To determine whether an individual is exhibiting symptoms of a hoarding disorder or if the hoarding is a symptom of another issue, a mental health professional or physician assesses the behavior. A hoarding disorder diagnosis requires confirmation of three specific conditions: ongoing difficulty to get rid of possessions, major distress if faced with the scenario of discarding possessions, and an unusable living space due to the accumulation of possessions. Further clues include indecisiveness, procrastination, perfectionism, and distractibility. To determine the individual's day-to-day level of functioning, the health professional may also ask permission to speak with family or friends.

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