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• Difficulty parting with items, even those with little or no practical value

• Strong emotional distress at the thought of discarding possessions

• Accumulation of items that makes rooms difficult or impossible to use as intended

• Acquiring new items even when there is no space or need for them

• Clutter that affects relationships, work, or daily functioning

• Feelings of shame, embarrassment, or isolation related to the home

Hoarding disorder is not laziness. It is not a choice. People with hoarding disorder often have deep insight into their situation but feel powerless to change without the right support.

Individuals who struggle with disorganization are not always hoarding. Same holds true for collectors; consult an expert to be sure.

Hoarding disorder affects people of all ages, cultural backgrounds, and income levels. Research suggests it is equally common in men and women, though it tends to be more severe in older adults. It often begins in adolescence or early adulthood and may worsen over time without intervention.

It is estimated that as many as 6% of the general population worldwide are directly affected by hoarding disorder.

But, hoarding disorder doesn't only affect the individual — it can impact family members, neighbors, landlords, and first responders. Family relationships often suffer. Housing stability can be threatened. In some cases, hoarding creates fire hazards, pest infestations, or other conditions that affect entire buildings or communities. description

Some guidelines that tend to help:

• Lead with compassion, not criticism; shame makes hoarding worse

• Focus on the relationship, not the stuff

• Ask how they are feeling, not just what they are going to do about the clutter

• Celebrate small victories. Even a single cleared pathway matters

• Avoid ultimatums or threats when possible; they rarely produce lasting change

• Ask permission before touching or moving anything in their space

What NOT to Do: well-meaning family members sometimes take actions that backfire:

• Forced cleanouts are traumatic to the person and often worsen the disorder

• Secretly discarding items destroys trust and can set back progress significantly

• Expressing disgust or judgment increases shame and isolation

When Safety Is a Concern: If you believe your loved one is in immediate danger; due to fire hazards, inability to care for themselves, or a medical emergency; contact your local Adult Protective Services or Emergency Services.

If the situation is urgent but not an emergency, the Hoarding Alliance of Long Island may be able to provide other local resources. You can email us at: hello@ha-li.org and someone will reply within 48 hours.

Disorganization is common and manageable. Hoarding disorder involves significant emotional distress around discarding items, acquiring behavior that continues even without space, and clutter that genuinely impairs the use of living space. It is the distress and impairment; not just the clutter level ; that distinguishes hoarding disorder from disorganization.

Yes. Cognitive Behavioral Therapy (CBT) is the most evidence-based treatment. Peer support programs and workshops have also shown effectiveness. Recovery is possible, though it often takes time and a committed support team.

This is one of the most common difficult questions families and professionals face. Hoarding disorder can't be resolved through forced cleaning or ultimatums. The most effective path is patient relationship-building, harm reduction, and connecting the person to support when they are ready. We can help you think through your options. Email us at hello@ha-li.org

This is a legally nuanced area that varies by jurisdiction. Generally speaking, landlords have obligations around habitability and safety, but also obligations around fair housing when a mental health condition is involved. We recommend consulting with a housing attorney.

We maintain a list of local therapists and clinicians with experience in hoarding disorder. You can also search Psychology Today and search by location and insurance.

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