Today I present a guest post by Molly Nox.  Molly is an aspiring grad student in Clinical Psychology, with a keen interest in Compulsive Hoarding.


The Connection Between OCD & Hoarding

Individuals who have a hard time throwing anything away may end up with a big mess on their

hands. Even though their quality of life is impacted, their spouses object, and their children are

embarrassed to have friends over, hoarders are still unable to part with their accumulations.

Hoarders often suffer from other mood and anxiety disorders, and their clutter often reaches a

point where psychiatric intervention and professional hoarding cleanup services need to be

called in order to begin recovery from Hoarding Disorder.

What Is the Link Between Hoarding and OCD?

Obsessive compulsive disorder is a mental challenge in which the sufferer exhibits some sort of

irrational, repeated behavior and cannot seem to stop him or herself. Historically, psychologists

classified hoarding solely as a symptom of OCD; recently, after the publication of the DSM-5,

Hoarding Disorder has been recognized as a separate disorder completely.

It is true that many people who have Hoarding Disorder also suffer from OCD, but the link is not

as concrete as once believed. Approximately 18% of people who have Hoarding Disorder also

have been diagnosed with OCD. While this is a significant number, it is worth noting that a

staggering 92% of people with Hoarding Disorder also suffer from other psychiatric conditions,

with over 50% having clinical depression. It appears that Hoarding Disorder is not as closely

linked to OCD as it is with other disorders such as depression and General Anxiety Disorder.

Another aspect in which Hoarding Disorder and OCD differ is their treatment. In the past, people

who exhibited hoarding symptoms were diagnosed with OCD and treated accordingly. We now

know that people with hoarding symptoms are very unlikely to respond to traditional OCD

treatment. Hoarding Disorder is notoriously difficult to treat, but interventions targeted

specifically toward hoarding symptoms show the most promising success rates.

Why Does a Person Become a Hoarder?

While there is no clear consensus on the cause of Hoarding Disorder, there are a handful of

contributing factors to consider:

  • Genetics – Hoarding Disorder tends to run in families. Researchers have found patterns

in chromosome 14 that are unique to families with multiple hoarders.

  • Trauma – Trauma often plays a significant part in the onset or expression of hoarding

behavior. This does not necessarily mean that trauma is a cause of Hoarding Disorder; it

is, however, considered a factor that can cause a “break” in a person who is already

genetically predisposed.

  • Biology – A recent study found that individuals with Hoarding Disorder experienced

frontal brain hypoactivity. This is a condition that leads to decreased dopamine levels in

the brain and is commonly associated with addiction. Frontal brain hypoactivity is not as

common in people diagnosed with PTSD though, which is further evidence that OCD and

Hoarding Disorder are very different indeed.

Why Call a Mental Health Professional?

Hoarding Disorder is a condition that goes untreated in a worrisome 80% of cases. Many

hoarders either do not think they need treatment or think treatment will not help them.

Treatments for Hoarding Disorder have improved drastically in recent years, but public

perception has not improved with it.

If the accumulation of excessive things is negatively affecting the hoarder’s quality of life and

relationships, then psychiatric evaluation is highly recommended. Therapy can begin the process

of helping a hoarder understand their compulsions and eventually live a clutter-free life. It can

be helpful to seek a therapist who specializes in helping patients who suffer from compulsive

hoarding and its related disorders. Additionally, enlisting in professional cleaning services to

clean up the entire site can help make their home inhabitable again.


Molly Nox is a freelance writer based in Los Angeles. She’s a California dreamer with a penchant for handwritten letters, the New York Times, and dark roast coffee. Follow her on Twitter: http://www.twitter.com/mollynox


I said to my Mother “When you’re ready to accept my help, let me know.  Until then….”  I trailed off.  She replied, “Until then, I’m dead to you, is that it?  Well, so be it.”

Those were the last words we shared before she hung up on me.  And I can’t help but wonder if those are the last words I’ll ever hear from her.

It started off innocently enough.  The regular Sunday night phone call to catch up on the week had grown increasingly shallow over the past few years.  Mom, on her cell phone, would undoubtedly be browsing in a store somewhere, and I’d get to hear commentary about other shoppers she observed, or comparisons on various household products.  Tonight was about coloured toilet paper.  I asked for updates on doctors appointments, but specialist appointments are always “some time next month” and “no, I haven’t heard back on test results.”

Eventually, conversation turned to her house.  “Wouldn’t you know it, ANOTHER bird got into the house!  It woke me up this morning fluttering around my room.  And there were 2 raccoons in the wall behind my headboard fighting.  You wouldn’t believe the racket!”  If you’re new to reading Not Just Clutter, let me assure you my Mom is not an animated princess who can command woodland animals.  Nope.  She simply lives in a rapidly deteriorating house where raccoons and other wildlife find refuge.  This is where things start to go south.

Since Dad died 8 years ago, she hasn’t been able to keep up maintenance.  She needs to move out and sell the property (and really, it’s the property that has value, not the house).  It’s not safe or healthy.  The whole place is falling apart and is packed to the rafters with her hoard.  Clearly, somewhere has crumbled enough that all sorts of critters are finding their way in.  She’s had trouble with raccoons for years.  And that bird?  That’s the third on in as many weeks.

I’ve been trying to encourage her to make more actionable plans to move out of this house.  She really resents this though, and any time I gently mention it, she finds a way to turn things around.  Like, mentioning the doctor thinks she has a heart problem.  Or she suspects her cancer is back.

Or she’ll try to deflect and say she’s working on things slowly in her own way.  “I’m not going to worry about it, and it’ll all work out in the end” is a common refrain.  But I worry.  Knowing all her ailments, including a frozen shoulder, shortness of breath, and limited mobility, I’ve offered to go help her.  I told her “Let me be your muscle.”  I know she can’t carry much, if anything, up and down stairs, so I’d be happy to be the pack mule if she points out what to move.  But she refuses any help and has her priorities all skewed.

If I lived in a house overrun by wildlife, I’d fill a suitcase and get out.  Instead, she insists she has to organize her craft supplies first.  I can’t possibly help her with that either because I “don’t know the difference between worsted weight, cotton, polyester, or wool” yarns.  I reminded her the birds are probably pooping on it, and the ‘coons are nesting in it.  She was pretty indignant after that.

I’ve tried my hardest to be patient.  I’m the one who always tries to be diplomatic.  I just couldn’t hold it in any more tonight.  I kept calm and rational, but I laid it out honestly with her.  I called her out for making excuses and procrastinating.  I told her I can’t understand why she won’t accept my help, when all I want is for her to be in a safe, comfortable home.  She insists she wants to do it independently because if she accepts help then she’s a failure.

I said imagine if you came across a person fallen to the ground, and you put your hand out to help.  If that person reaches up to accept your help off the ground, are they a failure?  Do you judge them?  I’m just reaching out my hand.

She accused me of making her more depressed.  Then she accused me of conspiring with my sister to make her miserable.  And THEN she said maybe it was best if we just cut ties all together.

That’s when I told her to think about my offer and get back to me when she’s ready to accept the help.  I don’t know what the next step is.  I’m so torn.  She’s so stubborn she might let her pride lead her, and she won’t call me again.  If I call, then what?  Go back to the same vacuous relationship where we talk about coloured toilet paper?  Do I pretend everything is ok?  Do I ignore my nightmares of her dying in her house because she couldn’t find her way through her hoard in a fire?  Do I keep pressing her?  If I don’t call, she’s alone.  No family left.  That’s not the kind of daughter I want to be, but at some point, I have my own mental health to think of.

Either way, hearing my own mother say “I’m dead to you” is a harsh way to end a phone call.


Hello.  It’s been a while.

I took a breather from Not Just Clutter to sweep some clutter from my own mind.  I felt a little too wrapped up in worrying about mental illness and any hit of clutter, that I stepped back for a while.  It was a good thing for me.  I was able to focus on happier things for a while, and put my energy into other areas of my life.

But if you’ve been reading this blog from the beginning, you might be familiar with a series of posts called Case of the Silent Phone.  That’s what’s prompted me to write again.

It’s been 4 weeks since I’ve heard from my mother.  If you’re new to Not Just Clutter, my Mom only has a cell phone.  No land line, just a cell.  And for a while after getting it, Mom frequently lost her cell phone.  In fact, I think she’s had 3 phones in the last 18 months and it’s NOT because she’s always on the cutting edge of technology.

I call my Mom every Sunday.  3 weeks ago, my call went to voice mail.  I assumed she would call back within a few minutes.

2 weeks ago, I got voice mail again.  I thought maybe she lost the phone, or it’s not charged up.

And tonight, voice mail.  I’ve left messages every time.  I just don’t know what to think.

It could be that she’s lost the phone or the charger.  Or she’s feeling depressed and is refusing to answer any calls.  Or maybe….I don’t know.  My mind goes a million places.


Isn’t it about time we end the stigma of mental illness?

One of my main goals for writing my Not Just Clutter blog is to help dispel the misconceptions of compulsive hoarding disorder.  By sharing my personal story, perhaps others will realize hoarders are not uneducated lazy slobs.  Compulsive hoarding is complicated, heart-wrenching, and utterly baffling, but by trying to understand the nuances of hoarding, we can break down the stereotypes of not just this disorder, but of all mental illness.

Stop the Stigma

1 in 5 Canadians will experience some sort of mental health illness in their lifetime.  The chances are pretty high you know someone struggling with mental health.  Maybe they’re anxious about paying the bills.  Maybe their mood swings from low to high to low before lunch time.  Maybe she’s wrestling with post-partum depression and feels guilty for not bonding with her newborn baby.  Maybe he’s new to Canada, having escaped with only the clothes on his back from his war-torn home country.

Maybe it’s you who feels like you’re barely keeping it together every single day.

And you hide it.

You hide it in shame.  You shouldn’t have to.

Chalkboard image of Stop the Stigma of Mental Illness

Teen Suicide

Last week, I was sent reeling when I learned of the death of a 16-year old girl.  This girl had been in my home several times, caring for my daughter, Maddie.  I knew her to be smart, sensible, and compassionate.  Talented and athletic.  With a broad smile you couldn’t help but reflect with her around.  She had plans, and her whole future ahead of her.  We lost touch when she moved away from town, but I always considered her to be a positive role model for Maddie.  It’s tragic enough that she died so young.  It’s unspeakable that depression got a hold of her, driving her to suicide.

As a mother, I couldn’t help but imagine my own daughters at age 16, and wonder how I’ll possibly save them from the same fate.  My heart weeps for this girls family and friends.  I only knew her a fairly short time, but it was enough to be affected by her for life.

More than One Mental Illness

Sometimes, someone might be suffering from more than one mental illness.  I know of someone with schizophrenia as well as depression & anxiety.  You might think the schizophrenia is what affects this person the most, but it’s actually well controlled by medication.  The anxiety is a daily struggle though.

A fellow child of a hoarder talks about her post-traumatic stress disorder and dysthymic disorder on her blog Hoarding Child. I didn’t even know what dysthymic disorder was until she shared it with me through Twitter.  A day later, another friend confided she also dealt with it.  I had no idea.  I respect the trust these people put in me.  If they couldn’t trust at least one person with this, would they feel alone?  Be a person other people can trust to tell, and together we’ll stop the stigma.

My Mom

My Mom has a laundry list of health problems, mental and physical.  I suspect they’re all related, and feed the compulsive hoarding.  How could one possibly deal with chronic pain for over 20 years without depression, post-traumatic stress, and other complications?  I remember one of the lows Mom went through when I was in my early Twenties.  She leaned heavy on the table, head in hands weeping.  I wrapped my arms around her without a clue of any other way of helping.  She told me she wished someone would drag her out to the field and just shoot her.

We weren’t exactly sympathetic back then either.  “Chin up.  Don’t let yourself get in a funk.”  What did we know?  I was talking about this very memory with my Mom last night.  And you know what?  She doesn’t ever remember saying that…she insists she was never so low she wished to die.  But I tell ya…that’s not something I’d dare make up, and I’m certain my ears work perfectly.  She’s either in denial (no surprise there), or her memory has gotten foggy in the last 20 years.

So there.  That’s 5 people within my inner circle who are dealing with mental illness; they’re just the first ones I thought of.  I know there are others, and I’m ok with that.  They’re not raving lunatics brandishing axes, nor are they speaking in tongues.  They’re not standing on street corners preaching about the end of the world.  They’re not homeless, own excessive amounts of cats, and I’ve never seen them go “postal.” (there’s a stigma that’s gotta go)

They’re just people dealing with a wicked twist of fate.  Imbalanced chemicals in their brains and suddenly everything changes.  No one asks for it.  No one deserves it.  Maybe it’ll be me next time.  I’m lucky to have a support system to help me.  My husband, Will, is rock solid.  I hope he knows I’ve got his back, too.

You’re Not Alone

Whatever you’re feeling, please know you’re not alone.  People love you, even people who don’t know you.  The young girl I know who commit suicide last week will never know how the community pulled together to support her family and friends.  When the mommy community in my town learned of this girls death, they immediately began an outpouring of concern and unbiased support.  People who’d never met the girl, or her family, stepped up to provide food, money, and even clothes for the parents to wear to the funeral.  Friends set up RIP Facebook pages with fond memories, smiling photos, and declarations of admiration.  There’s no mistaking this girl was deeply loved.  And she didn’t realize it when she needed it most.

What can we do?

Good question.  What can we do?  We need to be open-hearted for others to talk to us.  We need to listen when friends share their struggles with us.  Reserve your judgment and criticism, and show compassion instead.  We need to talk for ourselves when others are willing to listen.  As fellow citizens of Mankind, we all need to be supportive of one another.  When many carry the weight of a few, the weight is suddenly more manageable.  Do your best to avoid adding more weight with tasteless jokes and sweeping generalizations.  As individuals, we don’t need to have all the answers, but we DO need to persist when we have unanswered questions.

National Standard of Canada for Psychological Health and Safety in the Workplace

Very recently, a new voluntary standard has been released to give employers a guideline for promoting employees’ psychological health and preventing psychological harm due to workplace factors.  Brilliant!  It’s about time we started giving mental health as much attention as physical health.  They so often go hand in hand.  Bell Canada has shown its commitment to this initiative by including mental health training for all Bell managers, and implementing a return to work program for employees affected by mental illness.  Let’s see how many other corporations bring this on board.  Watch for activity on Twitter with #Bell_LetsTalk (Bell Let’s Talk Day). Using social media, Bell hopes to raise money, but more importantly, awareness for mental health research.

Bell Canada Let's Talk Logo

Continue the Conversation, Stop the Stigma of Mental Illness

This is an on-going story.  It’s being written every day, and you’re a supportive character.  And maybe, some days, you’ve a lead role.  I don’t know how the plot might twist and surprise us as we go, but there’s always hope for a happy ending.


Thanks to the Kings College London Institute of Psychiatry (the same people doing the Hoarding Study I recently participated in), I’ve learned compulsive hoarding is likely to be included as a new mental disorder in the Diagnostic and Statistical Manual for Mental Disorders or DSM-5. DSM-5 is due to be published in 2013.  I’m hoping this means more research and attention being devoted to treating compulsive hoarding.  I also hope it means less people thinking hoarders are just lazy deadbeats who just need to throw a garage sale.  There’s something about this being made “official” that gives me some hope.

Below are the proposed diagnostic criteria for Hoarding Disorder. All criteria A-F must be met to qualify for the diagnosis.

A. Persistent difficulty discarding or parting with possessions, regardless of their actual value.

B. This difficulty is due to a perceived need to save the items and distress associated with discarding them.

C. The symptoms result in the accumulation of possessions that congest and clutter active living areas and substantially compromise their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, authorities).

D. The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment for self and others).

E. The hoarding is not attributable to another medical condition (e.g., brain injury, cerebrovascular disease, Prader-Willi Syndrome).

F. The hoarding is not better accounted for by the symptoms of another DSM-5 disorder (e.g., hoarding due to obsessions in Obsessive-Compulsive Disorder, decreased energy in Major Depressive Disorder, delusions in Schizophrenia or another Psychotic Disorder, cognitive deficits in Dementia, restricted interests in Autism Spectrum Disorder).

For people meeting all diagnostic criteria A-F, the following ‘specifiers’ can be noted as well:

Specify if:

With Excessive AcquisitionIf symptoms are accompanied by excessive collecting or buying or stealing of items that are not needed or for which there is no available space.

Indicate whether hoarding beliefs and behaviors are currently characterized by:

Good or fair insight: The individual recognizes that hoarding-related beliefs and behaviors (pertaining to difficulty discarding items, clutter, or excessive acquisition) are problematic.

Poor insightThe individual is mostly convinced that hoarding-related beliefs and behaviors (pertaining to difficulty discarding items, clutter, or excessive acquisition) are not problematic despite evidence to the contrary.

*I believe this is where my Mother is, leaning towards Absent insight.

Absent insight (i.e. delusional beliefs about hoarding): The individual is completely convinced that hoarding-related beliefs and behaviors (pertaining to difficulty discarding items, clutter, or excessive acquisition) are not problematic despite evidence to the contrary.

You can find more information in the DSM-5 website.