who collect things like dolls or Michael Jackson memorabilia, even if they fill up a room. Hoarding is considered a mental disorder although whether it's a form of obsessive-compulsive disorder is up for debate.

Hoarding often goes undiagnosed for decades until people reach middle age and their clutter mounts to high levels even to the average pack rat.

"They can find a reason to keep almost anything," O'Bryan said.

The problem can lead to serious results: isolating the hoarder from friends and family; creating fire and public health hazards; causing neighbors' complaints over smell or rodents; removal of children from the home; and property being condemned.

As district health worker in social services for the Marion County (Indiana) Health Department, Geri Waggle sees the broken family relationships, isolation and harm that come to hoarders.

"I once had a client whose whole house was nonfunctional, and she lived outside," Waggle said. "She told me, 'I want to show you all my pretties.' "

Hoarding is more prevalent than even some mental health professionals have thought in the past. Some still don't recognize it as a mental illness.

Until recently, research has been limited. Within the past three years, three epidemiological studies in the United States, Germany and United Kingdom found that 2.5% to 5% of the adult population are hoarders, said Randy O. Frost, a leading hoarding expert, psychology professor at Smith College and co-author of Stuff: Compulsive Hoarding and the Meaning of Things.

Surprisingly, those numbers are higher than the 1% to 2% of people with other obsessive-compulsive disorders, he said.

"It looks like there has been a really large underestimating of hoarding in the past," said Jeff Szymanski, a clinical psychologist and executive director of the International Obsessive Compulsive Disorder Foundation in Boston.

In recent years, the largest number of calls and queries to the foundation were about hoarding. Because of that response and a lack of public information, the foundation launched a comprehensive online hoarding resource center at ocfoundation.org/hoarding. It provides a one-stop location for hoarding sufferers, their families, public health officials, researchers and therapists.

Hoarding isn't easy to diagnose or to treat, said Dr. Alan Schmetzer, professor of psychiatry at the Indiana University School of Medicine.

It can't be solved just by cleaning out the home, especially without the person's consent.

The mess eventually returns if the behavior isn't changed. If someone has a family member who hoards, Schmetzer said, it's best to get the person into counseling or therapy with a psychiatrist or other mental health provider.

"We tend to do a lot of things by habit," Schmetzer said. "It's a coping mechanism. Hoarders have to find ways to make changes, learn how to stop responses that are habit and replace them with behaviors that aren't problematic. That's hard for anybody."