What happens inside the brain of a compulsive hoarder?

Think about this: When you are out on the street, do you pay attention to each object you come across because, for you, it can be decisive for your survival? When a person with a compulsive hoarding disorder comes across everyday objects, they try to rationalize the reason that compels them to take those objects home. The idea is that each object is so precious – even if it is not – that they need to take them home.

In their minds, there is no possibility of getting rid of the objects they have because it anguishes them to think that they will not have them when they need them. They try to match their “collection of items” to the space where they live and organize the hundreds of elements in their way. Since livable space is limited, they wash dishes in the tub, walk along narrow improvised paths and eat on mounds of objects that are sometimes as high as the ceiling.

Their physical appearance quickly deteriorates as their house becomes damp, dusty, and mouldy. Their social status and public image change and they cannot help it. Neighbours judge them and point them out as different people with some kind of problem. Isolation begins. They stop talking to people and prefer to spend their time collecting more objects or at home living with what they already have. They are not interested in the outside world, only the one they have created in their homes.

Hoarding disorder was included in 2013 in the Diagnostic and Statistical Manual of Mental Disorders‘, published by the American Psychiatric Association, a document accepted by professionals for the diagnosis of this type of disorder. According to the publication, the main characteristic of a person with compulsive hoarding disorder is their persistent difficulty in discarding or separating possessions, regardless of their real value, caused by the need to save objects and the anxiety associated with discarding them.


Collectors and hoarders

How many of us have kept an object that has a special meaning? That ticket for the first hockey game or rock concert we attended, the suitcase we always use to travel with, and the first gift from our partner, among others. For experts, this emotional investment in objects is something normal and is part of our daily life.

The trouble with hoarders is when they must decide which belongings to keep and which to give away or throw away, which causes them anxiety that, in many cases, they cannot control. It is somewhat disruptive. They are afraid and anguished that they will lose the opportunity to take the object or that something will be missing if they do not. Hoarders collect and collect, and lose the ability to live. Then, getting rid of those things generates anxiety.

According to research, hoarders also avoid getting rid of something because they do not want to deal with the pain or negative feeling that not having it will cause them in the future. These feelings lead hoarders to choose to keep objects and not think about making painful decisions.

How do they live?

One of the traits of compulsive hoarders is that their homes are disorganized and they are unable to stop it.

In most cases, their homes are so full of objects and garbage that nauseating odours, the presence of rodents and animals, and dust become part of the landscape. Each corner has some collected element. To mobilize, the hoarder creates a corridor between hoarded objects. Sometimes there are rooms where light does not even enter because the windows are blocked by stuff or the doors cannot be opened easily. However, hoarders can develop a kind of visual and mental map to identify where their objects have been stored. Experts indicate that despite the scenario where they live, hoarders do not worry about it.

Their houses are so stuffed that they can cause problems in the community. In fact, hoarders alter their social interactions to avoid someone telling them to get rid of things.

A look inside the brain of a hoarder

Although there is scientific research on the disorder, there is no conclusive explanation for what happens in the brain of a hoarder, but there are hypotheses.

It is common to find or hear people who say that they organize clothes by color, place the clothes hangers in the same direction or order the pictures in the room by size, actions, and ideas that can be normal until they affect daily life. When those thoughts become obsessions, that is, recurring and uncontrollable thoughts that cause anxiety, anguish, and anger, they can become pathological.

“The hoarder stores things that, for the most part, are useless”

People with compulsive disorder often recognize that they have a “persistent idea”, but do not know how to stop it. Obsession is linked to compulsion, which is the connection between idea and behavior. For example, the fear of contaminating the environment generates excessive hand washing, or the concern for tidiness causes strict and meticulous organization of objects.

Is compulsive hoarding a type of OCD? Before it was considered a subtype, but lately, it was classified as a related disorder. This means that hoarding is not explained by the symptoms of another mental disorder or other medical condition, but it can occur with another associated illness.

Differences between hoarding and collecting

Is there a fine line between collecting and hoarding? For the experts, there are notable differences. Collectors are a bit of a hoarder, but they see the functionality in what they do. They know why they do it and for what purpose. The hoarder does not, and it stores things that, for the most part, are useless.

In the The Oxford Handbook of Hoarding and Acquiring, doctors Randy O. Frost and Gail Steketee establish the contrasts: in collecting, the objects kept are related by a theme and are organized by categories. There is planning involved in what to buy and when to get rid of objects. The activity is a pleasure for those who do it and there is no social isolation.

On the other hand, in hoarding disorders there is an excessive number of objects without cohesion, spaces are not structured or organized to arrange them, and there is a lack of social interaction among those who suffer from it.

The collector can be a social form of the one who hoards. The line between them is that collectors can stop and control purchases, and they will not expose themselves to situations that put them at risk.


Although it is common to find cases of hoarding interventions by family members, foundations, or specialists on television programs and social networks, experts agree it should be treated only by professionals. This type of intervention can cause hoarders “to enter into an episode of panic and agitation because the fear of parting with objects produced in them is destructive.” Therefore, each case is particular and requires professional psychological help.


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