Clutter vs. Hoarding: What's the Difference?

• Clutter vs. Hoarding: What's the Difference?

  
  

  By Paula Spencer Scott
  WebMD Feature

  Reviewed by Joseph Goldberg, MD

  When is a mess more than just a mess? You may worry that your paper-piled desk or clothes-strewn rooms mean you're a hoarder bound for a TV reality show. But most people, even sloppy ones, fall somewhere closer to normal on the clutter scale. 

  What's Hoarding?

  Someone who hoards collects huge amounts of things, often items of little value like ketchup packets or papers. "They don't have one can opener, they have 40," says Regina Lark, PhD, of the National Association of Professional Organizers. She specializes in helping hoarders.

  A hoarder finds it painful to let go of things, so she never does. Stuff piles up in ways that are unsafe or affect the person’s dealings with others.

  "Their shower stalls have become storage units and you can't walk up the stairs." Falls and fires are two big dangers.

  Marriages often strain when one spouse can't resist hauling more seemingly useless items into a house that’s already bursting.

  In 2013, hoarding disorder was named a distinct mental illness. Only 2% to 5% of people have this diagnosis. Some researchers think that for some people, severe hoarding may be a form of obsessive-compulsive disorder (OCD).  Other studies suggest hoarding may sometimes be related to ADHD or dementia. 

  What's Clutter?

  Many people live with a fair amount of mess, but the home is safe to move around in; they can straighten up enough to feel at ease having guests. Rooms are used the way they're meant to (no paper piles in the bathtub).

  Some people collect lots of things, but unlike a hoarder's stuff, these items have value or personal meaning.  Displays of holiday décor or model trains bring pleasure and pride, not the shame or sadness that often comes with hoarding.

  Where hoarding is a mental health concern, "clutter is largely in the eyes of the beholder," says Margit Novack, president of the National Association of Senior Move Managers. "Different people are comfortable with different degrees of clutter."

  People with problem-level clutter, though, may have trouble keeping their home tidy, even after they get help with cleaning or organizing. The mess returns.

  Signs of Trouble

  A red flag is when clutter affects your daily life. Ask yourself questions like these:

  • Do you buy many of the same things over time, because you can't find what you already have?

  • Does your stuff prevent you from having people over or having enough money?

  • Are you late paying bills because you can’t find your bills?

  • Do you have trouble getting dinner ready on time?

  • Does someone complain about your stuff? Does it cause family fights?

  • Are there narrow "goat trails" in your house to walk through between tall mounds of stuff?

  • Do you ever feel "I'm out of control" or feel bad looking at your piles of clutter?

  "Yes" answers mean your clutter might be a problem for you or others.
• Watch what you do: When you bring in mail, where does it go? When you see exactly how your clutter snowballs, you can get a better idea of how to stop it, Lark says. Could you stop at a recycle bin on your way from the mailbox to get rid of junk mail?

• Name the problem. People often tell Lark, "I cleaned my desk, but it all came back." This language distances you from the real issue of what's going on in that space. "It" isn't the problem -- your habits are.

• Set concrete limits. Saying "I'll buy less" is too vague. Better to say, "I'll limit my mess to these two rooms," Novack says.

• Accept neatness as a lifelong issue for you.  "It's a constant struggle, like losing 50 pounds and needing help to maintain it," Novack says. "You might gain 5 back and have to work hard not to gain 10 or 15."

• Try formal help. Self-help groups like Clutterers Anonymous and Messies Anonymous give ongoing support. A pro organizer can help you get on top of things and learn ways to improve. Also useful are cognitive behavioral therapy and treatment of underlying issues, such as ADHD or depression.

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Why Does Depression Return?

Why Does Depression Return?

"Return of depression is usually triggered by a change in social rhythms," says Dr. Kennedy. "This could be anything that causes a disruption in normal social routines, such as an illness or the loss of asocial support system."

Changes that can trigger a depressive episode include:

• Life-altering events. 
• the loss of a job,
•  the end of a valued relationship,
• Cheating by spouse
• ill treatment by children
• suffocating environment in work place ( like denying rightful promotions for years)
• comparing or expecting too much from life
• over demanding family 
• serious illness in a family or self 
• constant injustice 
•  or any other new and stressful situation.
•  "A common example would be when a spouse becomes ill and the person with a history of depression must become a caregiver," notes Kennedy.
• Other medical conditions. Being diagnosed with a serious medical condition may cause depression in some people. The onset of a major illness may introduce new medications and symptoms that could trigger a depressive episode. "Studies show that one-fourth of people will suffer a depressive episode after a heart attack. A stroke or a fractured hip may decrease independence and increase isolation, which also could lead to a return of depression," says Kennedy.
• The illness itself. It’s not always possible to pinpoint a trigger for a depressive episode. "Just like many other diseases, depression may get worse or come back even if you are doing everything right,” Kennedy says. “This is more common in older people, who may undergo changes in their brain that make depression more likely."
• Antidepressants are not working. "We often say that depression is treatable, but we should add that it is not always easy to treat,” says Kennedy. “About half of all people with depression don't improve on the first antidepressant medication.” Your medications may also become less effective over time. “The medication must then be changed, or a second antidepressant must be added," Kennedy says.

Avoiding the Return of Depression

With these steps for self-care, you can be more in control of your depression:

• Recognize the symptoms of a depression relapse. Learn your depression triggers and symptoms so you can tell your doctor about them. "Studies show that the best predictor of a return of depression is a change in sleep patterns,” says Kennedy. “Each person should be aware of their own warning signs. Sometimes a family member may be the first person to pick up on these symptoms." Other symptoms to watch out for include loss of interest in sex, loss of appetite, irritability, and negative thinking.
• Stick to your treatment. The most important thing you can do is follow your treatment plan. That means keeping all your doctor appointments and taking your medications as prescribed. "If antidepressants are part of your treatment plan, never stop taking them on your own," says Kennedy. "Antidepressants are not like pain medications. They take a long time to work completely, and starting to feel better does not mean that you are well yet. Patients who have had two or more depressive episodes may need to stay on antidepressants indefinitely."
• Maintain a healthy lifestyle. This includes learning how to deal with stress, developing a good support system, getting regular and adequate sleep, and exercising. "Regular exercise affects the brain in the same way as medication does. In fact, for mild depression, exercise often works as well as antidepressants,” says Kennedy. It’s also important to eat a healthy diet and limit alcohol consumption. “Studies show that two or more drinks of alcohol a day decrease the rate of recovery from depression by half," warns Kennedy.

Depression is a very treatable disease, but you need to be aware of the possibility of a relapse. "It’s important to treat all cases of depression aggressively and to continue treatment long enough to allow for maximum recovery," says Kennedy.

You can help avoid a return of depression by working closely with your caregivers and medical team, avoiding known triggers of depression, recognizing the early symptoms of relapse, and maintaining a healthy, active lifestyle.

Am I Causing My Husband's Depression?

Q: My husband suffers from depression and has been pulling away from me little by little. Now we are more like roommates than like husband and wife. He travels a lot for a living, so the growing apart has been very gradual. He's concluded that I am the root of his unhappiness and he refuses to get help because he truly believes that I am the problem. What can I do? 

— Karen, Colorado

A: 

I'm sorry to hear that you and your husband are growing apart. Relationship problems are seldom one-sided, but for the moment, you may need to seek help by yourself, at least to help clarify the issues and develop a plan of action. For starters, you might seek out a therapist or counselor who sees both couples and individuals. That may help you figure out some better ways to approach your husband about the issues you are facing as a couple.

http://www.everydayhealth.com/depression-specialist/am-i-causing-my-husbands-depression.aspx

Serotonin Syndrome

Symptoms of Serotonin Overload

Serotonin syndrome can cause a wide spectrum of symptoms due to overstimulation. Gastrointestinal symptoms include diarrhea and vomiting. Nervous system symptoms include overactive reflexes and muscle spasms, said Su. Other signs and symptoms include high body temperature, sweating, shivering, clumsiness, tremors, and confusion and other mental changes.

Symptoms of serotonin syndrome can range from mild to life threatening. In extreme cases, body temperature can become very high, muscles may break down, and a person may go into shock.

Treating Serotonin Syndrome

Serotonin syndrome usually requires treatment in a hospital. The first step is to stop any drugs that raise serotonin. You may need medication to control anxiety and relieve muscles spasms and possibly a drug that blocks serotonin production, called cyproheptadine.

"Cyproheptadine is only available in oral form. Sometimes we need to crush it and give it through a nasogastric tube. Cooling baths may be used to bring down body temperature. Fluids, blood pressure, and breathing support may be needed for severe cases. Most patients are better within 48 hours," said Su.

Drugs That Cause Serotonin Overload

"A single antidepressant can cause serotonin syndrome if a patient overdoses on the drug. Another cause is starting a new antidepressant before an old antidepressant has been completely washed out of the body," said Dr. Su.

"But the most common cause is adding on another type of drug. This can happen if a patient doesn't let a doctor know they are on an antidepressant or if a doctor is not aware of the danger." Some common add-on drugs that could lead to serotonin overload are the pain medication meperidine (better known by the brand name Demerol), the cough medication dextromethorphan, drugs called triptans used for migraine, and the recreational drug ecstasy.

Serotonin syndrome is a dangerous depression drug reaction.

Serotonin is a brain chemical that helps regulate mood and behavior, andincreasing serotonin is one way of treating depression. But if you're taking depression medication that increases serotonin too much, you could be at risk for a dangerous drug reaction called serotonin syndrome.

"Serotonin syndrome usually happens when a doctor prescribes a drug that increases serotonin to a patient already on an antidepressant," said Mark Su, MD, assistant professor of emergency medicine at Hofstra University and director of the Toxicology Fellowship at North Shore University Hospital in Manhasset, N.Y.

An Action Plan for Handling Stress

Stress can take a physical and emotional toll, so be prepared to address it head-on.

Stress is on the rise. 

 Among the leading causes of stress are money, work, family and health issues. Even children aren’t exempt —  looks specifically at stress in kids caused by marital conflicts at home.

But it does need to be addressed. Stress can have a very real impact on a variety of body systems, from the cardiovascular system to muscles. “There’s often also a physiological reaction in addition to the mental experience of feeling stressed,” said Bufka. “And that may manifest itself in terms of headaches, or stomachaches, or muscle tension.”

Any kind of exercise, from high-energy activities to yoga, can help. “When you exercise, your body releases endorphins, which are hormones that fight stress.

Eat well-balanced meals, limit alcohol and caffeine intake, and make sure you’re getting enough sleep.

People should also consider what the source of their stress is, and whether or not they feel it’s at a manageable level. “It’s when our ability to cope with stressful events exceeds what we have to offer…or when it starts interfering with our functioning and our ability to work or be a student or be a parent,” said Bufka. “That’s when we really need to think…maybe I might need some additional support from a mental health expert.”

Often patient does raise stress as an issue, some physicians may simply not feel that they can adequately address it. Doctors also may not recognize that a patient is overly stressed and needs help.

If you can’t identify what’s causing your stress or if it persists and starts interfering with your daily life, then speak to psychologist or counselors or psychiatriists.

9 Ways to Help a Loved One With Depression

Small Acts Add Up to Meaningful Depression Support

It's hard not to feel helpless when a loved one is dealing with depression. But there are many ways that you can offer support and help for depression.

By Marie Suszynski

Just Listen

Listening and providing emotional support really does make a difference to people dealing with depression because it’s common for them to isolate and withdraw, says Christy D. Hofsess, PhD, a licensed psychologist and assistant professor in the department of counseling and health psychology at Bastyr University in Kenmore, Wash. To offer depression support, listen with empathy, meaning try to step inside the person’s shoes and show compassion and warmth. Don’t try to “fix” someone with depression symptoms or say how to feel or what to do, Hofsess says.

Do Research

Giving depression support also means learning as much as you can about the condition. Find out what depression symptoms look like and try to understand the condition. It’s important to recognizedepression as an illness. “Just as if someone you love got diabetes,” Sabine says. Next, keep in mind that although you understand the process of depression, that is very different than comprehending what the person who is dealing with depression is feeling.

Help Find a Therapist

It can be difficult for someone with depression symptoms to pick up the phone and make the first appointment to get treated, but you can help by researching therapists and offering to make the appointment. If your loved one doesn’t feel a connection with one therapist, it’s important to keep looking until you find someone who’s the right fit. There are many medical professionals who help treat depression, including social workers, psychologists, and psychiatrists.

Be Positive

Your involvement in the life of a person with depression is a huge help, even if you don’t say a word, Sabine says. The key to offering depression support is to keep a positive and encouraging attitude. Don’t plead, scold, or cajole someone who is dealing with depression. Just be there. You may feel like you should come up with something insightful that will snap your loved one out of their mood, but you can’t, Sabine says. Let the therapist address the depression while you focus on simply being a positive presence.

Offer Distractions and Activities

Staying active and being around people are among the best ways to deal with depression — in addition to going to therapy and taking medication for depression symptoms, Sabine says. However, trying to get someone with depression to be active may feel like a losing battle. But even getting your loved one to go into another room of the house with you is one baby step that may lead to sitting outside, which could lead to a walk, and that can help immensely. If you offer invitations and get turned down, don’t get discouraged. Know that it’s a symptom of the depression and your encouragement and depression support does help.

Help With Daily Chores

You don’t want to encourage inactivity, but helping your loved one with tasks like cooking dinner or cleaning can ease feelings of despair or stress. If you offer to babysit or arrange for childcare so your loved one can get out of the house and do other activities, even better, Hofsess says. Logistical barriers to getting out of the house can feel overwhelming to someone dealing with depression.

Point Out Improvements

It’s very common for people with depression to stop their medication because they think either that the medication isn’t working or that they don’t need it anymore, Sabine says. However, to prevent relapse, a person should be well for six to nine months or longer before thinking about stopping antidepressants, and should do so only after discussing it with a doctor. Noting improvements as part of your depression support can show your loved one that the medication and other treatments are having an effect. Point out that the house is clean or that your loved one is more active or smiling and laughing more often.

Help Keep Track of Treatment

Sticking with medication is only part of managing treatment for depression symptoms. It’s also vital to keep up withtherapy appointments, which can lead to significant improvements in depression and your loved one’s life. “A lot of times people don’t want to pay for therapy,” Sabine says. Stay involved by asking your loved one about therapy sessions and pointing out what a huge help they can be for depression.

Check In Regularly

A “gentle consistency” is best for offering depression support, Hofsess says. If you call or visit regularly, your friend or family member will get the message that you’re there for support. Pay attention to cues from your loved one to decide how often is best, whether it’s a phone call or visit once a week or an e-mail or text every other day. And don’t give up on your efforts. It may take weeks or months of treatment to see improvement in depression symptoms, but it will happen.

http://www.everydayhealth.com/depression-pictures/ways-to-help-loved-one-with-depression.aspx#/slide-10