The frantic pace, family gatherings, and gift giving around the holiday season has the potential to leave just about anyone feeling overwhelmed and stressed, but for someone struggling with a hoarding disorder, it can be a particularly stressful time. David Prescott, PhD, psychologist at Northern Light Acadia Hospital, shares more about this commonly misunderstood disorder and how we can best support someone with a hoarding diagnosis who may be having trouble this time a year:
Q: Why can the holidays be a difficult time for someone with a hoarding disorder?
A: A hoarding disorder is a diagnosable mental health disorder that includes extreme difficulty in letting go of material possessions, excessive acquisition of new items, and high levels of disorganization particularly when dealing with the clutter. The holiday season can present unique challenges for people with a hoarding disorder. First, and perhaps most obvious, holiday decorations and gifts can quickly add to the clutter. Second, organizing holiday decorations amidst the clutter can be difficult, recalling that people with hoarding disorder usually struggle with organization. Third, the holidays may include more social interaction (people wanting to stop by) which can create unwanted attention or criticism.
Q: Is someone with a hoarding disorder likely to decline an invite to a gathering and can this lead to isolation and depression?
A: We think about half of the people with hoarding disorder have significant depression, where feelings of isolation and loneliness are symptoms. When we feel isolated and lonely, it becomes easy to tell ourselves that “nobody really wants me there” or, “it is too much work to go to a party” which reinforces those feelings. It becomes a self-perpetuating cycle. In treatment, we often ask clients to challenge these thoughts as they are probably not really true!
Q: Instead of pushing someone who might be reluctant to attend a gathering, is there something else someone can do to help them feel included?
A: In general, people who feel isolated, overwhelmed, and depressed, tell me in counseling how much they appreciate people who reach out. Whether you send a card, drop off a gift, leave a phone message, or make some effort to connect, people notice. Even when a person who is feeling isolated struggles to show their appreciation, the gesture matters. If you know of someone who might have hoarding disorder, depression, or just seem to be withdrawn, small acts of kindness and giving go a long way.
Q: Is there advice to support someone who may have difficulty with overbuying or gift giving?
A: For people with hoarding disorder, shopping or going out to buy one thing also creates an opportunity to add to the clutter. Therapists who treat hoarding disorder often focus on creating a shopping plan that is very specific. The idea is to think through the whole shopping trip before you go, and then just stick to the plan. During the calm of advanced planning, you can also start to break some of the automatic thoughts that lead to buying items that add to the clutter.
Q: Any recommended strategies to cope with the overwhelming feeling of holiday clutter?
A: Feeling burdened by holiday clutter seems like a universal feeling. I often start by encouraging people not to criticize themselves for feeling overwhelmed. Sometimes it works to just ride out the momentary wave of feeling overwhelmed by waiting a minute and taking a breath. After that, it helps to remember that you are in control of your clutter. When you look at the stuff around you, remember that you have lots of options. You can keep it, throw it out, give it away, or not decide in the moment. Just make your best decision about it for today. Afterwards, pick a system that works for you and follow it. For example, make a rule for the day, such as “I’m going to donate at least 10 things” or “I’m going to throw out all the broken things.” We spend less emotional energy when we have a system that we follow, rather than making up new rules and guidelines for each item.
Q: What other advice is there for someone who is trying to support a friend or loved one with a hoarding disorder?
A: For those of us trying to help others, realize that taking a few steps in the direction of reducing clutter may be a better place to start than dealing with the whole thing. In addition, try not to confuse decluttering with changing someone’s personality. Changing the basic personality traits of a person with hoarding disorder is difficult to do. Start off by reducing the impact, slowing down accumulation of additional clutter, or helping a person part with some of the things rather than all of them. It may be more realistic to manage the disorder rather than setting a goal of making it totally go away.
Lastly, it’s important to remember that working through a mental condition takes time and patience. It’s unrealistic to expect change overnight. However, positive changes can happen by selecting a few small positive steps forward to accomplish and then progressively building upon these achievements.
If you or someone you know is dealing with a hoarding disorder, help is available. Visit northernlighthealth.org/Services/Behavioral-Health for counseling, psychology services, and additional resources to help you live your best life.