Hoarding disorder, traditionally thought of as part of obsessive-compulsive disorder (OCD), based on recent studies is shown to also be closely related to ADHD, especially in those with a high level of inattentive symptoms. If you are living with a hoarding disorders, research shows you are 10 times more likely to also show signs of ADHD than those who have OCD without hoarding tendencies. This was the main finding in a research study published in the journal Depression and Anxiety in 2010.
How do I know it’s hoarding? Hoarding is often misunderstood. Many people collect both valuable and invaluable things. Many people keep a messy home, with piles of sometimes overwhelming clutter. But for those that hoard, the constant collection of items interferes with their ability to function. There might be so many newspapers, pieces of mail, photographs, magazines or even plastic bags that you can’t cook or move around in your living space. It might prevent you from socializing or the search for new items (such as a discarded container), can keep you away from other responsibilities or social situations.
According to the Anxiety and Depression Association of America (ADAA), hoarding is “the persistent difficulty discarding or parting with possessions, regardless of their actual value.” Some behaviors associated with hoarding include:
Inability to throw away possessions or indecision on whether to keep something
Increase in anxiety when attempting to throw something away
Difficulty with organizing possessions, including indecision on where to put something
Embarrassment about the quantity of possessions, sometimes resulting in living with no heat, electricity or broken appliances due to not wanting repair people to see your home
Worry that others are touching your possessions
Obsessive thoughts about possibly needing an item in the future
Checking to make sure an item wasn’t accidently thrown away
Loss of living space, social isolation, problems with relationships, financial difficulties because of loss of work time or compulsive buying of more items
In addition, hoarding can present health hazards because of cramped living conditions or the amount of possessions can pose a fire risk.
How ADHD and hoarding are linked
A number of studies have looked at a possible link between hoarding tendencies and ADHD. A study completed in Canada in 2015 looked at hoarding tendencies in children and adolescents between the ages of 6 and 17 in an effort to determine if hoarding was an aspect of OCD. Their results showed that hoarding tendencies were present in children with and without OCD, however, they were more apparent in children with more inattentive ADHD symptoms than in those with OCD only. Another study, published in the journal Depression and Anxiety in 2013, linked childhood ADHD with hoarding tendencies later in life. This study found that children with ADHD, particularly inattentive type ADHD, were more likely to exhibit hoarding tendencies later in life than those children without ADHD in childhood.
In the 2010 study, researchers found a “strong association between ADHD and hoarding.” However, scientists couldn’t be sure whether these two conditions were comorbid or whether symptoms similar to ADHD are a part of hoarding. Some results of the study pointed more toward overlapping symptoms, meaning that both conditions existed side-by-side; Researchers found that a high number of people showing symptoms of both ADHD and hoarding exhibited signs of ADHD years prior to exhibiting signs of hoarding.
Some results, however, indicated that people with hoarding had executive functioning deficits, something common in people with ADHD. It is possible that symptoms of this deficit were misinterpreted as a diagnosis of ADHD. The researchers noted that there were a number of participants who hoarded and did not fully meet the diagnostic criteria for ADHD. This too raises the question of whether the two conditions are not necessarily related but rather share symptoms.
Getting help for hoarding
Because of the health, emotional, relationship and financial problems associated with hoarding, it is important to get help if you are living with, or know someone living with this condition.
The first stage of treatment often involves acknowledgement, acceptance and education. This can be the most difficult step, as a major roadblock to treatment is that many people who hoard don’t see it as a problem but rather accept it as a way of life. These people might be resistant to receiving treatment. If there are family members, it is important to educate them about hoarding as well. Well-meaning family members might be enabling or ignoring hoarding behaviors, that’s why learning about the condition can help family members better deal with and respond to the situation.
Cognitive-behavioral therapy (CBT), a form of treatment for a variety of disorders, has been shown to be effective in treating those who hoard. According to SocialWorkToday.com, about 70 percent of people who hoard who were treated with CBT showed improvement after 26 sessions. Family therapy was only found to be effective when the person who hoards also participated in CBT.
During CBT sessions, the hoarder faces their anxiety around discarding possessions and works on sorting, organizing and decision making about their various possessions. As with all therapy methods, success is tied to the motivation and commitment of the person receiving therapy.
See more helpful articles on ADHD and related conditions:
ADHD Prevalence and Association with Hoarding Behaviors in Childhood-Onset OCD: Depression and Anxiety, The official journal of ADAA
Hoarding: The Basics: Anxiety and Depression Association of America