We have a church member who I think needs help. She was ill recently, and I took some food to her. I could hardly get into her home because of all the stuff she has hoarded. Old magazines and countless boxes of stuff, including items purchased at sales that were still in the original packets, unopened and unused. She seemed kind of sad and depressed, and not receptive to me helping her clear some of it out. What should I do?

Hoarding has been recently introduced into the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, as a mental disorder. This is not the mere collecting of specific things such as stamps or specific memorabilia, which many people do as a hobby. Instead, it’s a persistent difficulty in discarding or parting with possessions. The most commonly saved items are not necessarily of any value, such as old clothes, newspapers, books, and plastic bags. Many “reasons” for hoarding may be given, including sentimental value or the wish to avoid wastefulness.

One of the characteristic features of hoarding that helps to identify this problem is that getting rid of the “stuff” causes intense emotional distress.

I’m sure many wives will be thinking their husbands have this disorder, but hoarding far exceeds the desire to keep a worn-out pair of slippers or a favorite shirt!

The house/dwelling space may become so cluttered that movement down the corridor is impeded. Some people have difficulty having enough space just to be able to get into bed.

Such clutter prevents cleaning and permits the proliferation of vermin, such as mice and rats, roaches and spiders. This adds the additional danger of physical diseases carried by these pests.

Sometimes the hoarding is of animals. We all have read of people who have homes with some 50 cats in residence. The motives are often noble, but financial constraints are generally significant. Despite these difficulties, hoarders persist with this behavior.

Unfortunately these pathological hoarders do not have insight into their problem and are not willing to get help.

Sometimes the clutter spills into their yard and workplace. Severe cases pose serious risks of fire, infection, or falls. Family relationships become strained, with conflict ensuing when help is offered.

It’s estimated that some 75 percent of these hoarders have anxiety or mood disorders. The presence of attention-deficit/hyperactivity disorder (ADHD) is common. Elderly people with the disorder have poorer health in general and more medical problems.

It’s estimated that about 2 to 6 percent of the general population might suffer from this problem. The disorder gets worse and often begins to cause difficulties in functioning and living normally by the age of 30. There appears to be some genetic component to the syndrome. Other accompanying features may further classify people with this disorder.

Neurologic problems, such as brain injury or tumor, need to be excluded; mental disorders such as autism or dementia are also potential causes of the disorder. Most cases are manifestations of an obsessive-compulsive disorder.

Unfortunately there is very little to guide us in way of treatment. In some studies there has been improvement following cognitive behavioral therapy.

In the absence of appropriate, evidence-based guidelines, we can advise you only to be supportive of this member. Involvement of local social services and local public health agencies might be helpful too. The family doctor may wish to secure a consultation with a psychiatrist to address any additional problems. Your emotional support and recognition of incipient dangers may prove indispensable. Supportive, caring relationships and modeling gracious, Christ-centered caring may smooth the way for seeking and securing help in this and many other complex settings involving mental and emotional health in the church and the community.

Do not “grow weary in doing well,” and continue to pray and be as supportive as your friend will allow.

My granddaughter visited us in Maryland, and two weeks after she went home she developed a circle of redness like a target. The doctor said it was Lyme disease. That worried me, because I’ve heard it’s difficult to cure. Can you tell me about it?

Lyme disease is caused by a microorganism called a spirochete. The specific one causing Lyme disease is named Borrelia burgdorferi. Although Lyme disease was described in the eastern United States, there are some cases being reported in the northern Midwestern states, and less frequently in Oregon and northern California. Lyme disease affects males slightly more than females, and the age groups of 5 to 14 years and 40 to 50 years. The number of cases has been increasing since 1992.

There are other species of Borrelia in Asia and Europe that cause a very similar disease to Lyme disease, namely Borrelia afzelii and Borrelia garinii. There is another tick-bite disease that may cause a skin lesion and is associated with the Southern lone star tick, Amblyomma americanum.

In North America, B. burgdorferi is the spirochete that causes Lyme disease. The most common sign of early Lyme disease is the so-called erythema migrans lesion, which is a circular red patch, often with a paler center.

The usual symptoms include fatigue; arthritis; neurologic signs, the commonest one being a facial nerve palsy; a meningitis-like syndrome; and carditis (heart muscle inflammation), which commonly manifests with heart block, a heart rhythm disturbance.

The B. burgdorferi usually lives in mice, chipmunks, other small mammals, and birds, and from them gets to the ticks and the major tick carrier, the white-tailed deer. The deer do not actually host the B. burgdorferi, but carry the ticks. The deer tick, Ixodes scapularis, carries the germs in the Eastern, Northern, and Western states, and the Ixodes pacificus ticks in the Western states.

The ticks feed once in each of their three life stages (larva, nymph, and adult). Humans may not note the immature ticks. The ticks, once infected, may transmit the germ during a blood meal. The nymphs are most likely to be the ones carrying the disease, having become infected as larvae. The adult ticks are more noticeable. The tick needs to feed for quite a long time—probably 36 to 48 hours—before they pass the germs along in their saliva. People who bathe after being in the wild may wash the ticks away, and consequently be at less risk of infection. Spring and summer are the most prevalent times for transmission. There has been no evidence to date of transmission from mother to her unborn child. The organisms are very sensitive to doxycycline and amoxicillin, or even cefuroxime. There is about a 90 percent cure rate on the first course of antibiotic. Repeat treatment will cure the remaining 10 percent. In one study, 87 percent of patients were cured with a single dose of 200 miligrams of doxycycline.

Misinformation on the Internet has generated a lot of anxiety about Lyme disease. Patients in whom symptoms persist need to be investigated for other causes, as ticks can transmit other diseases. In most patients treated with appropriate antibiotics, symptoms resolve completely.

Prevention, of course, is important. Clothing that covers the legs and the use of DEET insect repellent have been shown to minimize the risks of being bitten. A good shower with vigorous soap application within two hours of exposure after being in tick territory, along with the laundering of the clothes worn, might be helpful. The removal of leaf litter and spraying of acaricides (form of pesticides) may also lessen the tick load in a yard frequented by deer.

The risk of Lyme disease following a tick bite is estimated to be between 1 to 3 percent; it’s in cases in which the ticks remain unrecognized that the transmission rates are higher. If ticks are recognized on one’s body, urgent consultation and early treatment are essential and prevent many of the complications. 

Send your questions to Ask the Doctors, Adventist Review, 12501 Old Columbia Pike, Silver Spring, Maryland 20904. Or e-mail them to [email protected]. While this column is provided as a service to our readers, Drs. Landless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend you consult with your personal physician on all matters of your health.