Ask the Doctor: How can I help a “hoarder”?

I have a 34 year old daughter who neglects her home and it has come to the point of hoarding items. She never cleans her home and there are piles of stuff all over her home. When I try to condense things for her, she makes excuses as to why they should be kept. To make things worse, her father has been diagnosed with paranoid schizophrenia. Also, her husband seems to put up with it.

Please help me make the right decision to help her and her hubby. They have 2 minor children in the home.

The most important thing about this question is that your daughter needs a good psychiatric evaluation. Rather than focusing on what might be wrong with her, instead its important to focus on getting her evaluated by someone who has the expertise and experience to determine whether she has a treatable psychiatric problem, and how to approach her about that treatment. In light of the family history, and some of the hoarding behavior that you describe, it certainly seems likely that she may well have one of a few possible treatable conditions. So, how to approach her?

First you might wish to let her (and her husband) know that, like heart problems, psychiatric problems can run in families, based on genetic and other factors. There is certainly some family history of a disorder there, and that makes both your daughter AND her children at higher risk.

Second, you can tell her that psychiatric disorders are actually more treatable than most heart problems.

Third, you might want to let her know that untreated psychiatric problems in parents can take a significant toll on their children in terms of the childrens’ mental health, social adjustment, and academic performance. So, getting an evaluation would be a big favor to her children.

Fourth, you might want to do some homework before this conversation and identify a psychiatrist in advance who would be willing to see her. You could speak with your daughter’s family doctor about your concerns and get a recommendation from that doctor (as well as have him support the idea of a consultation directly in a conversation with your daughter). You can even speak with the identified psychiatrist in advance of talking to your daughter about this–either by phone or through an appointment with that psychiatrist yourself. It is actually quite appropriate for family members to consult a psychiatrist about their troubled loved one, and get some guidance from the psychiatrist about how to bring them into treatment, preparing the way in the most welcoming fashion.

You might want to include her husband in any or all of the above discussions, even before you approach your daughter. Getting him on board with the idea of at least a one-time consultation, might be easier to do first, before approaching her.

Posted in Ask the Doctor Q&A.