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When collecting gets out of control, it's a problem

By Andrea Dorey

Do you enjoy collecting things? Do you know people who do? I have a friend who loves to collect squirrels in any medium, and has them on display all over her house. Another friend has matchbooks that she has collected from her travels around the world. She keeps them in shoe boxes under her bed, and she takes them out to show friends and to reminisce about the places she has seen and the people she has met.

But there is another kind of collecting that makes less sense. It's sometimes even somewhat amusing. We've all seen the quaint character on TV who occupies the only chair and desk in an office jammed with piles of books and magazines and videotapes, with papers and clippings and file folders strewn everywhere. Usually this character is eccentric and brilliant--able to locate in a moment the necessary information buried in what appears to be a roomful of chaos. And we smile at this eccentricity and see no harm in it.

But sometimes such intense collecting can turn into compulsive hoarding. Like the eccentric TV character, a person can begin with piles of information in various media, and then begin to collect coupons, junk mail, rubber bands, bottles, tie twists, aluminum foil and so on. The piles grow throughout the entire house until the collector has no place to sit, to eat or to sleep comfortably. Movement inside the dwelling becomes difficult, and the risk of fire is high.

There are famous cases of people who died as a result of severe hoarding: The most infamous is probably that of the two elderly Collyer brothers found dead in their New York mansion in 1947; the youngest (the only caregiver of his older brother) was crushed by the weight of accumulated trash. Despite the Collyer example, the typical hoarder has been characterized as an elderly female living alone. Although much publicity has centered on hoarders who collect animals, this form of hoarding is relatively rare. Curing animal hoarding is particularly difficult because the hoarder thinks she is protecting the animals, even though the urine and feces have made the home environment unhealthy and dangerous.

How does simple collecting become compulsive hoarding? What's known about hoarding is that it is sometimes associated with some personality disorders, eating disorders, head injuries, schizophrenia and dementia. The behavior is seen in almost 20 percent of those with obsessive-compulsive disorder; the estimate of 1 million victims of hoarding in the United States may be low. Unfortunately, excessive hoarding doesn't respond to the usual antidepressants used to treat the anxiety of OCD patients. Cognitive behavioral modification has been successful, but can take a year, a duration six to 12 times longer than the typical OCD therapy. An interesting study conducted about two years ago at the UCLA Neuropsychiatric Institute used brain scans in 77 subjects that included OCD patients, hoarders and controls; the study found decreased activity in areas of the brain that involved decision-making, concentration, problem-solving, spatial orientation and memory--deficits that could explain helplessness in prioritizing, categorizing and organizing.

How do we know if someone is a hoarder and not just a collector? After all, many of us keep items that we think we may need later: clothes that will fit when we lose weight, out-of-date gadgets that could become collectibles in the future, little family keepsakes that evoke memories or old tickets and receipts from traveling. All of them can pile up and begin to seem indispensable once they've entered our home. Stashing stuff like this in the attic or the garage where we have the room renders even a mild case of hoarding relatively harmless because it doesn't interfere with everyday life. What should be watched and resisted is any increase in this tendency to hoard.

Like my friend with the squirrels, true collectors are proud of their possessions and love to show them off. However, hoarders are usually embarrassed by their increasingly cluttered houses; they don't like to have visitors, and this fear of discovery increases their social isolation. Their collections are disorganized and of little interest or value to others; nevertheless, hoarders are overwhelmed by anxiety and grief at the prospect of parting with any of it. They seem to see each object as a living entity, with a hidden value which they are responsible to preserve. Some hoarders cannot resist a bargain and will haunt the local flea markets, compulsively buying, even going into debt to add to their collection. And so their collection grows until the impossible living conditions are discovered.

Hoarding can be improved and often cured. Mild cases are often alleviated by self-help programs and local support groups. Are you a happy collector? Or are you on your way to becoming a compulsive hoarder? Get help from the Obsessive Compulsive Foundation Inc. by dialing 203.401.2070, emailing info@ocfoundation.org or reading the useful information on the Compulsive Hoarding website at www.ocfoundation.org/1005/index.html. Don't let clutter take over your life.

Andrea Dorey has been a medical writer for more than 25 years; for queries or comments, please contact her at andi@wrytor.com.