When clutter is unhealthy

Consumer Reports News: June 02, 2010 10:53 AM

What’s the difference between messiness and hoarding?

Most messy people aren’t hoarders; they’re just messy. But if someone is no longer able to take care of work, family, or basic safety, they’ve crossed the line into mental illness. Their clutter might create a fire hazard or vermin infestation, or keep them from walking around in the house. They have an exaggerated attachment to items that prevents them from discarding things that most of us would consider to be junk, like stacks of old newspapers.

What if I suspect that a friend or family member is a hoarder?

Sit down, calmly explain why you are worried, and offer to help without taking control of the person’s life. The next step is to get the person some quality mental health care. Medications don’t seem to do much for compulsive hoarding. We recommend cognitive-behavioral therapy, in which we help the person identify and change irrational ways of thinking and practice new patterns of behavior. Even after treatment, most people are still hoarding, but it’s much better controlled and doesn’t cause safety problems or impinge on their functioning.

What if the person won’t accept help?

Don’t be tempted to take a shortcut, like clearing out the house when they’re away without telling them. It doesn’t work and often precipitates a mental-health crisis. If there are children in the house or the person is elderly and there’s an immediate hazard, you can call in your state’s protective services agency. They have the legal authority to mandate treatment. Otherwise, there’s usually not much you can do.

It’s horrible to watch a family member self-destruct, but if it comes down to a fight, you’re likely going to lose because the law protects a person’s right to be mentally ill. In those cases, the best option may be for family members to seek counseling themselves.

David F. Tolin, Ph.D.

Dr. Tolin is director of the Anxiety Disorders Center at the Institute of Living, Hartford, Conn., and author of "Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding" (Oxford University Press, 2007).

This article first appeared in the June 2010 issue of Consumer Reports on Health. For more on compulsions, such as hoarding, see our section on diagnosing and treating obsessive-compulsive disorder.

Aaron Bailey

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