Hoarder Or Serious Collector?

Most people have a hobby that sometimes involves collecting items — from stamps to vintage cars. But is it possible for this enjoyable leisure activity to cross the line into one of hoarding?

One in 50 people in Singapore will display hoarding behaviour in their lifetime. This is according to a study conducted in 2010 by the Research Division of the Institute of Mental Health (IMH). Of the 6,616 respondents in that landmark piece of research, 0.8% had demonstrated hoarding behaviour in the previous 12 months.

A follow-up study on the state of mental health in Singapore is expected to be completed in December. Called Singapore Mental Health Study 2016, it will explore how the landscape has changed since the inaugural findings of the 2010 study, including hoarding behaviour.

Understanding hoarding

Hoarders are people who find it extremely difficult to discard or part with possessions, regardless of their value or condition. This behaviour may result in negative emotional, physical, social, financial and legal implications for a hoarder and his or her loved ones.

Hoarders are different from other people in the quantity and quality of the collected items. Frequently, they could be considered mundane: newspapers, magazines, plastic bags, cardboard boxes, household supplies, food, clothing and animals.

Dr Kelvin Ng, a consultant with the Department of Community Psychiatry at IMH, explains that the problem with hoarding is the emotional distress that hoarders feel when throwing out items, as it is akin to reliving a loss they had suffered. They may not be able to articulate why they feel the way they do, as the reason that triggered them to hoard in the first place may have been forgotten or buried deep in their minds.

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorder, a person is classified as a hoarder when he or she:
  • always finds it difficult to discard possessions, regardless of their value
  • is distressed when attempting to discard possessions
  • accumulates so much stuff that the rooms they are stored in cannot be used as they were originally intended
  • shows significant distress or impairment in social, occupational or other important areas of functioning

Causes of hoarding behaviour

Dr Lim Boon Leng, a psychiatrist from Dr BL Lim Centre for Psychological Wellness, says the causes of hoarding are unknown, but are likely due to a combination of factors that are biological, psychological or social in nature as well as a genetic predisposition to this type of behaviour.

The disorder can occur in people with mental illnesses, who exhibit the hoarding behaviour as a part of a number of symptoms; and also in persons without any pre-existing mental illness.

Hoarders with mental health issues

A person may have an underlying mental health issue that causes him to hoard, but early recognition, treatment and control of the illness may improve and even prevent the behaviour. Such mental health issues include:

  • Schizophrenia: Hallucinations may cause a person to hear voices telling him to collect and hoard items. Even though he does not want to do so, he would obey the commands.
  • Obsessive Compulsive Disorder (OCD): The inability to decide what to throw or keep, as well as problems with symmetry, causes him to feel compelled to have multiple copies of the same item.
  • Severe depression: Resulting from an inability to look after himself, he may end up hoarding because he has lost the ability to clean up after himself. The eventual neglect of the home environment may look like hoarding.
  • Dementia in the elderly: Poor memory, impairments to speech or motion, and the inability to plan and perform complicated tasks, such as cleaning oneself and the house, could lead to hoarding. He may also have problems identifying objects or their use, gets confused easily, and would rather keep everything. As his executive functioning and planning capabilities deteriorate, he finds it difficult to organise and pack things, so he simply hoards them.

Hoarders without mental health issues
These hoarders function normally in every aspect of life and are not mentally incapacitated except that they have a hoarding problem.

Reasons for hoarding

Hoarders have usually experienced loss or stress in the past that causes them to have a void in their hearts that they try to fill with their collection. They feel that they should not or cannot waste anything, and thus are unwilling to throw away what they still deem useful. For example:

  • A retired electrician collects broken toasters and old TVs he intends to repair for use or sale, but may no longer possess the skill or doesn’t get around to repairing them. These appliances are his link to his past and reflect his self-identity.
  • An elderly widow hoards newspapers even though she is illiterate. However, she continues to keep them because her deceased husband used to read the newspapers as a daily routine. She hoards to hold on to his memory.

How can I help a hoarder?

Hoarding symptoms can present as early as 11 years; the behaviour worsens between the ages of 41 and 70. If you realise that a friend or family member displays reluctance in throwing things away, watch to see if this person develops the disorder. You can approach the town council for assistance or call the Mental Health Helpline at 6389 2222 for advice.

In another study, called Singapore Health 2 Study, conducted by IMH and the National University of Singapore’s Saw Swee Hock School of Public Health, researchers found that physical activity contributes to positive mental health. Engaging your loved one in any physical activity can bring about a positive impact in the way they live.

Dr Ng advises that, to have good mental health, it is important to maintain a healthy lifestyle with regular exercise and a balanced diet, and strike a good work-life balance with effective stress management.

To help the community better understand mental illness, IMH’s Community Psychiatry team regularly engages with grassroots leaders, constituencies and agencies to increase their understanding of common mental health issues.

According to Dr Lim, hoarders may not realise what they are doing and may refuse treatment. “Be firm and don’t play along with the hoarder as there are no limits nor passing phases to hoarding,” urges Dr Lim. “It is crucial to seek treatment from professionals.”