While many anxiety disorders are very responsive to treatment, compulsive hoarding is a unique disorder which defies classification and tends to be difficult to treat with either medication or psychotherapy. This likely has to do with the lack of insight that most hoarders have into their illness--many don't recognize their need for treatment or don't see the negative impact hoarding is having on their life.
Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), are the medications most commonly used to treat compulsive hoarding. Paxil (generic: paroxetine) is considered one of the most effective SSRIs for hoarding behaviors, but many compulsive hoarders fail to respond adequately to any of the medications available.
Cognitive-behavioral therapy (CBT) is the type of psychotherapy most often used to treat hoarding. Compulsive hoarders often have extreme difficulty making decisions about what to do with and how to organize their possessions, and CBT can help patients learn how to make these decisions and discard unneeded objects. CBT can also help patients address their emotional attachment to and beliefs about objects, so discarding objects becomes less traumatizing. In addition, CBT can also focus on developing coping mechanisms for managing situations that may trigger or worsen hoarding behavior.
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