Also, old people are likely to be living alone, without someone to tell them that they are doing something unusual, or to make them care about that fact. The aged have fewer pleasures than younger people do, and therefore may be more tempted by the prospect of having plastic flyswatters in five different colors. DSM-V says that hoarding sometimes begins in childhood, but that by the time the hoarders come to the attention of the authorities they tend to be old. Just as bereavement has an ordinary cause (death), so hoarding may be the product of unremarkable circumstances-notably modern medicine, which allows us to live longer. If you fail, the manual suggests, you may be the victim not only of grief but also of illness, which calls for treatment. Consider one: “persistent complex bereavement disorder.” That’s when you can’t get over the death of someone close to you within the period of time that the DSM considers to be appropriate: a year if you’re an adult, six months if you’re a child. In a section called “Conditions for Further Study,” the manual lists behaviors that it isn’t calling disorders yet but is asking us to think about. DSM-V has a new category, “excoriation (skin-picking) disorder,” which is where you could end up if you don’t stop picking your cuticles. For a number of years now, you haven’t had to do anything especially eye-catching to make it into the manual. The first edition was published in 1952 since then, it has undergone five substantial revisions, and, in the process, the concept of psychopathology has broadened. The document in which these guidelines are laid out is the fifth edition of the A.P.A.’s Diagnostic and Statistical Manual of Mental Disorders (2013), or DSM-V. says, are newspapers, magazines, old clothes, bags, books, mail, and paperwork, though valuable materials-indeed, cash and checks-may also be included with the junk. The items most commonly hoarded, the A.P.A. Hoarders also tend to go in for energetic collecting, often at inexpensive emporia-thrift shops, yard sales, and the like. is a persistent difficulty in discarding possessions, regardless of their actual value, to the point where the person’s accumulated goods congest living areas and impede their intended use. She died in 2010, and so she never had to find out that in 2013 the American Psychiatric Association declared her storage habits a diagnostic feature of a mental illness called “hoarding disorder,” or H.D. And here I came, year after year, throwing them away. Until that happened, she was making sure that she had plenty of things. Soon, she knew, she was going to lose everything she had, because she was going to lose her life. I was helping to keep her apartment in the kind of shape where no one could come in and say that she had to be moved to a nursing home-a possibility that she actively feared. She would stand below me, in her blue robe, her eyes sparkling with-what? Grief? Anger? Eagerness to fill the newly vacated space? I told myself that I was doing her a favor, and I was. I would get up on a stepladder, with a trash bag, and dump the containers in, one by one. Then, every year, shortly before Thanksgiving, I would fly in from New York to visit her, and the first thing we did on the morning after my arrival was clean out the polystyrene-container cupboard. I don’t know what she did with the dinners, but the containers were washed, patted dry, and carefully stacked on their designated shelves. She told me that she might use one as a desk organizer, or perhaps a sewing kit, with different kinds of buttons in the wells. But to my mother they were exotic, and attractive: gleaming and white, with little compartments, like a jewelry box. These boxes, with the flip-up lids, are common trash items of our time. What she did like, however, was the receptacles the dinners came in. Secretly, she wanted no part of the food. In her late years, my mother underwent several operations, and, for a long time, after she came home, Meals on Wheels delivered her dinner. She needed her kitchen cupboards for other purposes, such as her collection of polystyrene food containers. She lived in Santa Barbara, in an apartment with a perfectly adequate kitchen, but in order to store her dishes she had to buy a freestanding cabinet and install it in the dining room. My mother survived to the age of ninety-three, so she had time to develop a number of habits that people now consider to be symptomatic of dementia. Little Edie Beale in Grey Gardens, the home she shared with her mother, in 1972.
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