Hoarding Disorder

Timothy is a 47-year-old divorced male living alone, referred by Adult Protective Services following a 911 call during a panic attack in which emergency crews could not enter his apartment due to severe clutter. Hoarding behavior began in his early 30s with sentimental saving and progressively expanded to collecting newspapers, appliances, and broken electronics. His apartment is now largely unusable, and he experiences significant distress at the thought of discarding items, ongoing landlord conflict, social withdrawal, shame, and work impairment (frequently late due to difficulty locating items). He briefly saw a counselor at age 38 for "clutter issues" but discontinued after four sessions, finding it too intrusive, and has resisted prior decluttering attempts by family and friends.