Treatment for hoarding disorder

If you feel distressed by hoarding, you might want to consider seeking treatment.

A growing number of mental health professionals are aware of hoarding disorder. They should know that they need to help you take things at your own pace. And they shouldn't pressure you to make changes faster than you want to.

There are a variety of therapies that have together helped to support me and more importantly, allow me to understand why and how I became a hoarder, so I am able to change my responses.

Talking to your GP

The first step when seeking help is usually to visit your GP.

If they think you're experiencing hoarding disorder, they might refer you to a psychiatrist or other mental health professional. They will assess you. And they might look into whether there are any other health problems related to your hoarding.

The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in healthcare – hasn't issued treatment guidelines for hoarding disorder. But the guidelines for treating OCD mention hoarding because OCD and hoarding used to be grouped together.

These guidelines advise that:

• You should be offered evidence-based treatments, such as cognitive behavioural therapy (CBT).
• Healthcare professionals should consider offering you treatment in your home. Some people find this helpful.
• If you can't attend appointments or have visitors, your doctor should also consider treatment over the phone.

For more information about talking to your GP, see our pages on seeking help for a mental health problem.

Tools to help you talk to your GP

There are also some tools to help you start a conversation about hoarding disorder with your doctor.

Hoarding icebreaker tools

Filling in a hoarding icebreaker form could help you to talk to your GP. You can download a copy from the website Rainbow Red. It can help you explain how hoarding affects you.

Clutter Image Rating tool

Using this tool involves looking at pictures and choosing which ones most closely match your situation.

You can download a clutter image rating from Hoarding Disorders UK. You may also be able to find a free app by searching your app store for 'Clutter Image Rating'.

Not everyone finds the Clutter Image Rating tool useful and that's ok. It might not properly reflect the size or type of place you live in, for example if you live in a caravan. You might also have some other symptoms of hoarding disorder but not yet have a home that is very cluttered.

Talking therapies for hoarding disorder

The main talking therapy used to treat hoarding disorder is cognitive behavioural therapy (CBT). This focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour.

Evidence suggests that both individual and group CBT can help. It also suggests they're more likely to help if you follow a programme designed for hoarding disorder – rather than OCD, for example.

Hoarding-specific treatments are improving as researchers learn more about what can help.

Together with your therapist, you might:

• Examine your beliefs about needing to keep things
• Try to understand why it's hard for you to get rid of things
• Learn skills to help you cope with difficult feelings

Other types of talking therapy may also help you. But experts need more research to find out what could work best.

For more information, see our guides to talking therapy and counselling and cognitive behavioural therapy (CBT).

Therapy in the place you live

Some research suggests that it can help if your therapist visits you in the place you live. This way they can understand more about your situation and help you work out how to make changes.

Some people also find it helps to have treatment in a familiar environment.

As part of the course, we were also each given a 'declutter buddy'. Initially, the idea of someone coming into my home filled me with terror and dread, but as soon as my buddy, Ebi, arrived I felt calm and safe. Ebi helped me on a practical level as well as an emotional level.

Long-term therapy

You might need a long-term CBT approach to help manage your hoarding disorder. It can take a long time to feel comfortable and take steps to address your hoarding. But unfortunately, in most regions the NHS only offers short-term or medium-term therapy.

You may need to be very persistent to get the right help from the NHS. Or you may need to consider other ways to access treatment. An advocate may be able to help you. For more information, see our pages on advocacy and mental health.

If you can afford it, you can also seek private therapy outside the NHS. You can search for therapists who specialise in hoarding disorder through the:

• UK Council for Psychotherapy (UKCP)
• British Association for Counselling and Psychotherapy (BACP)

Medication for hoarding disorder

If you're diagnosed with hoarding disorder, doctors may offer you an antidepressant medicine. These types of antidepressant are called selective serotonin reuptake inhibitors (SSRIs).

You might also be offered medication if you're experiencing symptoms of another mental health problem alongside hoarding.

To be honest my recovery probably would not have started without medication. The anxiety and depression needed to be sorted out a bit before the house could even start to be sorted.