The Difficulty in Treating Compulsive Hoarding
The first step in treating OCD hoarding (also known as compulsive hoarding) is getting the person with OCD to recognize the problem. Unfortunately, this is often difficult or impossible. Many people who hoard maintain that they collect newspapers because they "plan to read them some day" or that they refuse to throw out their children’s old clothes because "I might have another child and need all the hand-me-downs." They do not see the downsides of hoarding, such as the inability to walk through their homes because of the accumulated junk, or even the dangers of hoarding, such as the fire evacuation risks and the likelihood of accidents.
In addition, many people with OCD who hoard also have a higher incidence of anxiety, depression, and social dysfunction. These co-occurring disorders can prevent hoarders from getting the help that they need. They also can create a blockage or barrier that must be dealt with before their hoarding tendencies can be addressed.
Hoarders may benefit from cognitive behavior therapy (CBT). A typical CBT course consists of six sessions, but research shows that using traditional CBT methods over this period of time is unhelpful in curing hoarding tendencies. Instead, twenty five sessions are recommended, and these sessions should be spread out over six months or a year for optimum efficacy.
Therapists can help people who hoard by helping them recognize why they hoard, explore alternatives to hoarding, teaching them basic organizing and decision-making skills, and helping them to emotionally manage changing habits that may have been developing for decades.
Support Groups for OCD Hoarding
Support groups can also be effective in treating OCD hoarding. Members of a support group can give each other encouragement and set goals that relate to their hoarding habits. Even having a buddy who has hoarded before can make it easier. Support groups are available both in person and over the internet.
Removing Hoarded Material
Well-meaning friends and family often dream of simply taking all of the hoarded materials and throwing them out while the person with OCD is away. As tempting as that may seem, it rarely works as easily as you might think. OCD hoarders will simply rush to restock their hoarded materials as quickly as possible. The relationship between the hoarder and whoever disposed of the material will be strained or broken entirely. This technique is little more than a short-term fix, and it does not work unless the hoarder is undergoing other treatments to prevent the reaccumulation of all of the junk.
If other methods don’t work, people with OCD hoarding tendencies may decide to use medicines. SSRIs, or Selective Serotonin Reuptake Inhibitors, have the fewest side effects, and may work for those whose hoarding habits are not so excessive. Those who rate stronger on the hoarding scale, however, may need to use stronger drugs. Options include a tricyclic antidepressant called clomipramine (Anafranil) and a serotonin norepinephrine reuptake inhibitor (SRRI) called venlafaxine (Effexor). Both of these are often more effective than the SSRIs, but they may have some side effects.