Types of Hoarding Disorders

Overview of Hoarding Disorder and Its Subtypes

Hoarding disorder is a recognized mental health condition listed in the DSM-5 under “Obsessive-Compulsive and Related Disorders.” The American Psychiatric Association defines it as persistent difficulty discarding possessions, a perceived need to save items, and resulting clutter that substantially compromises living spaces. While the clinical diagnosis is singular, mental health professionals and researchers describe several distinct “types” or patterns of hoarding that appear in practice.

All types of hoarding disorders share core features:

• Persistent difficulty discarding items, regardless of actual value

• Excessive accumulation that congests living areas

• Clutter that interferes with intended use of physical space

• Significant distress or impairment in social, work, or daily functioning

It’s important to clarify that “types of hoarding disorders” is not a formal DSM label. Instead, it’s a practical framework that describes different hoarding patterns—such as object hoarding, animal hoarding, digital hoarding, food hoarding, garbage hoarding, compulsive shopping, and sentimental hoarding. Recognizing these specific types helps clinicians, family members, and affected individuals tailor assessment, safety planning, and treatment approaches to address unique challenges.

Main Types of Hoarding Disorders

Research and clinical practice have identified several major hoarding types that appear across different populations. While formal diagnostic criteria don’t separate these into distinct disorders, understanding them provides a useful roadmap for intervention.

The key types widely described include:

• Object hoarding

• Animal hoarding

• Digital hoarding

• Food hoarding

• Garbage/rubbish hoarding

• Compulsive shopping and acquisition hoarding

• Sentimental and memory-linked hoarding

Most people don’t fit neatly into only one category. Instead, hoarding behavior often involves overlapping patterns—someone might struggle with both paper clutter and digital files, or combine compulsive shopping with sentimental attachment to purchased items. Use the sections below to identify which patterns are most relevant to your situation or that of someone you’re trying to help.

Object Hoarding

Object hoarding is the most common pattern and what most people picture when they think of compulsive hoarding. It involves excessive saving of everyday inanimate objects that have little or no current practical value, driven by a perceived need to keep them “just in case.”

Frequently hoarded objects include:

Clutter typically starts in one room and gradually spreads throughout the home. Over time, beds become buried, stoves and sinks become inaccessible, and pathways to exits narrow dangerously. This increases fire hazards and fall risks, particularly for older adults.

People who engage in object hoarding often hold strong beliefs about their possessions:

• “I might need this someday.”

• “Throwing things away would be wasteful.”

• “Someone else could use this.”

• “This item is part of who I am.”

Treatment for object hoarding typically involves hoarding-focused cognitive behavioral therapy (CBT) with in-home sessions. Therapists work alongside individuals to practice sorting, decision-making, and gradual discarding of items from the cluttered home.

Animal Hoarding

Animal hoarding involves keeping far more animals than a person can reasonably feed, house, and provide veterinary care for. Unlike responsible pet ownership or rescue work, people who hoard animals fail to meet minimum standards of nutrition, sanitation, and medical care—often while believing they’re helping the animals.

Typical situations include:

• Dozens of cats or dogs living in a small apartment

• Severe overcrowding in cages or enclosures

• Strong odors from accumulated waste and poor sanitation

• Untreated medical conditions, malnutrition, and suffering among the animals

• Floors covered in feces and urine, creating extremely unsanitary conditions

An animal hoarder often sees themselves as a “rescuer” or “savior,” which creates a powerful emotional barrier to recognizing the neglect or cruelty their behavior causes. This poor insight makes intervention particularly challenging.

The consequences of animal hoarding extend beyond the person’s mental health:

Animal hoarding is recognized as a form of hoarding disorder and typically requires coordinated responses involving mental health professionals, veterinary care providers, animal welfare agencies, and specialized cleanup services. Family members often need guidance on how to report concerns while maintaining compassion for the affected person.

Digital Hoarding

Digital hoarding is the compulsive saving of electronic material—emails, photos, documents, apps, screenshots, and downloaded media—far beyond what is useful or organized. While not yet formally included in DSM-5 criteria (which focus on physical clutter), it parallels traditional hoarding in its psychological drivers and functional impacts.

Common examples include:

• Tens of thousands of unread emails across multiple accounts

• Multiple hard drives and cloud storage accounts filled with unorganized digital files

• Never deleting old work projects, screenshots, or duplicates

• Downloading free items, apps, and media “just in case”

• Difficulty discarding items even when storage is maxed out

Digital hoarding causes real problems in a person’s life. Anxiety builds as inboxes overflow. Devices slow down under the weight of accumulated files. Finding important information becomes nearly impossible, affecting work performance and academic success. The disorganization mirrors the chaos of a cluttered home, even if no physical space is blocked.

This type often co-occurs with physical hoarding but can also exist independently, particularly among people whose work involves heavy computer use. Management focuses on building practical skills:

• Creating simple organizational systems

• Setting regular deletion schedules

• Backing up truly important files to easily accessible locations

• Learning to tolerate the discomfort of deleting nonessential content

Food Hoarding

Food hoarding goes beyond normal bulk buying or short-term “panic buying” during crises like the COVID-19 lockdowns in 2020. It involves persistent, excessive accumulation of food that the person cannot reasonably consume before it spoils.

Common patterns include:

• Overfilled refrigerators and freezers, often with rotten food hidden in back

• Cupboards stacked with expired cans and packages

• Hidden food stashes in bedrooms, closets, or other spaces

• Strong reluctance to discard spoiled or expired items

• Continuing to buy more food despite having an excessive amount already

Food hoarding often connects to past experiences of deprivation—childhood food insecurity, war, famine, or poverty. It can also be linked to eating disorders such as binge eating disorder, anorexia, or bulimia, where food takes on complex emotional meanings as a coping mechanism.

Health and safety issues are significant:

• Mold growth and contamination

• Pest infestations (rodents, insects)

• Foodborne illness risks

• Financial strain from repeatedly buying food that goes uneaten

• Blocked kitchen spaces preventing safe food preparation

Effective treatment combines hoarding-focused therapy with nutritional support. When eating disorders co-occur, integrated treatment addressing both conditions produces better outcomes than addressing either alone.

Garbage / Rubbish Hoarding and Diogenes-Type Presentations

Garbage hoarding involves the accumulation of discarded or soiled materials—food containers, packaging, broken items, and sometimes human or animal waste. Some people hoard garbage without recognizing the health hazards, while others feel overwhelmed by shame and depression, unable to begin cleaning.

This type is often associated with severe self-neglect and social withdrawal. In older adults, it can overlap with what the literature sometimes describes as Diogenes syndrome, characterized by:

• Extreme domestic squalor

• Social isolation

• Lack of concern about living conditions

• Rejection of help from family members or services

Living conditions in garbage hoarding situations include:

• Strong, pervasive odors

• Blocked plumbing and unusable bathrooms

• Insect and rodent infestations

• Rooms nearly impassable due to trash piles

• Fire hazards from accumulated paper and debris

Some individuals see potential value or use in what others consider rubbish—“I could recycle this” or “Someone might need these containers.” Others simply feel paralyzed, highly distressing as the problem grows beyond their capacity to address.

Garbage hoarding creates serious medical and safety risks, often requiring coordinated intervention from:

• Medical providers addressing physical health and self-neglect

• Mental health professionals providing psychological treatment

• Housing agencies and code enforcement

• Specialized cleanup teams trained in biohazard situations

Compulsive Shopping and Acquisition Hoarding

Compulsive shopping describes a pattern of repeated, often impulsive purchases that quickly turn into hoarding when items are rarely used, opened, or organized. The DSM-5 recognizes excessive acquisition as a specifier, noting that approximately 80-90% of people with hoarding disorder display these behaviors.

Common presentations include:

• Stacks of still-tagged clothing never worn

• Unopened online orders piling up near the door

• Duplicate household gadgets bought because they were “on sale”

• Collecting free items at events, stores, or from neighbors

• Excessive buying that creates financial strain

Emotional triggers drive the behavior:

The consequences compound rapidly. Credit card debt accumulates. Family conflict erupts over spending and clutter. The home fills faster than any organizational system can manage. Shopping habits that once felt pleasurable become a source of shame and secrecy.

Treatment addresses both the acquisition behavior and the underlying difficulty discarding items:

• Limiting access to credit cards and online shopping

• Identifying and managing emotional triggers

• Building tolerance for not acquiring free items or bargains

• Practicing decision-making about what to keep versus discard

Sentimental and Memory-Linked Hoarding

Sentimental hoarding centers on items kept for emotional or memory reasons rather than practical use or market value. Nearly everyone keeps some meaningful objects, but in sentimental hoarding, the volume becomes overwhelming and the inability to let go causes significant impairment.

Frequently hoarded items include:

• Childhood toys and belongings

• Children’s school projects from decades past

• Old letters, cards, and correspondence

• Ticket stubs, programs, and memorabilia

• Gifts from deceased relatives

• Clothing from weddings, graduations, or past relationships

The emotional attachment behind this hoarding is powerful. Grief, loneliness, and fear of forgetting important people or experiences make discarding these objects feel like a betrayal—a “second loss” of the person or memory they represent.

The impact on living spaces is substantial:

• Overflowing boxes in every closet and storage area

• Entire rooms devoted to memorabilia that crowd out current needs

• Guilt and anxiety when considering any removal

• Family conflict over what to keep and what to release

Therapy often focuses on grief work alongside hoarding-specific interventions. This includes:

• Processing losses that make letting go so difficult

• Creating alternative ways to preserve memories (photos, small curated collections)

• Developing rituals for saying goodbye to some items

• Learning that releasing an object doesn’t mean losing the person or memory it represents

Clinical Specifiers and Overlapping Patterns

Formal diagnostic systems like DSM-5 and ICD-11 describe hoarding disorder using specifiers rather than the informal “types” outlined above. The main specifiers include:

Most people with hoarding disorder show overlapping patterns rather than fitting a single, pure subtype. Someone might struggle with object hoarding, paper clutter, and digital hoarding simultaneously. Another person might combine animal hoarding with garbage accumulation.

Clinicians assess multiple dimensions beyond content:

• Severity of clutter (often using 5-level systems)

• Level of insight and motivation for change

• Safety risks (blocked exits, fire hazards, unsanitary conditions)

• Co-occurring conditions (depression, anxiety disorders, obsessive compulsive disorder)

Identifying dominant patterns—whether animals, garbage, food, sentimental items, or shopping-driven clutter—helps prioritize safety concerns and guide treatment planning. Hoarding-related beliefs vary by type, and addressing them effectively requires understanding what drives saving behavior in each case.

Symptoms Shared Across Hoarding Types

Despite differences in what is hoarded—animals, digital files, food, or inanimate objects—all types of hoarding share core psychological and behavioral symptoms. These shared features are what make hoarding a diagnosable mental health condition rather than simply a personality quirk or lifestyle preference.

Core shared symptoms include:

• Persistent difficulty discarding possessions, regardless of actual value

• Strong distress or anxiety at the idea of throwing things away

• A powerful urge to save items “just in case”

• Distress when others suggest discarding items

• Perceived need to maintain control over possessions

Functional impacts common across types:

• Living spaces become unusable for their intended use

• Conflict with family members, landlords, or neighbors

• Shame and secrecy leading to social isolation

• Reduced quality of life and personal hygiene neglect

• Financial strain from excessive acquisition or cleanup costs

Common cognitive patterns:

• Perfectionism (“I need to find the perfect home for this item before discarding”)

• Indecision and avoidance of decision-making

• Overestimating the likelihood an item will be needed

• Excessive responsibility (“If I throw this away and someone needs it, it’s my fault”)

• Strong emotions attached to possessions (comfort, safety, identity)

These hoarding symptoms distinguish the disorder from normal collecting or messiness. In hoarding disorder, the behavior causes clinically significant impairment and mental health problems that require professional intervention.

Causes and Risk Factors Across Hoarding Types

Research points to multiple interacting causes for all hoarding types rather than a single explanation. Understanding these factors helps frame hoarding as a complex condition with biological, psychological, and environmental roots.

Biological and cognitive contributors:

• Genetic factors and family history of hoarding or related disorders

• Differences in brain regions linked to decision-making and emotional attachment

• Executive functioning difficulties (attention, categorization, organization)

• Possible links to obsessive compulsive personality disorder traits

Psychological and developmental factors:

• Childhood trauma, neglect, or chaotic home environments

• Significant losses (death of loved ones, divorce, major life changes)

• Learning early to rely on possessions for comfort or security

• Growing up in a cluttered home without learning sorting and discarding skills

Age and progression:

Hoarding symptoms often begin during the teenage years (ages 11-15) and gradually worsen over decades. Severe hoarding typically becomes most visible in middle to older adulthood, when accumulated items and declining physical ability to manage them converge.

Type-specific risk factors:

These factors interact differently for each person, explaining why treatment must be individualized rather than one-size-fits-all.

Treatment Approaches for Different Types of Hoarding

All types of hoarding can be improved with appropriate, often long-term treatment. Progress is typically gradual—measured in months and years rather than weeks—but meaningful improvement is achievable for most people who engage with evidence-based care.

Hoarding-focused CBT remains the primary treatment:

• Cognitive restructuring of hoarding-related beliefs about possessions

• Skills training in organization, categorization, and decision-making

• Gradual exposure to discarding and non-acquiring with response prevention

• In-home sessions for practical sorting and decluttering practice

• Motivational interviewing for those with poor insight

Medication options:

Selective serotonin reuptake inhibitors (SSRIs) and other medications may help when hoarding co-occurs with depression, anxiety disorders, or obsessive compulsive disorder. However, no medication specifically targets hoarding itself, and response rates are lower than for typical OCD. Medication works best as part of comprehensive treatment rather than as a standalone intervention.

Practical supports that enhance treatment:

• Professional organizers trained in working with hoarding

• Specialized cleanup services for high-risk or biohazard situations

• Peer support group participation

• Case management for housing, financial, or legal issues

Type-specific treatment modifications:

Tailoring treatment to the predominant type increases both safety and effectiveness. A person who primarily struggles with excessive acquisition needs different interventions than someone whose difficulty centers on sentimental attachment to inherited items.

Supporting Someone with Any Type of Hoarding Disorder

Hoarding is a mental health condition, not laziness or a character flaw. Shaming, ultimatums, or forced cleanouts almost always backfire—triggering more intense hoarding behavior, damaging trust, and sometimes causing severe psychological trauma.

Effective approaches when supporting someone who hoards:

Approach conversations calmly and without judgment. Focus on safety and well-being rather than the appearance of the home.

• Listen to the person’s fears about discarding without dismissing them

• Acknowledge how difficult and highly distressing the situation feels

• Express concern rather than criticism

• Avoid labeling possessions as “junk” or “garbage”

Practical support strategies:

• Suggest professional help (therapists, primary care providers, local mental health services)

• Offer to help research treatment options or attend appointments

• Assist with sorting small, agreed-upon areas only with explicit permission

• Celebrate small progress rather than focusing on what remains

Critical warnings:

• Never conduct large cleanups without consent—this can cause lasting psychological harm

• Forced removal often leads to rapid re-accumulation and deeper secrecy

• Emergency cleanouts should be reserved for genuine safety crises, coordinated with professionals

Setting priorities:

When resources are limited, focus first on safety issues:

1. Blocked exits and fire hazards

2. Spoiled food and contamination

3. Animal welfare concerns

4. Access to essential facilities (bathroom, kitchen, bed)

5. Personal hygiene basics

Resources for family members:

• Educate yourself about hoarding through reputable sources

• Set realistic expectations—improvement is slow but possible

• Consider family therapy to address relationship strain

• Connect with support groups for families affected by hoarding

• Practice self-care to avoid burnout

Living with or supporting someone with any type of hoarding disorder is challenging. Progress requires patience, professional guidance, and a commitment to harm reduction rather than perfection. With the right combination of understanding, appropriate treatment, and practical support, meaningful improvement is within reach. T.A.C.T. North Atlanta is available 24/7 you can contact us at 404-985-5461 or email us at info@tactnorthatlanta.com