Psychiatrist Dr Lynne Drummond has warned that hoarding disorder affects at least three million people in the UK as she outlined key warning signs.
Dr Drummond, a consultant psychiatrist with more than 40 years of clinical experience, revealed that the condition drives one in four sufferers to take their own life. She warned that despite its severe impact, hoarding disorder is frequently treated as a punchline, causing immense shame that prevents individuals from seeking early medical help.
The physical dangers of the illness extend to fire risks in residential properties. Statistics from the London Fire Brigade show that in 2022, firefighters responded to 1,036 fires directly linked to hoarding in London, a city of nine million residents. Those incidents caused 186 injuries and 10 fatalities in a single year.
Personal impact of compulsive collecting
Mandi Simms, a retail worker from Walton-on-Thames, a town in Surrey, has lived with hoarding disorder for more than a decade. Friends know Simms as a bright, smiling individual who wears sparkly garments and chats with customers in a local clothing shop. However, behind closed doors, her compulsive buying habit resulted in £30,000 of debt.
Simms began buying and selling vintage clothes at the Birmingham Rag Market when she was 16 years old. Her passion for collecting escalated into compulsive behaviour 12 years ago following a series of personal crises. Grief, broken relationships, and taking voluntary redundancy from a charity job combined to trigger the urge. Simms said the emotional toll "made me start to lose my sparkle."
To cope with sadness, Simms sought a dopamine rush by visiting charity shops on her lunch breaks almost daily and attending car boot sales every weekend. Six years ago, the scale of the problem became undeniable inside her home. Simms recalled thinking, "it was like, what on earth has happened, Mandi? You can't have people round, you can't sit on your settee."
Social isolation and financial distress
The clutter gradually stripped Simms of her social life. She previously enjoyed hosting Sunday lunches and dinners for family and friends. Reflecting on the loss, Simms said, "And I can't do that now. That's very sad because I'm a very, very social person."
Her living space became so congested that there was barely room for her to move. On one occasion, she was forced to stay with a friend, explaining that "I couldn't cope, and it was depressing and sad to sit amongst beautiful things." Her spending habits accumulated £30,000 in personal debt.
The condition also strained her relationships with friends. Simms noted that while some friends offered support, "some have stayed away because it's too overwhelming to deal with for them, for their own mental health. Not that they don't love me or care for me - they just can't cope with what I've become."
Diagnosis, recovery, and mobile outreach
In 2015, Simms consulted her GP and received a formal diagnosis of hoarding disorder. Her doctor referred her to the Mary Frances Trust, an adult mental health charity operating in Surrey. Simms later became an ambassador for the national charity Hoarding UK, which provides advice and advocacy for sufferers.
Simms compares hoarding disorder to substance abuse, viewing it as a profound psychiatric condition rather than mere disorganisation. For the past four years, she has operated a pop-up shop in Walton-on-Thames to sell items from her collection, including sparkly clothing. Although the pop-up shop closes this weekend, she plans to travel across the UK in a campervan to sell higher-value items and deliver talks on mental health awareness.
Understanding hoarding disorder symptoms
Medical recognition of hoarding disorder is relatively recent. Prior to 2013, medical guidelines classified hoarding as a symptom of obsessive-compulsive disorder (OCD), a condition marked by intrusive thoughts and repetitive behaviours. It was recognised as a distinct psychiatric disorder in 2013.
Dr Drummond explained that while collectors can identify individual items within an organized collection, a hoard appears chaotic and makes retrieving specific objects difficult. Sufferers experience intense psychological distress when forced to part with items, even those of minimal value. Dr Drummond recalled one patient who likened discarding random possessions to sexual assault, describing a feeling of being completely violated.
The condition affects people of all ages and backgrounds, although it is often more visible in older adults living alone after decades of accumulation. Compulsive hoarding frequently stems from severe emotional trauma.
Clinical cases and extreme behaviours
Dr Drummond highlighted several case studies illustrating the varied ways hoarding manifests. In one instance, a young woman from a wealthy family was sent to boarding school at an early age by uninterested parents. She began collecting soft toys at home until her bed, living areas, and bathtub were completely filled, turning her kitchen into a fire hazard. When urged to clear them, she replied, "They're my only friends."
In another case, an intelligent man drove himself to despair by compulsively collecting his own hair and toenail clippings, aware that his behaviour was irrational but unable to stop. Dr Drummond also recalled discovering a foul odour in a psychiatric ward, where a patient had been storing plastic bags filled with dead squirrels, dead birds, and autumn leaves inside bedroom closets.
Other individuals engage in animal hoarding. Driven by a desire to rescue pets, sufferers accumulate more animals than they can properly care for, resulting in sick, neglected, or deceased animals inside the home.
Warning signs and diagnostic indicators
Dr Drummond outlined seven specific warning signs that indicate a person may be suffering from hoarding disorder:
- Difficulty stopping the accumulation and acquisition of items at home.
- A large volume of possessions that prevents normal use of living spaces.
- Safety hazards caused by faulty or obstructed equipment.
- Heightened anxiety and distress regarding potential changes.
- Interventions or threats from family members or friends to clear the home.
- Indecision and paralysis regarding how to resolve the situation.
- Secrecy and concealment regarding living conditions.
To determine whether professional help is needed, Dr Drummond advises individuals to assess daily functioning. Key diagnostic questions include whether a person can sit on living room furniture to watch television, access their bed unimpeded, or use the bathtub without moving stored items.
Seeking help and treatment options
People concerned about themselves or a family member can complete a self-assessment test on the Rainbow Red website at rainbowred.co.uk and present the results to a GP. General practitioners can refer patients to specialist NHS mental health teams or local support services.
Additional support is available through voluntary organisations such as Hoarding UK, accessible online at hoardingicebreakerform.org. Local fire brigades also offer home safety assessments to identify and mitigate fire risks associated with hoarding.
Treatment typically involves specialised cognitive behavioural therapy (CBT), a psychological treatment that helps individuals identify and alter harmful thought patterns and behaviours. Psychologists use CBT to address the underlying emotional triggers of hoarding. Antidepressant medications may also be prescribed. Dr Drummond, author of the book Everything You Need to Know About Hoarding, emphasised that while recovery requires time, effective treatment is achievable.
