My friend Mandi loves clothes and finding bargains. You’d never realise her shopping habit is actually a little-known mental illness that drives 1 in 4 sufferers to suicide: The UK’s top expert reveals subtle signs you could have it too

If you met my friend Mandi, you’d never know that something was amiss.

Bright-eyed, full of smiles and often wearing something sparkly and fabulous, she spends most of her days chatting to customers in the Walton-on-Thames clothing shop where she works.

Like many people – women especially – she has a passion for shopping, and especially loves hunting for bargains in charity shops and car boot sales.

But this habit was in fact a sign of a life-wrecking mental illness that’s plagued her for more than a decade, resulting in £30,000 debt.

I’m not talking about shopping addiction. As a psychiatrist who has been working at the sharp end of mental illness for more than 40 years, I’ve seen just about everything that can go wrong with a person’s mind.

But there’s one condition that never gets the spotlight it deserves, despite driving one in four sufferers to take their own life.

Hoarding disorder, which affects at least three million people in the UK, is a very serious condition – yet its sufferers are often punchlines in cheap jokes, which only adds to the shame that blights them.

I’ve seen this condition destroy countless lives, most of whom have been too embarrassed to seek help until it’s too late – and withered away in silence.

It’s not just damaging for the sufferer. Research shows that hoarding is a major cause of house fires. In 2022, the London Fire Brigade saw 1,036 fires directly related to hoarding, which resulted in 186 injuries and ten deaths – that’s one city, in one year, in a population of nine million.

So what exactly is it?

Well, all of us are collectors. But in a collection, you can find individual items. In a hoard, however, it is far more difficult and may appear a complete mess. Someone with hoarding disorder might be at risk of trips and falls because of their collection, or even infestations.

The key distinguishing factor between a hoarder and a collector is the extreme distress associated with relinquishing an item that holds little obvious sentimental value.

I’ll never forget the patient who likened clearing out her jumble of random items to sexual assault. They feel completely violated.

Hoarding has only been considered as a condition in its own right since 2013. Up until then, hoarders had often been placed under the heading of obsessive-compulsive disorder, as the behaviour can be a symptom of OCD.

People may think of mothers, fathers or grandparents who keep things ‘just in case’ as being the prime candidates for hoarding, but the condition can in fact affect anyone at any age.

However, it is often more obvious in someone who lives alone and has had an entire lifetime to build up their hoard. 

The condition can develop out of seemingly nowhere, but there’s usually an underlying traumatic experience involved.

For instance, I remember one young woman who came from a very well-to-do family, who had been sent off to boarding school at the earliest possible age; her parents were never really interested in her. 

At home, she started collecting soft toys until she really couldn’t move, couldn’t sleep in her bed, couldn’t do anything. The bath was piled up, the kitchen was a fire hazard because of these soft toys. But yet, if you suggested getting rid of them, she said, ‘They’re my only friends.’

While Mandi has been buying and selling vintage clothes at Birmingham Rag Market since she was 16, her habit of collecting only tipped into compulsive behaviour 12 years ago. 

Grief, combined with ‘broken relationships’ and taking voluntary redundancy from the charity where she worked, ‘made me start to lose my sparkle.’ She began going to charity shops almost daily on her lunch breaks and to car boot sales each weekend, seeking the dopamine rush to help her cope with sadness.

Looking around her home one day six years ago, ‘it was like, what on earth has happened, Mandi? You can’t have people round, you can’t sit on your settee,’ she told me.

Before then, Mandi took great joy in 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, very social person.’

There is barely space for her, let alone others. On one occasion, she had to go and stay with a friend ‘because I couldn’t cope, and it was depressing and sad to sit amongst beautiful things’.

She says her buying habits have ultimately led her to rack up £30,000 of debt.

Some friends have been a huge support, Mandi says, but ‘some have stayed away because it’s too overwhelming to deal with for them, for their own mental health. Not that they don’t love me or care for me – they just can’t cope with what I’ve become’.

In 2015, Mandi went to her GP, where she was diagnosed with hoarding disorder and directed towards the Mary Frances Trust, an adult mental wellbeing charity.

She is now an ambassador for the charity Hoarding UK.

Mandi, like me, says the condition is not simply a matter of finding it hard to throw things away, but a mental health issue on par with substance abuse.

As part of her own road to recovery, for the past four years, Mandi has been running a pop-up shop in Walton-on-Thames, selling some of the pieces she has amassed – including many sparkle-clad garments.

Sadly, that closes this weekend, but the rest of the items remain in her house; she has plans to start going out in a campervan to disseminate them to people across the UK – selling some of her pricier finds – along with giving talks about 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 continue with life – and still find joy.

This isn’t true for the vast majority of other patients I’ve encountered over the years.

For instance, there was the highly intelligent, lovely man who drove himself to despair collecting hair and toenails. He knew his behaviour was totally irrational, but couldn’t stop.

Another time, while working on a psychiatric ward in hospital, I suddenly realised there was a horrible smell coming from some of the bedrooms. 

It turned out that one of the patients had been walking around and picking up all the autumn leaves and dead squirrels and birds, and storing them in plastic bags in their room.

Others hoard animals – there are homes where people trying to save pets have instead taken in more than they can look after, leading to sick, neglected or even dead animals.

So how can you tell if there’s a real problem at play?

Ask yourself: is it interfering with your ability to function? Can you sit on a seat in the living room and watch television? Can you go to bed unimpeded, or do you have to climb over things? Can you have a bath, or is it filled with belongings?

If the answer to any of these is no and you (or the person in question) are not keen to get rid of things, I think there’s a problem.

There is a lot of stigma involved, so hoarders feel huge shame when it comes to seeking help – most are depressed.

I suggest contacting your GP, who may be able to point you to local services; the Fire Brigade can do in-home safety assessments, while there are also voluntary hoarding organisations, like HoardingUK, who can offer support.

Psychologists can offer a course of specialised cognitive behavioural therapy to help pick apart the root of an impulse to hoard, and some find antidepressants useful.

This is not something you can fix quickly. But it can be done.

Lynne Drummond’s book, Everything You Need to Know About Hoarding, is available now.

If you think you might need help with hoarding, visit hoardingicebreakerform.org