Compulsive hoarding comes into greater focus since pandemic

NEW YORK, Oct. 17 (UPI) -- News stories about hoarding seem to appear with greater frequency these days, telling tales of people who have little space to eat or sleep because their floors, countertops and bookshelves are cluttered with literally thousands of items that have little tangible value.

Occasionally, a story will describe someone who became trapped in a fire, with rescuers unable to reach them. Some accounts narrate how humane societies have seized overwhelming numbers of sick or starving dogs or cats from animal hoarders.

Since the COVID-19 pandemic, experts say they've seen a greater emphasis on hoarding disorder, characterized by resistance to give up any belongings no matter how useless they might be.

Such compulsive behavior presents a grave danger to hoarders, as well as to those around them and rescue workers.

"The excessive accumulation of materials in homes poses a significant threat to firefighters fighting fires and responding to other emergencies in these homes and to residents and neighbors," the National Fire Protection Association says on its website.

"Since studies suggest that between 3% and 5% of the population are compulsive hoarders, fire departments must become familiar with this issue and how to effectively handle it."

In general, hoarding has become more frequent and severe since the pandemic, Dr. Michelle DiBlasi told UPI in a telephone interview.

DiBlasi is the chief of inpatient psychiatry at Tufts Medical Center in Boston and an expert in the psychological reasons why people hoard magazines, papers, valuables, toys, clothing and even food.

While telemedicine is effective, in-person visits enable mental health professionals to engage with patients "on a deeper level and help them physically remove objects in the least stressful way," she said.

Hoarders are hyper-sentimental about their belongings for various reasons. Some have faced financial troubles or significant trauma such as abuse or neglect, while others experience difficulty connecting with people, DiBlasi said.

"It's a way to protect themselves," she said. "They're building up a wall" by not allowing people into their homes due to clutter.

To address hoarding disorder, mental health professionals typically recommend cognitive behavioral therapy -- a structured, intervention-based treatment - along with medication.

"Often, therapists will meet with the patient at their home and go through [possessions] at the patient's own pace. They discuss what each item means to the patient, why they find it difficult to part with and what it would mean if they let it go," Robert Chester, a psychologist at University Hospitals Cleveland Medical Center, told UPI via email.

Research indicates that more than 60% of individuals diagnosed with hoarding disorder have another mental condition -- most often depression, anxiety, social phobia or obsessive-compulsive disorder -- that complicates treatment.

However, Chester said, some studies have shown that the majority of participants experience significant decreases in severity of symptoms after therapy.

Retaining tangible objects isn't the only form of hoarding that has become prevalent, said psychologist Simon A. Rego, chief of the department of psychology at Montefiore Health System in the Bronx, N.Y.

"As we've moved squarely into the digital age, there is a new, less visible type of hoarding that some researchers are referring to as 'digital hoarding,' which follows a similar pattern to hoarding of inanimate objects," Rego said.

It's a habit of "acquiring and accumulating substantial amounts of digital content, with difficulty of discarding it, leading to digital clutter," he added.

In other cases, people hoard animals, psychologist David Tolin, director of the Anxiety Disorders Center at the Institute of Living in Hartford, Conn., told UPI in a telephone interview.

"When people save animals, it is usually because they think they're doing the animals a service, although in cases of animal hoarding, we find that they are slowly killing the animals," he said.

"Not only are they accumulating a lot of animals, but they are failing to provide the animals with basic nutrition, sanitation and veterinary care. It usually requires quite a bit of convincing that you're not doing these animals a favor."

Dr. Asim Shah, a professor and executive vice chair of psychiatry and behavioral sciences at Baylor College of Medicine in Houston, said in a telephone interview that he has seen a significant increase in hoarding, particularly among people who did so before the pandemic.

Hoarding is "an issue in people who are indecisive, who are perfectionists, who procrastinate," he said. "People who hoard usually have a level of shame and embarrassment because of hoarding. They also exhibit a need for control."

The disorder is "a persistent, slowly progressing, condition that has a typical onset in adolescence," Jennifer Pinto, a licensed mental health counselor and Trotman director of behavioral health at Beth Israel Deaconess Hospital-Needham in Needham, Mass., told UPI via email.

"Due to the complexity of the disorder, treatment appears to be most effective when customized to the patient, as there hasn't been a clearly identified one-size-fits-all approach," she said.

Different minds have various ways of responding to tough situations, David Nathan, a psychologist at Minneapolis-based Allina Health, told UPI via email.

"As the pandemic was a very difficult experience for all involved, we saw increased rates of all stress reactions, and that includes increases in hoarding behaviors," Nathan said.

"Treatment helps patients understand what is going on in their mind that connects 'safety' with having these possessions, and the therapist/caregiver can help the patient find other ways to feel safe and comfortable without needing to keep all of these possessions."

Treatment can take a while and tends to only work if the patient strives to break a strong habit.

"We can't just flip a switch and make it go away," Nathan said.