Patients with messie syndrome live in absolute chaos. The cause of the chaos is obsessive-compulsive disorder with mostly neurotic fear of letting go. Treatment is a combination of medication and talk or behavioral therapy.
What is messie syndrome?
Messie syndrome takes its name from the background of the English verb “to mess up,” which means “to make a mess of something.” People with messie syndrome, colloquially known as messies, live in an unbearable mess. Messiness is the norm for their homes and, at times, their workplaces. In the ICD-10, Messie Syndrome is not treated as a medical condition, but is classified under Obsessive Compulsive Disorder. Obsessive-compulsive disorder is characterized by unpleasant thoughts through which certain actions impose themselves in a repetitive manner. The patients can neither resist the thoughts nor the resulting actions. Mostly, they perceive the thoughts as not belonging to themselves or inconsistent, i.e. as ego-dystonic. There are fluid boundaries between normal obsessive-compulsive behavior and obsessive-compulsive disorder. So also between the Messie syndrome as a pathological state of mind and Messie behavior as an expression of normal conversions of the psyche. In this context, reference should be made to adolescents in whose rooms chaos likes to reign. This chaos does not necessarily indicate a psychological problem, but expresses a threshold of development. With the disorder they resisted the parental orders and look for their own way.
Causes
The cause of Messie Syndrome, in the narrow definition, is obsessive-compulsive disorder. In many cases, for example, the origin of the mess is the active accumulation of objects, with the accumulation serving a psychological function. In the broader definition, Messie Syndrome may also be based on a mere inability to provide structure or order in the personal environment. This relationship, in turn, does not necessarily have to be associated with obsessive-compulsive disorder. The inability to keep order can just as well accompany illnesses such as ADHD and thus be due to a lack of attention. ADHD sufferers often tackle several projects at the same time, are ultimately unable to manage them in a goal-oriented manner, and get bogged down. Chaos and a loss of overview are the result. Beyond ADHD, psychoses can also be responsible for a lack of order. In this case, severe thought disorders give rise to chaos, which is often primarily based on disinterest. Similar correlations apply to severe depression, which deprives the patient of any drive. Lastly, disturbed executive functions can be disturbed in the context of physical diseases such as dementia. In this case, the lack of order is due to the inability to act in a goal-oriented or planning manner. In other, physical illnesses, the ill person often has insufficient energy to create order.
Symptoms, complaints and signs
True messie syndrome in the context of obsessive-compulsive disorder is relatively uniform in its clinical appearance. For example, patients’ leading symptoms include an inability to keep their living or work areas in order as needed. In addition, true messies primarily symptomatically collect and hoard objects with no or at least questionable usefulness. As a rule, they are unable to part with unusable items, so that the living area can become cluttered. Accompanying symptoms of the real Messie syndrome are social isolation in the context of an obsessive-compulsive disorder. The affected persons are not able to carry out everyday practical tasks or to keep interpersonal agreements. In most cases, they are also plagued by self-esteem doubts and feelings of shame, which further support the social withdrawal. The symptoms of true Messie Syndrome are thus quite different from those of the broader concept of Messie. Crucial in this context are the traits of compulsivity that distinguish true messie syndrome in the narrower definition from all spurious forms of messie behavior.
Diagnosis and course of the disease
Messie syndrome is diagnosed by a psychiatrist or psychotherapist. During the case history, the therapist obtains crucial clues that suggest obsessive-compulsive disorder.In the context of diagnostics, it is particularly important to differentiate a genuine messie syndrome from spurious forms caused by ADHD, dementia, psychoses or depression. Only through this differentiation will the therapist be able to develop an appropriate therapy. The prognosis for messies differs with the individual case. The faux messie syndrome due to dementia, for example, is hardly curable.
Complications
The obsessive impulse to make one’s home increasingly littered by collecting useless things has not yet been recognized as a disorder in its own right. This leads to discrimination and other complications such as losing one’s home. Health consequences are also conceivable, because those affected are no longer able to meet the normal requirements of physical hygiene or cleanliness in the kitchen in a littered apartment. Whether it is a messie syndrome at all or the harbingers of dementia, kleptomania or a psychotic illness can hardly be determined if the facts are not known. But an obsessive-compulsive disorder like messie syndrome can get so out of hand that sufferers experience enormous distress. This can lead to depression and suicidal thoughts. In addition, increasing clutter, in conjunction with animal husbandry getting out of hand, can lead to illnesses such as diarrhea, scabies, or fleas. Littering syndrome represents a variant of the messie syndrome. Since the affected persons rarely reveal themselves to others out of shame, they remain alone with their problems for a long time. The increasing littering of the apartment, the increasing neglect and the accompanying social withdrawal can lead to complications with the landlord. Often, the end result of this conflict is homelessness. In addition, addiction problems may arise.
When should you go to the doctor?
The Messie syndrome is often the most burdensome for the affected person himself than for his fellow men. No one would like to be considered a messie or admit such a problem to himself. It is therefore all the more important to seek medical and, above all, psychological help if you suspect you have a messie. It is sufficient to go to the family doctor and describe the problem – he will initiate all further steps and offer help. First of all, a physical examination of the patient is also important in the case of a messie syndrome. With this, organic diseases can be excluded. In addition, this will check whether the patient has been harmed by possibly unhygienic living conditions. Longer than with the family doctor a patient with the Messie syndrome will work however with a psychologist. Together with the patient, the psychologist finds out why objects are hoarded in the first place and why it is not recognized when something needs to be disposed of. Step by step, skills are built up and developed to let go of things, keep things tidy and lead an orderly life again. The Messie Syndrome is easily treatable even when it is already far advanced and leads to the fact that the living conditions put a heavy burden on the affected person himself.
Treatment and therapy
Treatment of messie syndrome depends on whether the chaos is caused by compulsive hoarding as part of an obsessive-compulsive disorder or corresponds to a concomitant of other problems. ADHD patients, in addition to prophylactic ADHD treatment, are provided with everyday organizing strategies for their individual organizing needs. Real messies, on the other hand, have psychological resistances that oppose order. Obsessive-compulsive disorders can be treated with antidepressants. ADHD patients, on the other hand, are given stimulants. Patients with psychosis are given neuroleptics, dementia patients are treated with antidementia drugs and depressives with antidepressants. Psychotherapeutic approaches are considered the therapy of choice for the causal solution of the problem. Behavioral therapy approaches, for example, may have as their immediate goal the establishment of healthy order. In the case of neurotic resistance to letting go, inner-emotional conflicts are made more conscious to the patient in therapy. Supportively, the principle of self-help applies. A trusted person can, for example, give the affected person coaching in tidying up. Patients with real messie syndrome proceed step by step and must not be overtaxed in the practical implementation of tidying. During the tidying work, it is important to consciously pay attention to their inner experience.
Outlook and prognosis
The prospect of being able to live a normal everyday life again, despite the messie syndrome, is the original motivation for therapy for many of those affected. Depending on the severity of the messie syndrome, they may no longer be able to find a way out of the chaos on their own. The long-term prognosis depends to a large extent on whether the impulses of the therapy can be transferred safely into everyday life. The quality of the therapy is therefore of decisive importance. The more clearly possible psychological causes are uncovered and dealt with, the better the chances are that those affected will no longer fall back into old patterns. In most cases, those affected also learn in therapy how to tidy up, how to sort out and how to recognize that there is too much clutter again. It is important to provide those affected by the Messie Syndrome with options during the ongoing therapy that they can try out directly in everyday life. If at some point the therapist’s support is no longer available, the patients should have learned how to organize themselves in concrete terms. The long-term prognosis is also more likely to be favorable if affected individuals have a stabilizing environment. Support from family and friends is important so that, on the one hand, the situation is kept in perspective, especially in the first weeks after the end of therapy. On the other hand, there will always be phases, especially with a strongly pronounced messie syndrome, in which those affected find it difficult to apply the new patterns. Here, constructive support is a positive prognostic factor.
Prevention
Manifest, true messie syndrome can be prevented by mental stability. This stability can open psychotherapy in situations of mental challenge.
Aftercare
Because a messie’s syndrome is due to severe mental, the condition usually requires a lifetime of follow-up care. A new onset is possible shortly after the initial therapy, as well as years to decades afterward. In the aftercare of this disease, it is primarily the patients themselves who are called upon to observe themselves critically and to register emotional imbalances sensitively. Those affected must decide for themselves when to seek professional help again. However, it is advisable to contact the former psychotherapist as a preventive measure if necessary. This makes sense, for example, in the event of major changes or stressful life situations. Strokes of fate can also attack the mental stability of those affected. Often, those familiar with the patient are better able to recognize whether there is a need for renewed therapy. In principle, a stable living environment is beneficial for former Messie Syndrome patients and helps prevent new outbreaks.
Here’s what you can do yourself
Strategies that the affected person has worked out together with a therapist or counselor should usually also be used in everyday life. Behavioral therapy approaches in particular can only really work when developed strategies are put into practice. Throwing things away can lead to nervousness and anxiety in messies. In everyday life, it is therefore often necessary to endure this anxiety – much like an alcoholic who has to resist the cravings of his addiction. The more often a sufferer stands firm and doesn’t give in to the desire to keep things, the easier it becomes to throw them away over time. Often, messies look for ways to get around rules that loved ones or they themselves have established or that have been worked out with a therapist. This search for excuses can be very stressful for the sufferer as well as for roommates and loved ones. Here, too, a consistent attitude is usually called for. Unwarranted compromise can result in Messie Syndrome persisting or slow progress in treatment. In practice, the urgency of action can vary widely. Hygienic and health risks can arise directly from soiling, mold or fecal matter, but also from fire hazards or blocking escape routes. Eliminating these hazards has a very high priority because they endanger health.
