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ADHD And Hoarding – Is There A Link?

There are some similarities between people diagnosed with ADHD and hoarders. But when does it go beyond ADHD clutter and become hoarding disorder?
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ADHD And Hoarding – Is There A Link?

21/09/2022
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Initially, it would appear that there are some similarities between people diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and Hoarding Disorder. ADHD can make it challenging to keep an organised and tidy home. Hoarders’ homes are excessively and sometimes dangerously cluttered. According to a recent UK study, 1 in 5 adults with ADHD exhibit hoarding symptoms. So when does it go beyond clutter that is exacerbated by ADHD to become a hoarding disorder?

About Hoarding Disorder

Hoarding disorder occurs when someone collates an excessive number of possessions that they simply cannot part with. Their homes become overwhelmed and their quality of life is impaired due to all the clutter. Items may have little or no monetary value but a hoarder will attach importance to them that other people find hard to understand. It is an accepted psychiatric diagnosis that can cause danger to life if ignored.

Hoarding disorder used to be classified as a form of OCD, until it was recognised in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013 as a condition in its own right. Hoarding has hit the media in the last few years and scenes from hoarders’ homes are often shocking.

Dr Frost describes three primary criteria for hoarding disorder:

  1. The persistent need to save items
  2. Distress is associated with being parted from items. There is always a reason why someone saves something.
  3. A home becomes cluttered to the point where the home and the items in it can no longer be used for their intended purposes.

It’s important to understand that a person who is simply untidy and has a lot of possessions is not a hoarder. Dr Frost describes three main manifestations of hoarding disorder:

  • Excessive acquisition
    Hoarders acquire most of their possessions by buying them or being given them. A small minority may also steal them as the motivation to acquire them is so powerful.
  • Compulsive saving
    Hoarders save the same things as non-hoarders, just more of them. They form strong attachments to their possessions and find it difficult to part with them. There are three types of attachments:
    Sentimental – Objects evoke memories and form part of an individual’s identity.
    Instrumental – Objects are considered to be useful or potentially useful.
    Intrinsic – Someone appreciates qualities in items others would regard as disposable.
  • Disorganisation
    A hoarder may attempt to organise their possessions but ends up just ‘churning’. This is when they go through items looking at them but just put them back as they are unable to part with them or put them anywhere else. A hoarder may fear having possessions that are out of sight. An example of this is when someone prefers to keep clothes on top of drawers instead of in them.

Hoarding Disorder and ADHD

According to Dr Rodriguez, ADHD is highly comorbid with hoarding disorder, with up to 30% of hoarders also having ADHD. There are certainly some commonalities between ADHD and hoarding disorder. Underlying issues with executive functions, in particular attention and decision-making, are linked to both ADHD and hoarding. An accurate diagnosis is essential to determine if hoarding behaviours are attributed to hoarding disorder or some of the overlapping features of ADHD.

A key difference between ADHD and hoarding disorder is the reason why people have so many possessions. A person with symptoms of ADHD may be untidy or live in a cluttered home because they are unable to organise their things whereas a hoarder will have a specific reason why they can’t let go of something they own.

Treating Hoarding Disorder

It’s important to uncover the cause of the hoarding and adapt the treatment to address the cause. A higher proportion of hoarders have experienced trauma than people with other related conditions such as OCD. As someone begins to declutter it can unmask their trauma symptoms. A hoard that takes years to accumulate is not going to go away quickly and a hoarder requires a great deal of support as they recover.

Cognitive Behavioural Therapy (CBT) is a highly effective treatment for both hoarding disorder and ADHD as well as other mental health conditions. It helps to process emotions such as negative thought patterns that drive hoarding. It can also help people to adjust their behaviour and reduce their ADHD symptoms.

Motivational Enhancement Therapy also works well as a treatment for hoarding. This counselling approach involves working with hoarders to understand what is gained from parting with possessions and not just focusing on what is lost.

As yet there is no approved medication to treat hoarding disorder, but there are trials in place with medicines that are also used to treat ADHD. It’s possible that cognitive behavioural therapy combined with medication used for other comorbid conditions may be effective in treating hoarding disorder.

Advice For ADHD Hoarders

If you suspect a friend or loved one might have a hoarding disorder, it’s imperative to approach it sensitively. Often a hoarder will feel ashamed or embarrassed about the situation. They might not be aware of the stress it can cause not only to themselves but to people around them. It’s important that they seek help and that you show them plenty of support and respect.

Child ADHD and Hoarding

According to Dr Frost, at least one study has found that ADHD in children predicts the development of hoarding. Now, that doesn’t mean that a child with ADHD will develop a hoarding problem, but children with ADHD are more likely to develop a hoarding problem than children without ADHD.

Children with hoarding problems sometimes have an abnormal level of personification, known as anthropomorphising. This is when children worry about the feelings of the object. While personification and imaginative play is a normal part of childhood, in a hoarder, it can become excessive. If a child is suspected to have a hoarding problem, either with or without ADHD, it’s key for them to work with therapists and mental health professionals as early as possible.

To find out more about our private ADHD assessments and our different ADHD treatments and coaching plans, please contact us at The ADHD Centre on 0800 061 4276 or via enquiries@adhdcentre.co.uk

Further Information

Hoarding Disorder With Dr Randy Frost

What Is Hoarding vs. ADHD Clutter?

Hoarding disorder: A comprehensive clinical guide.

A book by Dr Randy Frost and Dr Carolyn Rodrguez

Hoarding Disorder (NHS)

ADHD And Hoarding: What’s The Connection?

To find out more about our private ADHD assessments and our different ADHD treatments and coaching plans, please contact us at The ADHD Centre on 0800 061 4276 or via enquiries@adhdcentre.co.uk

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