Hoarding behaviors are associated with many mental health conditions, including depression. Seeking treatment for hoarding can help you cope.

If you have sentimental attachments to items and have difficulty letting go of things, you may be experiencing hoarding behaviors. Hoarding can lead to a cluttered home and problems living in your space as you intended.

These behaviors can cause significant embarrassment and shame. As a result, you may not want to let people into your space due to fear of judgment.

Hoarding is associated with many other mental health conditions. One of the most prevalent associations with hoarding behavior is its link with depression.

Hoarding is when a person has difficulty discarding items or acquires large amounts of possessions.

According to the American Psychiatric Association, around 2.6% of people meet the criteria for hoarding disorder. The rates are higher in people ages 60 and over, and people with other mental health conditions — particularly anxiety and depression.

Research from 2011 reported that over 50% of people with hoarding disorder had received a diagnosis of depression.

And a 2019 study indicates that hoarding disorder shows elevated rates of comorbidity with mood disorders and anxiety disorders.

Signs of hoarding include:

  • having trouble getting rid of possessions even if they aren’t valuable
  • saving items because of potential needs in the future
  • distress associated with throwing away items
  • cluttered areas in the home
  • congested living areas in homes that block their intended use
  • uncluttered areas being a result of third-party intervention

Hoarding behavior and hoarding disorder can cause difficulty in social or occupational domains. Your relationships may be impacted by hoarding behavior. To receive a diagnosis of hoarding disorder, the symptoms cannot be caused by another mental health disorder or medical condition.

Additionally, because depression can cause a lack of motivation and increased fatigue, living in an uncluttered space can be more challenging.

Hoarding is associated with many other mental health conditions outside of depression.

A 2021 study found that hoarding is associated with conditions such as:

Additionally, a 2019 study found that experiencing trauma was associated with hoarding behaviors.

There are many potential causes of hoarding behavior:

Genetics

Genetics may influence hoarding behavior.

For example, a 2015 study of 71 older adults that evaluated hoarding disorder found that approximately half of the participants reported that their mother had hoarding tendencies, while a quarter of participants reported that their father had hoarding tendencies.

The same study found that the participants reported, on average, two biological relatives with hoarding disorder. The research suggests there may be a genetic component to the development of hoarding behaviors.

Medical conditions

Many medical conditions are associated with hoarding behavior.

Damage to the brain’s frontal cortex can lead to hoarding behavior. For example, a case study of a 42-year-old person found that hoarding behaviors developed after a brain hemorrhage at age 19.

Other research that discusses numerous case studies about traumatic brain injury (TBI) and hoarding also supports the notion that collecting and saving items may occur due to damage to the brain’s prefrontal cortex.

Research indicates that hoarding and collecting items is also associated with a rare genetic disorder known as Prader-Willi syndrome.

Emotional factors

There are several emotional factors associated with hoarding disorder.

A 2018 study of 122 participants compared deficits in emotion regulation between individuals diagnosed with hoarding disorder and a control group. The findings from this study suggest that those with hoarding disorder have greater difficulty implementing emotional regulation strategies.

The hoarding disorder participants specifically reported troubles in these areas:

  • lack of clarity regarding emotions
  • trouble managing their behavior when distressed
  • difficulty engaging in goal-directed thoughts and behaviors
  • trouble implementing strategies to feel better when overwhelmed or experiencing distress
  • trouble accepting emotions and emotional responses

This research indicates that emotion regulation may play a role in hoarding disorder.

Experiences of loss and deprivation

Many people with hoarding disorder report experiences of loss and deprivation.

A 2021 study of 117 individuals on stressful and traumatic events among individuals with hoarding problems highlights this connection.

The researchers found that events that involved deprivation or loss were related to the person’s emotional attachment to objects.

If you have difficulties with hoarding and depression, treatment options are available.

If you have a loved one or know someone who needs help with hoarding and depression, getting them on board for treatment may be challenging. Many individuals with hoarding disorder have challenges accepting the trouble hoarding has caused them.

If you have problematic hoarding behaviors, it may be difficult to accept help because you may experience emotions such as guilt, shame, or embarrassment. However, it’s okay to ask for help, and there are ways of improving your quality of life.

Treatment options for hoarding

Treatment options for hoarding are a growing area of research; however, there are some methods of treatment that have reduced hoarding symptoms.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) helps individuals address beliefs that drive hoarding behavior in addition to helping reduce clutter.

A 2016 study examined the effectiveness of a psychologist-led CBT group and a peer-led group that used exercises in the workbook “Buried in Treasure” and found a 22% improvement overall in hoarding behaviors.

The participants had reported problematic hoarding behaviors. The most noticeable improvement they found in the study was a change in the hoarding severity scale scores.

Additionally, a 2019 study that examined the effects of 16-weekly CBT sessions on individuals with hoarding disorder found changes in individuals’ self-reported impulsive behaviors.

CBT is frequently cited in the literature as a standard treatment for improving hoarding behaviors.

Cognitive rehabilitation and exposure/sorting therapy

Cognitive rehabilitation and exposure/sorting therapy (CREST) is a cognitive therapy that helps individuals work on their executive functioning. It also uses exposure techniques to help people with problematic hoarding behaviors deal with distress surrounding letting go of objects and not acquiring new ones.

A 2018 study compared the treatment effects of CREST to a case management group and found a 38% decrease in hoarding symptoms among those in the CREST group. The individuals in the case management group reported a 25% decrease in symptoms. Both groups reported sustained treatment effects after 6 months.

Medication

No specific medications are used to treat hoarding, as more research is needed in this area. One 2014 study of a small sample of 24 participants found some effectiveness of extended-release venlafaxine in the treatment of hoarding. Currently, there are no FDA-approved medications for the treatment of hoarding.

Treatment options for depression

It is also important to seek treatment if you are experiencing depression in conjunction with hoarding. Treatments for depression involve both medication and psychotherapy.

If you think medication might help, a mental health professional may prescribe you antidepressants. To get started on antidepressants, it may be a good idea to speak openly and honestly to your healthcare professional about your history and current symptoms. They can answer questions and help you find the best options for you.

Psychotherapy for depression may include:

Looking for a therapist, but not sure where to start? Psych Central’s How to Find Mental Health Support resource can help.

If depression and hoarding are causing significant problems, or you are overwhelmed by mental health concerns, treatment is the first step in finding relief.

You can find a licensed mental health professional that specializes in hoarding treatment or find a therapist near you that provides therapy useful for treating hoarding disorder.

You can find additional support for hoarding and depression by checking out these resources:

Additionally, Hoarding Cleanup offers a nationwide directory of professionals trained in hoarding behaviors, such as:

  • therapists
  • psychiatrists
  • cleaners

Remember, you aren’t alone. While the first step may feel scary, it’s often worth it.