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Treatments and drugs
By Mayo Clinic staffTreatment of hoarding is often a challenge that meets with mixed success. For one thing, many people who hoard don't recognize the negative impact of hoarding on their lives or don't believe they need treatment. This is especially true if their possessions or animals offer comfort. And people whose animals are taken away will often quickly collect more to help fulfill emotional needs.
Treatment of hoarding is also difficult because researchers aren't yet sure which treatment is best. Try to find a therapist or other mental health provider who has experience in treating hoarding. While therapy can be intense and time-consuming, perhaps taking many months or even years, it can pay off in the long run.
There are two main types of treatment for hoarding — psychotherapy and medications.
Psychotherapy
Cognitive behavior therapy is the most common form of psychotherapy used to treat hoarding. As part of cognitive behavior therapy, you may:
- Explore why you feel compelled to hoard
- Learn to organize and categorize possessions to help you decide which ones to discard
- Improve your decision-making skills
- Declutter your home during in-home visits by a therapist or professional organizer
- Learn and practice relaxation skills
- Attend family or group therapy
- Be encouraged to consider psychiatric hospitalization if your hoarding is severe
- Have periodic visits or ongoing treatment to help you keep up healthy habits
Medications
Research continues on the most effective ways to use medications in the treatment of hoarding. The medications most commonly used for hoarding are selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant.
These medications often work well for obsessive-compulsive disorder. However, studies of SSRIs as a treatment for hoarding symptoms have produced varied results. Although some research suggests that people with hoarding symptoms are less likely to respond to SSRIs, other research has found that the SSRI drug paroxetine (Paxil) may improve hoarding symptoms as well as other symptoms associated with OCD.
- Maidment K. Compulsive hoarding syndrome - An introduction. Obsessive Compulsive Foundation.http://www.ocfoundation.org/hoarding/about-hoarding/compulsive-hoarding-syndrome-introduction.php. Accessed April 14, 2009.
- Neziroglu F, et al. How compulsive hoarding affects families. Obsessive Compulsive Foundation.http://www.ocfoundation.org/hoarding/effects-family-society/how-compulsive-hoarding-affects-families.php. Accessed April 14, 2009.
- Abramowitz J, et al. The status of hoarding as a symptom of obsessive-compulsive disorder. Behaviour Research and Therapy. 2008;46:1026.
- Pertusa A, et al. Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both? The American Journal of Psychiatry. 2008;165:1289.
- Saxena S. Recent advances in compulsive hoarding. Current Psychiatry Reports. 2008;10:297.
- Frost RO, et al. Measurement of compulsive hoarding: Saving inventory - revised. Behavior Research and Therapy. 2004;42:1163.
- Obsessive-compulsive disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Jan. 20, 2009.
- Maidment K. Problems in treating compulsive hoarding. Obsessive Compulsive Foundation. http://www.ocfoundation.org/hoarding/treatment/problems-in-treating-compulsive-hoarding.php. Accessed April 14, 2009.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. April 17, 2009.
