In 2009, the reality TV show “Hoarders” debuted on A&E. The next year, “Hoarding: Buried Alive,” premiered on TLC. These shows and others have sparked awareness about a surprisingly prevalent disorder that occurs in up to 5 percent of the population (although many more cases of hoarding remain unrecognized and untreated).

What exactly is hoarding disorder? The American Psychiatric Association states: “People with hoarding disorder excessively save items that others may view as worthless. They have persistent difficulty getting rid of or parting with possessions, leading to clutter that disrupts their ability to use their living or work spaces.”

Hoarders have trouble discarding things that most other people would get rid of. They save items that they feel they may need in the future, are valuable or have sentimental value. Their homes are often cluttered, and they often buy things that they don’t need.

What else should we know about hoarding? Let’s review 8 common questions:

What’s the difference between hoarding and collecting?

Collectors look for specific items (e.g., model cars, stamps) and may proudly display them and keep them organized. Those who hoard often save random items and store them haphazardly. They are usually embarrassed about their posessions and their living space is often cluttered.

What items do people hoard?

Individuals with hoarding disorder may commonly hoard books, newspapers, magazines, junk mail, cardboard boxes, photographs, household supplies, food, clothing, containers and other items.

Why is hoarding a problem?

Hoarders may live in homes that are so cluttered, it interferes with normal functioning. Serious hoarding can cause health and safety concerns. It can lead to family or relationship conflicts, financial difficulties, and problems socially and in work.

When does the disorder begin?

While hoarding is more prevalent in older adults, symptoms usually start in the teen years, with 13 the average age of onset. If it goes untreated, the disorder can become chronic and more severe over time. On average, a person seeks treatment for hoarding at age 50.

What causes it?

It is not known what causes hoarding disorder. Experts believe hoarding is more common among individuals with a family member who also has a problem with hoarding. Brain injuries or a stressful life event, such as the death of a loved one, may trigger symptoms of hoarding.

What are signs of hoarding?

Hoarders often have these symptoms:

• Inability to throw out or give away possessions
• Severe anxiety when attempting to discard items
• Trouble organizing and categorizing possessions
• Indecision about what to keep or where to put things
• Feeling overwhelmed or embarrassed by possessions
• Suspicion of other people touching items
• Excessive shopping or collecting free things
• Not realizing the seriousness of the problem

Many people with hoarding disorder have problems such as indecisiveness, perfectionism, procrastination, disorganization and distractibility. Some also experience other mental disorders, including depression, anxiety, ADHD or alcohol use disorder.

Hoarding differs from obsessive-compulsive disorder (OCD). For example, impaired decision-making can be more extreme for hoarders.

Why can’t hoarders just get rid of stuff?

People with hoarding disorder have difficulty discarding items because of strong perceived need to save items, and/or distress associated with getting rid of items. They may believe that an item will be useful or valuable in the future. Or they feel it has sentimental value, is unique and irreplaceable.

How is the disorder treated?

The main approach to treating hoarding behavior is with psychotherapy and/or medication. Cognitive behavior therapy (CBT), particularly motivational interviewing, can help individuals gradually learn to discard unnecessary items with less distress, increase motivation to change behavior, and learn to improve skills such as organization and decision-making.

If you know someone who hoards, attempts to de-clutter their homes without treating the underlying problem usually fail. Also, the hoarder may experience extreme distress if it’s done without their consent.

Approach them with supportive phrases like: “I’m worried that you could fall or become trapped” and “I can help you find a therapist or group that specializes in hoarding.”

Hoarders often endure a lifelong struggle with hoarding, but with ongoing treatment, there is hope for a normal life.

If you or someone you know has a problem with hoarding, support is available. Get help from Linden Oaks Behavioral Health.