“Hoarding” is derived from an Old English word, hord, which as a verb means “to amass” and “preserve” for future use. As a noun a “hoarding” would refer to the treasure itself, or something to treasure like money or wealth. As an inappropriate behavior, hoarding refers to saving objects that usually are not of great value. This is not just “collecting” objects. A collector might amass valuable objects such as antiques, baseball cards, or Civil War memorabilia. Collecting is done thoughtfully and systematically, and the collector knows the value of the objects. The extreme form of hoarding can be classified as a mental disorder, a criminal behavior if involving the hoarding of animals in unsanitary conditions, and certainly inappropriate or offensive when it amounts to unhealthy living conditions for the hoarder and his or her family members.

Hoarding can be compared to cluttering which is different and less problematic and not a mental disorder. “Clutter” (from Middle English clotter, meaning “to run together”) is a sixteenth-century word referring to a confused collection or litter. Cluttering appears as piles or stacks of objects on tables or couches that are generally considered as messy or untidy. These messy piles are invariably Page 187  |  Top of Articlecleaned up, tossed out, or recycled if the messy clutterer expects to have visitors in the home. In contrast, the hoarder is not be able to clean up or toss the random assortment of objects. The hoarder finds it painful to get rid of their worthless junk; they cannot let go of it even when it starts to negatively affect their living conditions.

An extreme hoarder sits in his apartment in New York City in 2016, with floor-to-ceiling stacks of clutter. According to the DSM-5, extreme hoarding represents a type of obsessivecompulsive disorder related to other forms of anxiety disorders. (AP Photo/Seth Wenig) (AP Photo/Seth Wenig)

Hoarders tend to be indecisive, distracted, avoidant procrastinators who have difficulty organizing or planning things to do. They are not bothered by living in unsanitary conditions. Inappropriate hoarding is done by both women and men. It is more likely exhibited by older adults (over 55 years of age) than younger ones (34-44 years). Those getting treatment for hoarding disorders are usually in their fifties. It is difficult to tell when children are hoarding because young children's messes tend to be cleaned up by parents and caregivers. Hoarding usually begins in early adolescence, begins to become problematic or impairing by the mid-twenties, and gets worse with each passing decade. Hoarding is associated with stressful life events, which tend to make the behavior worse. The hoarding habit runs in families; about 50 percent of hoarders have a relative who does the same. Many hoarders also have psychological problems with depression or with anxiety.

Hoarding disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013), has several criteria that need to be met for the diagnosis. The hoarder has longstanding problems discarding possessions regardless of their value. They profess a perceived need to hang on to the items and experience distress associated with discarding them as trash or recycling them or giving them away. These thoughts lead to accumulations that clog up and clutter living areas so much that it is difficult to do activities that normal people would carry out in the living room, dining room, kitchen, or bathroom. Sometimes the hoarding will spill over to other areas of the home such as the garage, the yard, or vehicles on the property. These areas will only become uncluttered through other peoples' interventions; the hoarder will not do it. Finally, hoarding behavior causes significant disturbances of the person's social life, his or her employment or job, and maintaining a safe living environment.

Animal hoarding is a special kind of hoarding. Animal hoarders collect large numbers of animals but fail to care for them properly. They do not feed properly or take care of waste and feces, nor do they take the animals for veterinary care on a regular basis, if at all. They usually hoard other objects, too. Animal hoarders tolerate grossly unhealthy conditions with little insight into what they have done to the animals or to themselves.