People who struggle to organise their belongings often report having mental health issues and an overwhelming sense of being out of control.

The mess can lead to feelings of embarrassment and shame, according to decluttering and mental health professionals.

Emma Beagley, from Bristol, started to struggle with clutter following a stroke, which caused permanent paralysis on her left side.

Her psychologist recognised that she was "bordering on hoarder status" and would need to find a solution before moving on with her life, she said.

Hoarding disorder was formally classified as a mental health condition by the World Health Organisation in 2018. It is estimated that up to four million people in the UK live with it.

Anna Davies, co-founder of The Good Sort, an organising and decluttering service based in Shirehampton, Bristol, said there was often a deep reason why people held onto their possessions and it was "only with support that they could start to ask questions".

Mental health professionals agree there are many reasons why people hoard. Gemma Mason, a psychotherapist from Trowbridge in Wiltshire, said it was important to address the underlying causes.

"We have to be careful of removing the surface problem, but not the underlying psychological need, which is not met if you just take items away," she said.

Beagley, who is in her 40s, said her mental ability to process things deteriorated after the stroke in 2018 and it had been difficult to adapt to needing carers.

"My house was stacked with boxes and things that weren't adding to my daily life," she said.

"I struggled to answer the carers' questions about where to put things, so stuff started to pile up and I felt ashamed."

"They needed my input to tell them how they could help me to rearrange my living space so that I didn't have to spend so much of my energy and time explaining things to carers," said Beagley.

Davies says clients usually approach her because they are overwhelmed by their environment and do not know where to start.

"Decluttering is about asking yourself why you're holding on to the things you're holding on to," she said.

"It's understandable that there's a temptation to keep everything from your past, especially if it cost you a lot of money. Our belongings can connect us to old identities, lost capabilities, financial guilt and difficulty accepting change.

"But the 'what ifs' keep you locked into living in the past," she added.

Chloe Wright, who runs Goddess Organising in Frome, Somerset, said she had experienced many clients who had been "manipulated" by marketing into buying more items than they actually needed.

"It could be somebody who spent loads of money on makeup and cosmetics and even though they're not using them any more, or they're not right, they still can't get rid of them because they feel guilt-tripped and don't want to be wasteful and add to landfill."

Wright says people often feel "embarrassed and ashamed" when they meet her, but soon change once they started the process of decluttering.

"Every decision can be quite slow and traumatic and it involves a lot of coaching and negotiating and then by the end of the day, they've realised that the world hasn't burnt down by removing this thing and their decisions get easier," she said.

Mason, who has been in practice for 26 years, said often people who develop hoarding tendencies have had a traumatic event in their childhood.

"They may have grown up in a poor environment or they may have lost someone at an early age, so the clutter becomes a manifestation of something they've not been able to psychologically process."

She said it was important to understand what the symbolic meaning of possessions was to the client as the clutter often "represented something to them that they can't let go of".

"One of the common themes that I've seen is that people become very ashamed of their home environments and so they don't invite people in and it becomes a kind of secret that they keep."

Gemma Nicoll founded The Home Edit Bristol in 2022 and specialises in helping clients with ADHD and neurodivergence.

She says there is a growing interest in decluttering services as people are increasingly recognising how much their home environment can affect how they feel.

"The particular struggles for people with neurodivergence can be task initiation, so they sit at home and know that they want to get things organised, but can't actually get the job done.

"It helps for me just to work alongside them, so they've got somebody to keep them motivated," Nicoll added.

One of her clients, Ellys Binding, from Yate, who is neurodivergent, said making decisions was the hardest part of decluttering.

"I just freeze up and it can be very overwhelming when you look at a space and it's really hectic," she said.

"The storage spaces in my house are quite impressive, as I have very big cupboards.

"But what's happened is that all those spaces have gotten full of the stuff I don't need, and all the stuff that I use on a daily basis is on the surfaces so that I can grab it quickly."

She said it had got to the point where everywhere she looked was "always a complete mess".

"To be able to have someone like Gemma come along and say, 'this time we're going to focus on this' and to do it with you, really helps me to stay on track," she added.

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