How to help with hoarding: Advice from an A&E ‘hoarder’ expert | Hartford Health Care

August 30, 2022

Anyone who has cleaned their house knows that it is not always easy to get rid of your belongings. But for some, it is more serious. About 19 million Americans suffer from compulsive hoarding, a condition that causes a strong urge to collect things: newspapers, magazines or clothing are common items. Hoarding disorder is more likely to affect older adults and those with other psychiatric diagnoses, such as anxiety and depression. If you have a loved one who might be hoarding, is there anything you can do? > Learn more about hoarding in this free seminar

Is it affecting you?

The first question to ask yourself is if hoarding is affecting you; otherwise, it might be best to brush the problem aside altogether, explained David Tolin, PhD, medical director of the Center for Anxiety Disorders at the Institute of Life, part of the Hartford HealthCare Behavioral Health Network. “If it’s a real security hazard, I suggest approaching it delicately, without arguing. Say something like, ‘Mom or Dad, I’m really worried about you and the living situation here. I am concerned about your safety. Is there anything we can do about it?’” Dr. Tolin offered. > Want more health news? Text MoreLife to 31996 to sign up for text alerts

starts and stops

It could take more than one conversation, Tolin explained. Like other major behavioral health changes, it takes a lot of “starts and stops,” a pattern also seen in people who want to lose weight or quit smoking. But the key is to avoid being argumentative. “You can’t really force someone into treatment or harass them. Arguing actually has the opposite effect: they stand their ground, they fold, and they get defensive,” said Dr. Tolin.

Combined causes

Hoarding disorder is a condition caused by a combination of environmental, psychological and genetic factors, Tolin said. In his experience, he said: “There are very real changes in brain function when people with hoarding disorder have to make decisions, so that the brain regions responsible for helping you decide what is important and what is not, are not working very well. ”, Dr. Tolin said.

Is it hoarding or are they just messy?

Hoarding, Dr. Tolin emphasized, is different from clutter. For a diagnosis, one of two factors must be looked at: In some cases, hoarding can also present trip, fall or fire hazards, Dr. Tolin said. Australian researchers investigated fatal home fires for 10 years and found that hoarding caused a quarter of deaths. Affecting more people than obsessive-compulsive disorder, schizophrenia, or panic disorders, hoarding disorder overlaps with depression in half of those affected and with attention deficit hyperactivity disorder in about 28% of those affected. people.

retrain the brain

There is no effective medication for hoarding disorder, but Tolin’s patients benefit from cognitive behavioral therapy (CBT), psychotherapy through which they learn to retrain their behaviors and resist patterns that contribute to hoarding. “CBT teaches them to think differently, to practice new patterns of behavior. We have built a virtual store with things that people might want to purchase to help them tolerate their emotions and not pick things up,” she said. Treatment can address layers of behavioral health issues, and CBT is very effective at combating the buildup, but Dr. Tolin said it won’t stop it entirely for most people. “What will likely happen is your house will be much cleaner, much safer, much easier to get around, you will have full use of your home, and your quality of life will improve,” he said.

Investigation of a new treatment

Dr. Tolin and his team are launching new research on the effect of real-time neurofeedback on hoarding disorder. Study participants will participate in an fMRI scan of the brain while making decisions about their possessions. The goal is to train yourself to change brain function to make decision making easier. If successful, the approach can be combined with CBT, Tolin said.

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