Hoarding disorder is more common than many realise but remains oft-misunderstood. The Diagnostic and Statistical Manual of Mental Disorders, the bible of psychological concerns for mental health practitioners, has only recently listed hoarding disorder as a unique condition. Previously, the urge to hoard had been considered an offshoot of obsessive compulsive disorder.
If hoarding is not linked to OCD, could it arise from personal trauma? That certainly appears to be the case. Back in 2004, a study investigated a selection of patients that displayed hoarding tendencies. The patients all had something else in common – they had experienced injuries to the brain.
The patients in question underwent MRI scans. Doctors compared the results to healthy brain scans that had not suffered physical trauma. There was a marked difference; the hoarding patients all shared damage to the right-hand side of the frontal cortex. Essentially, a particular part of the brain ensures that we do not allow ourselves to hoard. Injury can render this frontal lobe ineffective, so a hoarder lacks the cognitive drive to dispose of waste.
Further interesting findings unfolded in 2008, following investigations into the bilateral anterior ventromedial prefrontal cortex, aka the VMPFC. The VMPFC is the part of the brain that manages complex thoughts and feelings, found only in mammals. When psychologists refer to the “mammal brain” instead of the “reptile brain”, they discuss the VMPFC. The latter works exclusively on survival instinct.
As part of the study, investigators compared brainwave patterns of hoarders with a group that showed no such tendencies. There were distinct differences in the results, suggesting that hoarders struggle to make decisions that many of us take for granted. You or I, for example, may not think twice about tossing yesterday’s newspaper into the recycling. A hoarder’s brain struggles and wrestles with this idea, growing too emotional to make such a choice.
Initially, this may seem a little contradictory. One study claims that hoarders lack the ability to think about throwing items away, while the other suggests that hoarders overthink, eventually defaulting to taking no action. In a nutshell, however, both commands are served by the nervous system.
These studies confirm that hoarders think differently, explaining why hoarding disorder should be considered a unique mental health concern – separate from OCD. Further research is still ongoing, but this must be viewed as a breakthrough. Medication prescribed to combat traditional OCD is often ineffective, and we now understand why. Eventually, medical science will surely isolate a treatment for hoarding disorder.