Mental Illness and Disorganization

In honor of Mental Health Awareness Month this May, I would like to share some information about the link between mental illness and disorganization/hoarding.

Many individuals with mental illnesses also have issues with disorganization. This is primarily because the area of the brain most often affected by mental illness is the Central Executive. The CE is the primary area for planning future actions, initiating retrieval and decision processes, and integrating information coming into the system, all necessary for successfully organizing.

Disorders that can arise from a faulty CE are depression, attention deficit hyperactivity disorder (ADHD), learning disabilities, compulsive disorganization, and hoarding.

To clarify, disorganization is not the same as clutter. Clutter can also be thought of as messiness whereas disorganization is broader. Disorganization is a lack of basic categorization accompanied by excessive clutter.

The Institute for Challenging Disorganization defines chronic disorganization using three criteria: having a past history of disorganization in which self-help efforts to change have failed, an undermining of your current quality of life due to disorganization, and an expectation of future disorganization.

Sometimes, we all suffer from faulty CE functioning, especially where time management, attention and switching focus is concerned. Ways to help CE include: organizing workspace, minimizing clutter, and creating “to do” checklists.

When dealing with your own or someone else’s clutter and disorganization, it’s important to approach with compassion. Staying organized and relatively clutter free is difficult for everyone at some point in time. Compassion will create a nurturing environment in which to learn good organizing skills.

The Different Levels of Clutter/Hoarding and How to Recognize Them

Clutter can mean different things for different people. For some, a small pile of clothes in the corner of an otherwise well-ordered room constitutes serious clutter. For others, the clutter might only register when a room in their house becomes inaccessible.

To help us more accurately distinguish the level of the clutter and provide appropriate help, we use the International OCD Foundation Hoarding Centre Clutter Image Rating and The Institute for Challenging Disorganization (ICD) Clutter–Hoarding Scale™ (C–HS™).

Clutter Image Rating

The International OCD Foundation Hoarding Centre created a series of 9 pictures of rooms in various stages of clutter – from completely clutter-free to very severely cluttered. People can just pick out the picture in each sequence that comes closest to the clutter in their own living room, kitchen, and bedroom. In general, clutter that reaches the level of picture # 4 or higher impinges enough on people’s lives that we would encourage them to get help for their hoarding problem.

Example of the International OCD Foundation Hoarding Centre Clutter Image Rating

Example of the International OCD Foundation Hoarding Centre Clutter Image Rating

Clutter–Hoarding Scale™

The Institute for Challenging Disorganization (ICD) developed the Clutter–Hoarding Scale™ (C–HS™) to serve as an observational guideline tool for the assessment of residential environments, and is intended for the assessment of the household environment only. There are five levels to indicate the degree of household clutter and/or hoarding from the perspective of a professional organizer or related professional.

 

The levels in the scale are progressive, with Level I as the lowest and Level V the highest. ICD considers Level III to be the pivot point between a household that might be assessed as cluttered and a household assessment that may require the deeper considerations of working in a hoarding environment.

Within each level are five specific categories that describe the degree of clutter and/or hoarding potential.

1. Structure and Zoning

Assessment of access to entrances and exits; function of plumbing, electrical, HVAC (any aspect of heating, ventilation or air conditioning) systems and appliances; and structural integrity

2. Animals and Pests

Assessment of animal care and control; compliance with local animal regulations; assessment for evidence of infestations of pests (rodents, insects or other vermin)

3. Household Functions

Assessment of safety, functionality and accessibility of rooms for intended purposes

4. Health and Safety

Assessment of sanitation levels in household; household management of medications for prescribed (Rx) and/or over-the-counter (OTC) drugs

5. Personal Protective Equipment (PPE)

Recommendations for PPE (face masks, gloves, eye shields or clothing that protect wearer from environmental health and safety hazards); additional supplies as appropriate to observational level

Example of Clutter- Hoarding Scale Level 5

 

Visit the Kane County Hoarding Task Force website for more resources on help for hoarders: https://www.kchoarding.org/

Choose Love, Not Stuff

I wrote this while my mother was ill some time ago, but the message is still true: Choose balance, choose love, and replace “things” with treasured memories and happy days.

There is never enough time.

Find time for balance in your lifeAs I sit here in the ICU with my ailing mother I lament on what I should have done. What else could I have done? There is never enough time. We all have choices as to how we live our lives and sometimes it is difficult to know when you need to take time away from work to help someone else or when it will be ok to just carry on your day.

I am so aware of my actions and emotions these days that I often feel that ignorance is bliss. How much easier it would be to just react and not be proactive. I have to catch myself and encourage myself to live in this moment. Last night I thought my mother wasn’t going to last through Christmas she was so sick. Today is a good day. She is alert, smiling and eating. I am happy, in this moment, at this time to have her, to love her.

I am reminded of the story “I’ll Love you Forever.” It is a story of a mother that cares and nurtures her son. As a baby she rocks him and tells him she will love him forever. As the story goes on it depicts the relationship of the mother and son and how it changes until the little boy is a grown man caring for and nurturing his mother, rocking her as she had rocked him. As I am blessed to be able to care for my own mother I realize that this transition has occurred. I am now her parent.

When I was a little girl I used to love to be rocked, (truth be told, I still rock when I am stressed). Instead of asking my mother if she would rock me, I would ask her “Momma, can I rock you?” I, like the son in the story, would love nothing more than to pick her up and rock her to sleep. Sleep, with sweet, sweet dreams of heaven.

Only God knows when he will take her, but I know she is ready. She has told me so. What a blessing to know that she is satisfied with her life and that she, while frightened of the unknown like all of us, is at peace knowing she is going “HOME” soon.

Part of having a balance in life is being able to live with the choices you make. Loving and being loved go hand-in-hand.

May you always realize that time and love are your greatest gifts. May you always remember what is important in life. May you make good choices, starting with choosing happiness and love over objects and clutter.

Hoarding and Mental Health – Finding the Support You Need

Living Life with Dignity on TLC's Hoarders: Buried Alive
Fran Piekarski (left), President of Living Life with Dignity, on TLC’s Hoarders: Buried Alive

For adults with disabilities or special needs, disorganization can be a huge problem — for both the individual and the family.

Individuals with mental health issues often exhibit the attributes of hoarding disorder.

Understanding the delicacy, privacy and pain of a hoarder’s situation is key to gaining their trust and reducing their stress during the process of change. Living Life with Dignity helps people who hoard by providing them with the tools to make decisions about their belongings and their future. We work with mental health professionals, condo associations, municipalities, and families to address the needs of those suffering with chronic disorganization and/or hoarding.

We offer the following services for clients affected by hoarding:

  • Confidential assessment
  • Assembly of customized team
  • Collaborative planning in coordination with your therapist or recommended mental health professional
  • Assistance with execution of our recommendation and collaboration

Transitions – Finding you the place that meets your needs

Often a disability will require a change in an individual’s environment. You or your loved one may be dealing with a temporary or permanent new need and the current environment may no longer suit your needs.

With over sixteen years of experience, we are skilled in working with the hoarding community, including crisis situations and eviction threats.

We can assist you in either re-equipping your current environment or providing new accommodations. Our goal is to locate the least restrictive, most beneficial option available. After all, part of quality living is a quality living environment.

Contact us for more information on help with hoarding.

Image Credit: St. Louis-based artist and photographer Carrie M. Becker created a miniature diorama of a hoarder’s house.