9-minute read time.
Today’s post only scratches the surface of the elaborate field of mental health disorders and is certainly not the last time I will write about it. In the near future, I plan to publish more definition-based explainers about other mental health conditions that relate to, influence, and have symptoms similar to hoarding disorder alongside other personal and research essays. For now, please enjoy this post and as always, please let me know if you have any questions, concerns, comments, etc.
Also, I thought it would be fit to include a trigger warning since this piece briefly mentions symptoms of depression that might not be suitable for some readers.
I recently had a conversation with a very close friend of mine, wherein she made an excellent point. She said this,
“Okay, this is random, but from reading your blog, I thought this idea was interesting. Based on the definitions/levels of hoarding post you explained in your blog, technically, my house would have been classified as level 3 hoarding or something like that. I find it interesting because I think the circumstances were so different than a typical “hoarder” that you think of or why it happened with your mom. Visually, our house would look like a hoarding house, but the reasons behind it weren’t necessarily a drive to hold onto things. Instead, it was because my mom was too depressed to throw things out, and it got to a point where me and my brother were too overwhelmed to handle it ourselves. There was so much trash everywhere, clothes everywhere, and animal byproducts everywhere, and it was crazy. Now that I am older, I am very passionate about throwing things away, and all my belongings are only the things in my dorm room. I get rid of stuff if I can’t find a place for it, even if I want to keep it. I thought that was interesting because I wouldn’t call my mother a hoarder. It was more due to circumstances caused by other mental health issues, but it had similar effects where I could never have friends over, and I would feel ashamed, and I would even sometimes have people not drop me at my actual house to go home. I was scared of people finding out where I lived or asking to come over.”
According to my friend, her mother was clinically diagnosed with major depressive disorder, bipolar depression, generalized anxiety disorder, and substance use disorder. The depressive states her mother would go through were so severe that there would be consecutive months where she wouldn’t leave the house and would barely get off the couch.
This made me think about a few things.
Hoarders can have other mental health disorders. In fact, my mother, who has been diagnosed with hoarding disorder, is also diagnosed with depression, anxiety, and ADHD, all of which she takes medication for and seeks therapy for. And I am sure that her mental afflictions affect the way that she hoards, how much she hoards, and her motivation to clean. But they aren’t what compels her to hoard. My theory is that my mother’s hoarding and acquisition is brought on by many things, in part her mental health, her genetics (her mother was a hoarder), her environment, the trauma she has experienced, and so much more I don’t even know about.
But can those with mental health disorders like depression and anxiety be categorized as hoarders? Can it be flipped the other way around?
As a reminder, the definition of hoarding disorder according to the DSM-5 is as follows:
- “Persistent difficulty discarding or parting with possessions, regardless of their actual value.”
- This difficulty originates from a perceived need to hold on to their items and the mental distress they feel when getting rid of them.
- The difficulty of getting rid of these items results in an accumulation that clutters living spaces and compromises their integrity and function.
- If these spaces are cleaned, it is only because of an intervening force, such as family members, cleaners, or authorities.
- Hoarding causes “clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment safe for oneself or others).”
- The DSM-5 notes that hoarding disorder is not caused by another medical condition, like brain injury, cerebrovascular disease, or Prader-Willi syndrome, and is not better explained by the symptoms of other mental disorders, such as:
- Restricted interests in autism spectrum disorder;
- “Obsessions in obsessive-compulsive disorder;
- Decreased energy in major depressive disorder;
- Delusions in schizophrenia or another psychotic disorder;
- Cognitive defects in major neurocognitive disorder;
Thus, my answer to the question above is no.
Hoarding disorder is unique because of the hoarder’s motivation behind their actions. For those with mental health disorders that cause symptoms of hoarding like clutter and mess, the reason why their space becomes the way it does is not because of an emotional attachment or unhealthy acquisitions. Rather, it’s because their mental state does not allow them to have the capacity to clean or organize, at least during the time they experience severe symptoms.
For example, someone with depression, according to the World Health Organization, might experience a change in mood or loss of pleasure or interest in activities for a long period of time. They might feel sad, irritable, or empty. They might lack concentration, have excessive feelings of guilt or low self-worth, feel hopeless about the future, and think about death or suicide. They might not be able to sleep or eat properly. They might have little to no energy. They might experience mild, moderate, or severe depressive episodes that limit their ability to function, interact with people, including their family, and be able to stick with their responsibilities, including school or work (4).
One of those responsibilities that my friend and I believe her mother was unable to do while experiencing severe mental health crises was to clean the house, leading to the build-up of trash and clutter similar to that of a level 3 hoarder. Her mother did not collect for the sake of collecting, nor did she have an emotional attachment to the items in the home that made them hard to dispose of, but instead had most likely a lack of emotional attachment to most things, including a sense or standard of cleanliness, and an extreme fatigue that made it impossible for her to leave the couch.
Talking about this situation with my friend reminded me that lately, I have seen a pattern of videos on social media sites like TikTok where people make cleaning up a space affected by a mental health condition into content. They call their space their “depression room” and say that the only way they feel the motivation to clean the room is if they film it. I think my friend’s mother experienced a similar depression-room symptom to these content creators. But, because her mental state was so severe, it transformed the entire house, causing it to look almost like a hoarder’s home.
According to the National Institute of Mental Health, around 21 million people a year are diagnosed with depression in the United States (4). Forty million people worldwide have bipolar disorder (5). 6.8 million adults in the US have generalized anxiety disorder in a given year (6). According to the 2023 United States National Survey on Drug Use and Health, 45.8 million Americans had substance use disorder that year (7). This makes me wonder, just how many people have symptoms similar to that of hoarding due to another mental health disorder?
I never intend to invalidate anyone’s experiences, but I can’t help but wonder if some individuals might misdiagnose themselves or their family members with the wrong disorder, thinking that the person has hoarding disorder when they might be experiencing something else mentally. Of course, much more research is left to be done about hoarding disorder in the psychology and neuroscience fields. I have much more research to do on my own. But I can’t help noticing that although the diagnoses are different, the similarities of symptoms of hoarding disorder and other mental health disorders affect the families of those afflicted in analogous ways. My friend observed this as well.
“People who have survived hoarder parents or things of that nature can find community with people who grew up with parents like mine,” says my friend. “Although it isn’t the same thing, they can relate to some of those experiences, and it helps both communities feel like they are seen and understood.”
When I first met my friend, we bonded over a few things we shared: our body types, our sense of humor, and our struggles with men (since then, we have both gotten into very happy relationships, and my friend got skinny on me (shoutout to her when she reads this!), but we still share the same sense of humor). As our friendship developed, we trusted each other with the more shameful and embarrassing parts of our lives, including our family histories and the chaos that comes with them. When I talked to her, I felt seen. I felt understood. There were very few people who I trusted with this part of my life at that time, and even though her mother’s struggles were different than my mother’s, I felt connected to her because of our shared experiences. It helped form a bond that I have shared with no one else but my biological brother. She is forever in my heart, and I love her like a sister. She is more than a friend. She is family.
References:
- Institute of Health Metrics and Evaluation. Global Health Data Exchange (GHDx). https://vizhub.healthdata.org/gbd-results/ (Accessed 4 March 2023).
- Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord. 2017;219:86–92.
- Evans-Lacko S, Aguilar-Gaxiola S, Al-Hamzawi A, et al. Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys. Psychol Med. 2018;48(9):1560-1571.
- https://www.who.int/news-room/fact-sheets/detail/depression#:~:text=During%20a%20depressive%20episode%2C%20a,patterns%20of%20depressive%20episodes%20including:
- https://www.who.int/news-room/fact-sheets/detail/bipolar-disorder#:~:text=Bipolar%20disorder%20is%20a%20mental,women%20are%20more%20often%20diagnosed.
- https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad#:~:text=GAD%20affects%206.8%20million%20adults,stressful%20ones%2C%20play%20a%20role.
- https://americanaddictioncenters.org/addiction-statistics
