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Family Living Focus: When Hoarding is a Disorder

The Journal

Oct 19, 2019 by Gail Gilman  

You may have seen reality TV shows about people who hoard mail, gadgets, cats, and even trash. Or, maybe for you, the reality is a little closer. It could be a neighbor or a family member.


When people aren’t able to throw things away, piles can grow to the ceiling. These piles can make it impossible to use bathrooms, bedrooms, and kitchens.


The piles may fall over, trap, and injure people. They can catch on fire. Cluttered homes and yards may attract pests. Neighbors may call the police. Parents may lose custody of children.


People don’t choose to be hoarders. And they aren’t being sloppy or lazy. “This is a very real mental disorder,” says hoarding disorder expert Dr. David F. Tolin of Hartford Hospital’s Institute of Living. “It is important to recognize that people with hoarding disorder have lost control of their decision-making abilities.”

Tolin’s research suggests why it’s hard for people with this disorder to part with items, even things with no real-world value. He found that brain activity was different between people with hoarding disorder and healthy people.


“We’re always puzzled by the fact that many people with hoarding disorder often don’t seem terribly bothered by their circumstance,” he says. “If they don’t have to make a decision, the parts of their brain that are largely in charge of becoming bothered are underactive.”


If they are forced to decide about whether to discard something, that part of the brain becomes overactive. “And so, the brain is essentially screaming that everything is important.”


Doctors don’t know what causes hoarding disorder. There’s no X-ray or blood test for a diagnosis. Instead, doctors assess how well people are functioning in their lives.

Hoarding disorder can start during a person’s teens or later. It may grow more severe over the decades.


Try not to start an argument. “If a person is not really motivated to do something about the problem, they can dig in their heels. Arguing can even make the problem worse,” Tolin warns.


There’s no effective medication for hoarding disorder, although studies are in progress. Tolin says, “Right now, cognitive behavioral therapy is the only evidence-based treatment we have for hoarding.” This is a type of talk therapy that teaches people how to change their thinking patterns and react differently to situations.


Tolin’s team hopes to improve cognitive behavioral therapy so that it’s even better at helping people to discard items. They’re analyzing the brain activities of people before and after they’re successfully treated for hoarding disorder. If the research team can identify the biological mechanisms of successful treatments, they may be able to develop treatments that are even better.


Some people with hoarding disorder are helped by joining a support group with others who have the disorder. There are also organizing professionals who specialize in helping people get rid of clutter.


How to Help a Person Who Hoards


Explain why you’re concerned:


“I’m worried that you could fall or become trapped.”

“I’m concerned that you may lose custody of your children.”

“I’m afraid your home will catch on fire.”

Then say how to get help:

“I can help you find a therapist who specializes in hoarding.”

“We can look for a self-help program on how to let things go.”

“We can find support groups for people who hoard.”

“We can ask the county for resources.”


Information adapted from article by National Institute of Mental Health, in the Caregiver Newsletter 2-8-18.

If you or your family member has progressed to the point that cleanup is a possibility, you may begin to feel overwhelmed and unsure of where to begin. Cleaning out a hoarder's home is difficult and, in some, cases it can even be dangerous.


It is best to hire professional help for a hoarding cleanup. Bio-One Raleigh and Raleigh Hoarding is a trusted Triangle hoarding cleanup specialist services Raleigh, Durham, Chapel Hill, Wake Forest, Cary, Apex, Pittsboro, Holly Springs, Fuquay-Varina, Fayetteville and the entire surrounding areas.


Our compassionate, professional team has helped people reclaim their homes from this condition. We don't just show up with shovels and dumpsters and start emptying the home. We work closely with the homeowner and family. The Bio-One Raleigh team is committed to making our clients feel safe and comfortable throughout the process.


Trust the hoarding cleanup to professionals.


Contact Bio-One Raleigh today at 919.800.9435 or


Karen & Rick Jacobs are the owners of Bio-One Raleigh and Raleigh Hoarding. We offer trauma, mold and hoarding cleanup services including biohazard, blood cleanup, suicide/homicide, feces & bodily fluid, animal waste, undiscovered death, and mold testing & remediation.


We proudly serve North Carolina’s Triangle and surrounding areas including Raleigh, Durham, Chapel Hill, Cary, Apex, Pittsboro, Holly Springs, Clayton, Carrboro, Fuquay-Varina, Garner, Hillsborough, Mebane, Morrisville, Wake Forest, and Wendell; as well as the following counties; Wake County, Durham County, Cumberland County, Guilford County, Orange County, Chatham County, Harnett County, Johnston County, Nash County, Franklin County and Pill County. We also provide services to Greensboro and other areas throughout North Carolina.


Bio-One Inc. is the world's first crime scene cleaning franchise. Nationally respected and locally owned, Bio-One has earned its reputation through being trusted to handle the Mandalay Bay mass shooting in Las Vegas in 2017, the Pulse nightclub shooting in Florida in 2016, and consulted on the Sandy Hook Elementary School massacre in 2012. In 2019, Bio-One was once again included in the best and most comprehensive franchise ranking list – Entrepreneur Magazine.