Filthy homes with decomposing cats, huge cleaning bills and the death of a pensioner are some of the extreme outcomes of tragic hoarding disorder.
Hoarding disorder is the mental health problem that has led people to leave their homes in filthy conditions, piled high with rubbish and has even led to a number of court cases over the last few months.
Last month the ECHO reported on Richard Wallach , from Toxteth , who was found guilty of killing his wife Valerie through gross negligence after she was found in what emergency service workers described as " the worst conditions of any living human " that they had ever seen.
In another case, Damien Beales and Robert High were convicted after failing to appropriately look after a number of cats that were found to have been eating other decomposing pets when police and the RSPCA were called to their home in Stoneycroft and met with disturbing sights of filled bathtubs and floors caked in animal faeces .
Also in September, the ECHO reported on a hoarder house in Runcorn that was so filthy that neighbours had to buy it in the hope of clearing it out.
A stomach churning video showed a cleaner making his way through the junk filled home after neighbours Stephen and Colette Dowd claimed they had suffered years of hell living next door.
While covering each of these cases it became clear that mental health will have undoubtedly played a part into the states of the homes.
Richard Wallach was diagnosed with hoarding disorder shortly after the death of his wife, while Damien Beales and Robert High both claimed in court to suffer from serious mental health problems.
The Royal College of Psychiatrists and the NHS have significant information about hoarding disorder and what it can mean for people day-to-day but also explains that hoarding can lead to significant problems, such as those above.
Here are some of the most common questions about hoarding disorder, what it means, and how to stop it getting out of control.
What is hoarding disorder?
Hoarding disorder is where someone acquires an excessive number of items and stores them in a chaotic manner.
This usually results in unmanageable amounts of clutter and in some cases, like the cases of Richard and Valerie Wallach, Damien Beales and Robert High, and the Runcorn hoarder house.
Usually, the items are worth little or no money and include rubbish and filth.
Most common items that people hoard
Some people with a hoarding disorder will hoard a range of items, while others may just hoard certain types of objects.
Items that are often hoarded include newspapers and magazines, like those seen in the pictures of the Wallach home, books, clothes, receipts and household supplies.
Some people, like Damien Beales and Robert High, also hoard animals, which they may not be able to look after properly.
More recently, hoarding of data has become more common.
This is where someone stores huge amounts of electronic data and emails that they're extremely reluctant to delete.
Why do people hoard?
The reasons why someone begins hoarding are not fully understood but it can often be a symptom of another condition.
Mental health problems associated with hoarding include severe depression, psychotic disorders and obsessive compulsive disorder.
In some cases, hoarding is a condition in itself and often associated with self-neglect. These people are more likely to live alone, be unmarried, have had a deprived childhood or have a family history of hoarding.
Many people who hoard have strongly held beliefs related to acquiring and discarding things, such as: "I may need this someday" or "If I buy this, it will make me happy".
Others may be struggling to cope with a stressful life event, such as the death of a loved one.
How can hoarders be treated?
Hoarding disorders are challenging to treat because many people who hoard frequently do not see it as a problem, or have little awareness of how it's affecting their life or the lives of others.
Many do realise they have a problem but are reluctant to seek help because they feel extremely ashamed, humiliated or guilty about it.
It's really important to encourage a person who is hoarding to seek help, as their difficulties discarding objects can not only cause loneliness and mental health problems but also pose a health and safety risk.
If not tackled, it's a problem that will probably never go away.
The main treatment is cognitive behavioural therapy (CBT). The therapist will help the person to understand what makes it difficult to throw things away and the reasons why the clutter has built up.
This will be combined with practical tasks and a plan to work on. It's important the person takes responsibility for clearing the clutter from their home. The therapist will support and encourage this.
Antidepressant medicines called selective serotonin reuptake inhibitors (SSRIs) have also been shown to help some people with hoarding disorders.
