What is hoarding disorder and how do you recognize it? Psychologist on signs, symptoms and how to help

It's a mental illness that often presents feelings of shame, isolation and embarrassment.

Hoarding disorder, which includes a persistent difficulty letting go of their belongings, impacts millions of Canadians, especially those over the age of 54.

It's estimated that about two million people in Canada have the disorder, but psychologist and expert Murray Anderson said he thinks that estimate is actually on the low end.

"If we're talking about locally, like in Victoria or Vancouver, we normally talk about six per cent of the population in those cities," he said in an interview on CTV Morning Live Thursday.

"I think it's closer to 11, which makes it much higher of a mental health issue than a lot of existing mental health concerns – schizophrenia and such."

Hoarding disorder wasn't a standalone diagnoses until as recently as 2013, he said. In terms of what it looks like, Anderson said it's important that people who "just collect a lot of things" and find comfort in that are not confused with those to whom the diagnosis applies.

"My wife always jokes 'If you want to see a hoard, show them your record collection. Take them down to the basement,'" he said.

"Really what happens when it is a mental health issue is it's not a laughing matter. You can tell that that person has extreme anxiety about removing any of those items, even if they can't utilize that room, such as a kitchen or a bedroom, for its primary purpose."

Anderson said too that for those with the disorder, when areas of the home are cleared out, they're soon "re-cluttered" in a shorter amount of time than it took to fill them in the first place.

"The third thing is the insight these people have into the issue. Often these people are upstanding individuals, they have good relationships – not all of them but outside of the home they're able to connect with people – and hold down a solid job," Anderson said.

Those with the disorder are able to function at all levels of employment, he said, listing doctors and lawyers as examples.

"But they have very little insight when it comes to this being an issue in their homes, so there's a very significant split between the insight outside the home and inside."

Anderson was asked how family members or loved ones can offer support to someone they believe has the disorder, or who has been diagnosed.

He said the first step is to approach with respect and choose language carefully. He said it's already a very stigmatized mental illness, so language choices are key in such a delicate conversation.

It's also important to approach the topic from a place of legitimately wanting to help.

Anderson recommends downloading the Frost Clutter Scale, created by professor Randy O. Frost, to get an idea of the situation. Here's a link to a PDF of the scale, posted by the City of Vancouver on a page about its Hoarding Action Response Team. 

"It's a very simple progression from zero to nine, zero being your place is pristine, to 'it looks like you had a pizza party and didn't clean up,' all the way to nine, which shows a significant hoard and basically being unable to use that space for what's intended," Anderson explained.