Writer and broadcaster

My dad has chronic depression and has started to hoard junk. The Guardian

Dear Annalisa

My dad will be 54 in February and he has recently seen a drastic decline in his depression. He was first diagnosed and treated for depression when he was made redundant 11 years ago, and he stayed at home to look after me and my two sisters while my mother went to work. My parents split up not long after, when I was 14 and my youngest sister was 11. It wasn’t an easy split but there are no lingering feelings of regret between my mom and dad now (although he won’t ever be in the same room as her). He has been working voluntary roles and training to be a counsellor in the past few years but lost another job about 10 months ago. He has seasonal affective disorder (SAD) quite severely so his mental state always deteriorates at this time of year but it is now worse than ever.

On top of it all, he has a worrying need to hoard everything. His house is full of junk. His youngest brother died about eight years ago and the event was quite tragic, he then lost his mother and his older brother, to whom he was quite close, died a few months ago. Some of the stuff is from his brothers’ houses so must have some kind of sentimental value, although it is mostly useless bits and pieces.

I don’t know how to approach him properly to help him improve his mental health. I asked to accompany him to the doctors and he says he has been put on antidepressants but I think he should try some other therapies. His sisters are supportive but don’t fully understand the nature of depression and can sometimes be quite brash and destructive when they speak to him. I’m worried his thoughts might be taking a dark path and that any action I take might be too late already.

I answered a letter on hoarding four years ago, the answer to which you may find useful. But I felt this was different. I wondered how much your dad was hoarding and how much this was “not clearing up” (there is a difference) because of his state of mind.

What’s striking is how much loss there’s been in your family, there was something about your father that seemed stuck, almost frozen in fear. And grief and fear are linked. Your dad has lost his job, his marriage, his mother and two brothers. You have all suffered losses. This is a lot to deal with. You mention that your father has been training to be a counsellor so clearly therapy is not something he is averse to, and I do think this is something he needs to look at through his GP or privately. Or Cruse (cruse.org.uk), which provides excellent bereavement counselling either online or via email or in a group.

I consulted Julia Bueno (ukcp.org.uk), a psychotherapist and counsellor, and she also wondered if your dad had had any psychological support along the way. She also wondered about the split from your mother: “I’m not convinced there are no ‘lingering feelings’ regarding his divorce if he can’t be in the same room as your mother. It sounds like there are unresolved feelings there.”

Bueno explained that hoarding is “often a response to tremendous loss and symptomatic of depression by investing in stuff in the here and now. There can be a strange happiness residing in the ‘useless junk’, these are things that won’t die on him, especially if there are associations with his brother.” But we both also wondered that, as well as hoarding because he’s imbuing objects with emotions, how much of the hoarding was a symptom of a lack of motivation to look after himself, as part of his depression.

You asked how to approach him. Why not head on? I don’t mean be confrontational but just a gentle opener, such as “how does life feel at the moment?” Take things slowly, and don’t be too frustrated if you don’t get anywhere immediately.

Bueno recommended a family approach (but leave the aunts out of it for now). Could you and your sisters take a multi-pronged approach? This is as much to give him all-round support as to not over-burden just one of you.

I think it’s quite important not to disempower him further. I wouldn’t, for example, just clear up around him. But try to get him talking. What does the “junk” around him mean to him? What does he fear will happen if it’s removed? Is there a half-way house with some of it? Could you or your sisters take pictures of it as a memento but get rid of some of it? Would he come to a Cruse meeting with you? (After all, you’ve been bereaved, too.)

Bueno suggests, “if your dad is training/trained to be a counsellor, ask him what he would do if he had a client in his position?” She also suggests thinking about getting a lightbox to help with the SAD. And although his GP can’t discuss your dad with you, you can approach him and tell him your concerns.

This article first appeared in The Guardian on 28 November 2014.