It may seem like a quirk of someone’s personality, or a sign of sentimentality, that they save up their possessions and can’t bear to throw anything away. Many people struggle to give up items they’ve bought, made or been given, however much clutter they might accrue over the years. In fact, when it presents a health and safety issue to the hoarder and their family or housemates, hoarding becomes a psychological problem that cannot be ignored.

The NHS has recognised hoarding as a medical condition since 2013, and it is estimated at least 1.2-3 million British adults may be hoarders to some degree. Those over the age of 55 are three times more likely to have hoarding tendencies, but many sufferers will have shown early signs as teenagers.

There is a difference between hanging onto things you love (no matter their cost or value) for good memories or reassurance, and being unable to remove them without feeling loss or distress. As humans we attach emotions to objects quite easily – we think about what they represent, from holiday souvenirs to our child’s first pair of shoes or their favourite toy. It’s perfectly normal to feel emotional when we see key items, and to gather memory boxes of things we hang onto.

It’s also fun to become a collector as a hobby, whether you’re into film memorabilia, rare books, or the latest trainers – something young people seem particularly obsessed with. Building up a collection is usually a solo hobby, but going to conventions and trade fairs or talking on forums can add a social element.

The difference comes when you can attach meaning and emotions to what might normally be passed on: sweet wrappers; threadbare socks; clothing you’ve never worn and you can’t fit into. We live in a throwaway society, but we’re gradually returning to a ‘make do and mend’ mindset, turning our backs on single-use plastics and fast fashion, but that doesn’t mean we need to build up infinite piles of things we never use. Keeping things to rework or fix is fine if you always get round to using them, but not if they just take up space and you feel uneasy or unwell at the thought of letting them go.

A hoarder’s inability to declutter will eventually make their home unsafe, with floor to ceiling piles of anything from newspapers to cleaning products. Simply going in there and removing items isn’t enough; this can provoke the hoarder’s anger and make them lash out or cut off contact. The psychology behind the hoarding must also be tackled, and emotional support must be offered.

There are added complications when other people share the living space – family members and housemates can suffer as a result of the hoarding, and may face anxiety themselves. Television presenter Jasmin Harman spoke out about her mother’s chronic hoarding in a 2011 documentary, My Hoarder Mum and Me, and has continued to raise awareness of hoarding ever since.

Hoarding can be tied to other mental health issues, particularly anxiety and depression, but also Post-Traumatic Stress Disorder (PTSD) and Obsessive Compulsive Disorder (OCD). Your childhood experiences can also be related to hoarding tendencies – if you grew up in poverty but later earned a lot of money, you might accumulate things to make up for the years you went without. In an extreme example, many concentration camp survivors have been known to hoard food, as they are terrified of being on starvation rations again.

Some people even hoard animals – either rescue pets or shop-bought pets – and, despite being wanted in the household, this is harmful to the animals. Though the owners mean well and aren’t trying to be cruel, the animals usually have to be removed to receive proper care.

Hoarding can be treated using a combination of talking therapies, such as Cognitive Behavioural Therapy, and practical sessions with experts on decluttering. The therapy element is important because decluttering alone won’t stop the behaviour; real change comes from altering the mindset and the core beliefs of the hoarder, and freeing them from emotional associations with the things they hoard.

Written by guest contributor Vikram Das for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).