Help for Hoarders: Yup, Insurance Covers That

Hoarding gets redefined as its own mental illness so treatment will be covered like other mental health conditions

If someone you know hasn't been able to throw out a newspaper since 1983, or the idea of parting with one of infinite collectibles causes mental anguish, help is on the way (without having to guest on a reality TV show).

The fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-V) -- the so-called bible of psychiatry -- will now recognize hoarding as its own disabling disorder, which means insurance companies will begin covering treatment when the updated manual is published in May 2013.

Hoarding’s addition to the DSM-V doesn't just mean easier access to treatment; it paves the way for better treatment as well. Hoarders can get help for their illness with cognitive-behavioral therapy (CBT), a type of talk therapy that helps patients identify and change unhealthy thoughts and behaviors, as well acess to medication.

For those who have never caught an episode of Hoarders or Buried Alive, hoarding is a condition in which its sufferers compulsively stockpile stuff that most of us would regard as trash. More than being stubborn pack rats, hoarders may amass so many possessions that their homes can be more reminiscent of junkyards than houses. There is often no room to sit, sleep or even eat, which can lead to unsafe and unsanitary conditions. This inability to part with belongings often causes extreme emotional, social, financial and sometimes legal issues for hoarders and their loved ones.

So how does one catch the condition before it becomes a full-blown crisis? Hoarding, like most obsessive behaviors, starts small--and early. According to Sanjaya Saxena, M.D., director of the Obsessive-Compulsive Disorder Program at UCSD School of Medicine, the condition usually begins in one’s early teen years. Clutter, he says, isn’t the first sign you should look for, because even though the behavior may be there, it takes years (or even decades) to accumulate a worrisome amount of stuff. Besides, he says, clutter could be a sign of something else, like depression or dementia. Here, the early warning signs of hoarding to look for:

  • Being disorganized in daily activities; procrastinating; having trouble making decisions; being afraid of making mistakes
  • Difficulty discarding possessions and an exaggerated need to hold on to things
  • Keeping stacks of newspapers, magazines or junk mail
  • Excessive acquisition of seemingly worthless items; buying things that won’t be used, stocking up on free brochures or free napkins from restaurants
  • Saving bags of trash because something valuable may have gotten thrown out
  • Being inordinately attached to possessions, and feeling discomfort if others touch or move things
  • Moving items from one pile to another, without throwing things away

Because most hoarders don’t realize they have a problem, it can be difficult to get them help. If you feel like you’re wading through your spouse’s piles of junk, Saxena says start with a simple conversation to find out what's going on: “You’re really having trouble parting with things, and we can barely walk on the bedroom floor. What do you think will happen if we cleared it all out?” Some people may become defensive and deny there’s a problem; others will say they’ve been struggling with this and want help.

If the hoarder doesn't want help, don't argue, says David Tolin, Ph.D., author of Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding. Try to understand their emotions, instead. And don’t bully them. Respect their right to live as they wish, but appeal to their bigger life values. If they wish to be a better grandparent or have closer friendships, ask whether the way they’re living is helping -- or hurting -- those goals.

Saxena also suggests sharing articles or self-help books written for people with hoarding problems, so they can read about it and possibly identify with.

In addition to hoarding, binge eating and post-traumatic syndrome will also be added to the DSM-V next year.

Other less well-known disorders recognized by the mental health community include frotteurism, characterized by sexual fantasies, urges or behaviors that involve touching a non-consenting person, and intermittent explosive disorder, where sufferers can't resist aggressive impulses that result in assault or destruction of property.

If you're afraid you’re holding onto too much junk and it might mean you're headed toward hoarding, ask yourself this question: Do you frequently collect things that you don’t use and have a hard time letting go of them? If the answer is yes, consider talking to a mental health professional. If you just haven't had time to bag up and donate old clothes and other things you no longer use (but you really want to), you probably don't need to worry.

To get more information, visit the International OCD Foundation web site to find a CBT professional who has experience with hoarding.

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