If you met my friend Mandi, you would never know anything was wrong.
Bright-eyed, smiling and often dressed in something sparkly and fabulous, she spends most of her days chatting to customers at the Walton-on-Thames clothing store where she works.
Like many people – especially women – she has a passion for shopping, and especially enjoys hunting for bargains in charity shops and car boot sales.
But the habit was in fact a sign of a life-wrecking mental illness that has plagued her for more than a decade, leaving her with £30,000 in debt.
I’m not talking about shopping addiction. As a psychiatrist who has worked on the cutting edge of mental illness for more than forty years, I have seen just about everything that can go wrong with a person’s mind.
But there is one condition that never gets the attention it deserves, despite the fact that one in four patients commit suicide.
Hoarding disorder, which affects at least three million people in Britain, is a very serious condition – but sufferers are often punchlines in cheap jokes, adding to the shame that plagues them.
I have seen this condition destroy countless lives, most of whom were too ashamed to seek help until it was too late – and languished in silence.
Mandi Simms, from Walton-on-Thames, has suffered from the condition for more than ten years
It is not only harmful to the patient. Research shows that hoarding is an important cause of house fires. In 2022, London’s fire brigade saw 1,036 fires directly linked to hoarding, resulting in 186 injuries and ten deaths – that’s one city in one year with a population of nine million.
So what exactly is it?
Well, we’re all collectors. But in a collection you can find individual items. However, in a treasure it is much more difficult and can seem like a complete mess. Someone with hoarding disorder may be at risk of trips and falls from collecting, or even pests.
The main differentiator between a hoarder and a collector is the extreme distress associated with giving up an item that has little apparent sentimental value.
I’ll never forget the patient who compared cleaning up her clutter of random items to sexual assault. They feel completely violated.
Hoarding has only been considered a condition in its own right since 2013. Until then, hoarders were often classified as obsessive-compulsive disorder, because the behavior could be a symptom of OCD.
People may think of mothers, fathers, or grandparents who keep things “just in case” as prime candidates for hoarding, but the condition can actually affect anyone at any age.
However, it is often more apparent in someone who lives alone and has had a lifetime to build up his treasure.
Mandi has racked up £30,000 in debt as a result of her condition – which affects millions
The condition can arise out of nowhere, but there is usually an underlying traumatic experience.
For example, I remember a young woman who came from a very wealthy family and was sent to boarding school as early as possible; her parents were never really interested in her.
At home she started collecting stuffed animals until she really couldn’t move anymore, couldn’t sleep in her bed, couldn’t do anything anymore. The bath was piled up, the kitchen was a fire hazard because of these soft toys. Still, when you suggested getting rid of them, she said, “They’re my only friends.”
Although Mandi has been buying and selling vintage clothing at the Birmingham Rag Market since she was 16, her habit of collecting only led to compulsive behavior 12 years ago.
Grief, combined with “broken relationships” and voluntarily resigning from the charity where she worked, “made me start to lose my luster.” She started going to charity shops almost every day on her lunch breaks and car boot sales every weekend, looking for the dopamine rush to help her cope with grief.
One day six years ago, as she looked around her house, she thought, What the hell happened, Mandi? You can’t have people around you, you can’t sit on your couch,” she told me.
Before then, Mandi happily enjoyed her Sunday lunches and dinners surrounded by loved ones.
‘And I can’t do that now. That’s very sad, because I’m a very social person.’
There is barely room for her, let alone others. Once she had to stay with a friend “because I couldn’t cope, and it was depressing and sad to be among the beautiful things.”
She says her shopping habits ultimately led to her racking up £30,000 in debt.
Some friends have been a huge support, Mandi says, but “some have stayed away because it’s too overwhelming for them to deal with, for their own mental health. Not that they don’t love me or don’t care about me; they just can’t handle what I’ve become.”
In 2015, Mandi went to her GP, where she was diagnosed with hoarding disorder and referred to the Mary Frances Trust, an adult mental wellbeing charity.
She is now an ambassador for the charity Hoarding UK.
Mandi, like me, says that the condition is not simply a matter of finding it difficult to throw things away, but that it is a mental health problem on a par with substance abuse.
As part of her own road to recovery, Mandi has been running a pop-up shop in Walton-on-Thames for the past four years, selling some of the pieces she has collected, including many glitter-covered garments.
Unfortunately, it will close this weekend, but the rest of the items will remain in her house; she has plans to head out in a camper van to distribute to people across the UK – selling some of her more expensive finds – and to give talks on the importance of mental health support.
But Mandi is one of the lucky ones; Although she still struggles with her condition, she has found a way to get on with life – and still find joy.
This is not true of the vast majority of other patients I have encountered over the years.
For example, there was the very intelligent, sweet man who drove himself to despair collecting hair and toenails. He knew his behavior was completely irrational, but he couldn’t stop it.
Another time, when I was working in a psychiatric ward in the hospital, I suddenly realized that there was a terrible smell coming from some of the bedrooms.
It turned out that one of the patients was walking around picking up all the fall leaves, dead squirrels and birds and keeping them in plastic bags in their room.
Others hoard animals – there are homes where people trying to rescue pets have instead taken in more than they can care for, leading to sick, neglected or even dead animals.
So how can you tell if there’s a real problem at play?
Psychiatrist Lynne Drummond wants to raise awareness about hoarding
Ask yourself: Is it interfering with your ability to function? Can you sit on a chair in the living room and watch television? Can you go to bed unhindered, or do you have to climb over things? Can you take a bath, or is it filled with stuff?
If the answer to any of these questions is no and you (or the person in question) are reluctant to get rid of things, I think there is a problem.
There is a lot of stigma attached to it, so hoarders feel immense shame when it comes to seeking help; most are depressed.
I suggest you contact your GP who may be able to refer you to local services; the fire brigade can carry out home safety assessments, while there are also voluntary hoarding organisations, such as HoardingUK, that can provide support.
Psychologists can offer a course of specialized cognitive behavioral therapy to help determine the cause of the hoarding tendency, and some find antidepressants helpful.
This isn’t something you can fix quickly. But it can be done.
As told to Charlotte Lytton
Lynne Drummonds bookEverything you need to know about hoarding is now available.
If you think you need help with hoarding, come see us hamsteringicebreakerform.org
