Living with a Hoarder: How to Help Hoarding Behavior

Hoarding can feel overwhelming for the person experiencing it and for the Caregiver.

Many wonder whether recovery is possible and what meaningful support actually looks like. But can hoarders recover? How do you help someone who is a hoarder? In this post, we’ll review the following:

• Levels of hoarding
• Reasons for hoarding
• The intersection between hoarding and mental illness
• How to live with a hoarder
• Providing help for hoarders

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Are There Stages of Hoarding?

Before we get into topics such as how to help hoarding or living with a hoarder, let’s try to understand the levels of hoarding. These levels include:

• Level 1: Light clutter with a fully accessible, clean home; early signs include difficulty discarding items and mild excessive acquiring.
• Level 2: Mild hoarding disorder with noticeable clutter with at least one unusable area, mild odors, minor repairs needed, and emerging withdrawal or hygiene neglect.
• Level 3: Clutter throughout most of the home, multiple unusable rooms, strong odors or pests, declining hygiene, and growing social/relationship impacts.
• Level 4: Severe clutter making most rooms unusable, structural or utility issues, major health hazards (mold, pests), and significant personal and social deterioration.
• Level 5: Extreme hoarding with unsafe, unsanitary conditions, severe infestations, serious health and safety risks, and potential legal or housing consequences.

Soon, we will take a look at providing help for a hoarder but let’s review the causes of hoarding first.

What Mental Disorder Causes Hoarding?

Hoarding disorder often overlaps with other conditions. This connection between mental illness and hoarding behavior helps explain why symptoms can be intense and why anxiety associated with an adult hoarder is so common.

Mental health conditions commonly linked to hoarding include:

• OCD and OCPD
• ADHD
• Depression

These conditions can worsen anxiety and hoarding by affecting decision-making, tolerance for uncertainty, emotional regulation, and organization.

Common cognitive challenges seen in hoarding disorder include:

• Difficulty with planning and organization
• Problems with sustained attention
• Trouble with working memory and problem-solving
• Indecisiveness, procrastination, and perfectionism

Additional risk factors:

• Family history of hoarding disorder
• Traumatic or stressful life events
• Brain injury
• Impulsive buying or collecting free items
• Substance use disorder
• Certain genetic conditions (e.g., Prader-Willi syndrome)

Next, let’s review the causes of hoarding. 

What Causes Hoarding in Adults?

The exact cause isn’t known, but hoarding in adults typically develops from a mix of emotional, cognitive, and environmental factors, especially anxiety, which makes discarding items feel unsafe or overwhelming.

Common symptoms that drive hoarding behavior include:

• Strong urge to save possessions
• Extreme stress when trying to discard items
• Anxiety about needing items in the future
• Distrust of others touching their belongings
• Living spaces becoming unusable due to clutter
• Social withdrawal

Adults may hoard because they believe:

• An item will be useful or valuable later
• It has sentimental or irreplaceable meaning
• It was a bargain
• It helps them remember important people or events
• They “can’t decide,” so keeping it feels safer than discarding it

In many cases, hoarding becomes an emotional coping strategy to manage anxiety, loss, or a sense of lacking control. Next up, let’s take a look at how to deal with a hoarder family member.

How Do You Cope Living with a Hoarder?

Living with a hoarder can be cumbersome but you can cope by taking the following actions:

• Communicate with “I” statements instead of blame. Use phrases like “I feel overwhelmed by the clutter” — this keeps conversations calm and constructive.
• Recognize hoarding as a mental-health issue, not laziness. Understanding that hoarding often stems from anxiety, emotional attachment, or disorders like OCD can help you stay empathetic rather than resentful.
• Declutter one small area at a time. Tackle a drawer, shelf, or corner for 20–30 minutes a day — small wins add up without overwhelming either of you.
• Reserve a clutter-free zone for yourself. Maintain at least one room or space (e.g. a bedroom) as off-limits to hoarded items to preserve your mental comfort and personal boundaries.
• Encourage professional help and self-care. Suggest therapy for the hoarder, and seek support or counseling for yourself — coping with hoarding can take a mental and emotional toll.

Finally, let’s review how to help hoarders.

How Do You Get Help for a Hoarder?

There are several resources to help hoarders. These include:

• Hoarding Cleanup (800-462-7337). Provides a national directory of fee-for-service cleanup teams and mental-health providers specializing in hoarding; website includes webinars and additional resources.
• International OCD Foundation (IOCDF). Offers education for families and professionals and provides a directory of therapists, clinics, treatment programs, and support groups.
• National Association of Productivity & Organizing Professionals (NAPO). Offers a directory of fee-for-service organizers trained to work with individuals with hoarding disorder.
• Psychology Today. Features a “Find a Hoarding Therapist” tool to locate clinicians experienced in treating hoarding disorder.

To learn about our home care services, contact our caregiving team today at 1-800-GRISWOLD or find a Caregiver near you.