For Hoarders, Letting Go Is Nearly Impossible

The small kitchen is nearly impassable, its floor covered with ankle-deep piles of trash. Dirty dishes and empty deli containers are heaped in the sink, obscuring the faucet. The stove and the counters disappeared from view long ago, buried under a foot of papers, bottles and other debris.

A narrow pathway around a 5-foot-high stack of old phone books and past guest rooms too packed to enter leads to Edwards' tiny bedroom. The sheets on Edwards' king-size bed have not been changed in at least four months: There's simply too much junk piled on it. She sleeps on a 3-foot swath closest to the bathroom.

The surreal condition of Edwards' four-bedroom rambler is a reflection of her psychological malady, not her deficits as a housekeeper. Edwards is a hoarder, and her problem, which began in childhood, is imperiling her health, jeopardizing her relationships with family and friends, and making it impossible for her to lead a normal life.

She knows that most people, including her grown children, to whom she is close, don't understand why she saves almost everything or why she becomes acutely anxious at the prospect of throwing out things others discard without a second thought: junk mail, an empty Kleenex box, decades worth of church programs.

"Discarding anything is a problem," said Edwards, who does throw out smelly refuse, like banana peels. "People look at this mess and think, 'How could anybody let this happen?' I look around and I think, 'Oh, my God.' I know in my head that I don't need any of it, but I just can't bring myself to throw it away."

At 70, Edwards, a gregarious, energetic, intelligent woman who sports fresh lipstick, clean clothes and well-tended nails, seems the embodiment of the term "active senior." She is involved in several community groups, ushers at church, travels regularly, works part-time as a real estate agent and has many friendships, some of which go back nearly 50 years to her undergraduate days at Wellesley College in Massachusetts.

But her hoarding, for which she has several times received therapy that proved ineffective, is getting worse.

A Mental and Public Health Problem

Hoarding, a little-understood psychological malady, is not new--historical accounts of it date to ancient Egypt--but it is newly recognized as both a mental-health issue and a public-health problem.

While many people think of a hoarder as someone who obsessively collects and neatly categorizes thousands of similar objects--shoes, matchbooks, record albums--the reality is vastly different, experts say. Most hoarders more closely resemble pack rats, and their "collections," often of junk, are neither neat nor categorized, as would be those of a compulsive collector.

In the annals of hoarding, the Collyer brothers, two eccentric recluses who were found dead in their Manhattan brownstone in 1947, are legendary.

The tabloid press chronicled the discovery of their bodies and the excavation of their house, which contained 136 tons of junk. Among the things police found were 14 grand pianos, the chassis of a model T Ford and medical specimens from their father's gynecology practice. A network of tunnels had been carved out of the debris and, fearful of intruders, the elderly men had rigged booby traps of trash, one of which triggered accidentally, entombing them.

Because hoarding is seen in a variety of illnesses, including schizophrenia, dementia, anorexia, substance abuse and mental retardation, it has been difficult to place definitively in a diagnostic category.

A growing number of experts believe it is a sub-type of obsessive-compulsive disorder. OCD affects an estimated 2 million Americans, although most OCD sufferers display more common symptoms such as compulsive hand-washing. Between 10% and 20% of hoarders report no other symptoms of OCD.

Experts who study hoarding say the problem is hugely underreported--it is estimated that only about 5% of cases come to the attention of authorities--and rarely becomes known to outsiders until it is so severe that a person is facing eviction, a competency hearing or action by a local health department.