I have a 62 year old male family member who has not let anyone into his home since his youngest child left (approximately 13 years ago). In that time the house has been filled with useless items obtained at garage sales and flea markets as well as trash associated with day to day living. He has been widowed for nearly 25 years. He has had one serious relationship since his wife’s death that ended in part, because of issues related to his impotence. He maintains relationships with his immediate family members and several long time friends but his interaction with us is sometimes belligerent and always on his own terms. He also has a tendency to be very cynical, assuming people in power (especially lawyers, politicians and CEOs)are intent on taking advantage. It just recently came to our family’s attention that his home is virtually uninhabitable although he continues to reside there. He travels often, admittedly to avoid being at home. Upon our being informed of how serious his living conditions had become, we have begun working with him to seek out psychiatric and psychological help. He is compliant in regards to taking his medication (Prozac) but has not made an effort to maintain psychological appointments. In an effort to continue to work with him to change his lifestyle (which he admits he wants to do) I am seeking out information and support for his disorder. I’m having trouble though, determining if his problems are anxiety and/or depression specific or if there is a separate classification for individuals who, like him, have literally turned their living quarters into a garbage dump. Please advise!
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It would be difficult for me to properly diagnose your relative were I to have a complete consultation with him. It is impossible for me to do it via email. However, nothing you’ve presented here is necessarily more complex than the range of behaviors compatible with a moderate to severe and recurrent depression. Of course – he might have many other things going on too. The only thing I can say for sure is that with this stuff going on for 25 or 13 years – it is certainly now a chronic lifestyle even if it started long ago as an acute problem. I’m not aware of any separate classification for persons who trash their living quarters. Maybe one useful way to proceed is to focus on what sorts of practical problems your relative is experiencing. For one thing – he has hygiene and socialization problems. You might do him a world of good by helping him to make some progress in these areas. For instance – does he feel helpless with regard to his mountains of trash? Provided that is is interested – try helping him to break down the work to be done into manageable sized ‘doable’ chunks and help him to know what the skills are he needs to make that progress. For example – maybe he can only handle throwing out some trash from one room in his home. Show him how this is done (e.g., collecting and bagging trash) and then see if he can do a bag of it by himself. Work with him to set reasonable goals that he can manage for getting the clean up done (e.g., he’ll collect and throw out one bag of trash a day). Chart his performance so that he can see the relationship between his sustained effort and the condition of his home. This sort of approach is how any large project gets completed – and yet it can be beyond the grasp of depressed persons to see this (as they tend to be perfectionists and quick to judge themselves negatively). Good luck.