About Messie Syndrome

Patients with messie syndrome live in absolute chaos. The cause of the chaos are obsessive-compulsive disorders with mostly neurotic fear of letting go. Treatment is a combination of medication and talk or behavioral therapy.

What is Messie Syndrome?

The messie syndrome gets its name from the English verb “to mess up” which means “to mess something up”. People with messie syndrome, colloquially referred to as so-called messies, live in an unbearable mess. Disorder is the norm in their homes and sometimes in their workplaces.┬áSee AbbreviationFinder for abbreviations related to Messie Syndrome.

In the ICD-10, the messie syndrome is not treated as a clinical picture, but assigned to the obsessive -compulsive disorder . Obsessive-compulsive disorder is characterized by uncomfortable thoughts that force certain actions to occur in a repetitive manner. Patients can neither resist the thoughts nor the resulting actions.

Most of the time, they perceive the thoughts as not belonging to themselves or as inconsistent, i.e. as I-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 changes in the psyche.

In this context, attention should be drawn to young people who like to have chaos in their rooms. This chaos does not necessarily indicate a psychological problem, but expresses a threshold of development. With the disorder, they defended themselves against the parental orders and are looking for their own way.


The cause of the messie syndrome is, in the narrower definition, an obsessive-compulsive disorder. For example, in many cases the origin of chaos lies in the active accumulation of objects, the accumulation fulfilling a psychological function. In the broader definition, the messie syndrome can also be based on a mere inability to provide structure or order in the personal environment.

This connection does not necessarily have to be linked to an obsessive-compulsive disorder. The disorder can just as well accompany diseases such as ADHD and thus be due to a lack of attention. ADHD sufferers often tackle several projects at the same time, ultimately cannot manage them in a goal-oriented manner and get bogged down. The result is chaos and a loss of overview.

In addition to ADHD, psychoses can also be responsible for a lack of organizational ability. In this case, severe thought disorders create chaos, which is often primarily based on disinterest. Similar relationships apply to severe depression, which deprives the patient of all drive.

Finally, disturbed executive functions can be disturbed in the context of physical illnesses such as dementia. In this case, the lack of organizational ability is due to the lack of ability to act in a goal-oriented or planning manner. With other, physical illnesses, the patient often has insufficient energy to create order.

Symptoms, Ailments & Signs

True messie syndrome in OCD is relatively uniform in its clinical presentation. One of the main symptoms of the patient is, for example, the inability to keep order in the living or working area as needed. In addition, real messies collect and hoard objects with no or at least questionable utility.

As a rule, they cannot part with things that are unusable, so that the living area can sometimes become littered. The real messie syndrome has an accompanying symptomatic effect in the context of an obsessive-compulsive disorder in social isolation. Those affected are unable to carry out everyday activities or to keep to interpersonal agreements.

In most cases, they are also plagued by self-doubt and feelings of shame, which further encourages social withdrawal. The symptoms of the true messie syndrome are thus clearly different from those of the broader messie term. In this context, the traits of compulsiveness are decisive, which distinguish the true messie syndrome in the narrower definition from all false forms of messie behavior.

Diagnosis & disease progression

The diagnosis of messie syndrome is made by a psychiatrist or psychotherapist. In the anamnesis, the therapist receives crucial information that suggests an obsessive-compulsive disorder. In the context of diagnostics, what is particularly important is the differential diagnosis of a real messie syndrome from fake forms caused by ADHD, dementia, psychoses or depression.

Only through this demarcation will the therapist be able to develop a suitable therapy. The prognosis for messies differs with the individual case. The false messie syndrome caused by dementia, for example, can hardly be cured.


The obsessive impulse to have your own home increasingly littered by collecting useless things has not yet been recognized as an independent disease. This leads to discrimination and other complications such as home loss. Health consequences are also conceivable, because those affected are no longer able to meet the normal requirements for physical hygiene or cleanliness in the kitchen in a littered apartment.

Whether it is a messie syndrome or the harbinger 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 those affected feel enormous psychological strain. This can lead to depression and suicidal thoughts.

In addition, increasing littering in combination with uncontrolled animal husbandry can lead to diseases such as diarrhoea, scabies or fleas. The littering syndrome is a variant of the messie syndrome. Since the people affected 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 associated social withdrawal can lead to complications with the landlord. Homelessness is often at the end of this conflict. Addiction problems can also occur.

When should you go to the doctor?

The messie syndrome is often more stressful for those affected than for those around them. No one wants to be seen as a messie or admit such a problem to themselves. It is therefore all the more important to get medical and, above all, psychological help if you suspect a messie syndrome. It is enough to dare to go to the family doctor and describe the problem – he will initiate all further steps and offer help. First of all, in the case of messie syndrome, a physical examination of the patient is also important. With this, organic diseases can be excluded. In addition, it is checked whether the patient has been harmed by possibly unhygienic living conditions.

However, a patient with messie syndrome will work longer with a psychologist than with the family doctor. Together with the person concerned, he finds out why objects are hoarded at all and why it is not recognized when something needs to be disposed of. Step by step, skills are built up and developed to let things go, to keep things in order and to lead a regular life again. The messie syndrome is easily treatable even if it is already well advanced and causes the living conditions to weigh heavily on the person concerned.

Treatment & Therapy

Treatment for messie syndrome depends on whether the chaos is caused by compulsive hoarding as part of an obsessive-compulsive disorder or is a corollary of other problems. In addition to prophylactic ADHD treatment, ADHD patients are given everyday organizational strategies for their individual need for order. Real messies, on the other hand, have psychological resistance that opposes order.

Obsessive-compulsive disorder can be treated with antidepressants. ADHD patients, on the other hand, receive stimulants. Patients with psychosis are given neuroleptics, dementia patients are treated with anti-dementia drugs and depressed people with anti- depressants. Psychotherapeutic approaches are the therapy of choice for the causal solution to the problem.

Behavior therapy approaches can, for example, have the establishment of healthy order as their immediate goal. In the case of neurotic resistance to letting go, the patient is made more aware of inner-mental conflicts in therapy. The principle of self-help applies in a supportive manner.

A person of trust can give the person concerned coaching in cleaning up, for example. Patients with real messie syndrome proceed step by step and must not be overwhelmed with the practical implementation of the order. During the clean-up work, it is important to consciously pay attention to their inner experience.

Outlook & Forecast

The prospect of being able to live a normal everyday life again despite messie syndrome is the original motivation for therapy for many of those affected. Depending on the extent of the messie syndrome, they are no longer able to find a way out of the chaos on their own. The long-term prognosis largely depends on whether the impulses from the therapy can be safely transferred to everyday life. The quality of therapy is therefore of crucial importance. The clearer possible psychological causes have been uncovered and processed, the better the chances that those affected will not fall back into old patterns.

Most of the time, those affected also learn in therapy how to tidy up, how to sort out and how to recognize that too much clutter is emerging again. It is important to give those affected by the messie syndrome options that they can try out directly in everyday life during the ongoing therapy. If at some point the support from the therapist stops, the patients should have learned how to organize themselves in concrete terms.

The long-term prognosis is also more favorable if those affected have a stabilizing environment. Support from family and friends is important so that the situation can be kept under control, especially in the first few weeks after the end of therapy. On the other hand, there will always be phases in which those affected find it difficult to apply the new patterns, especially in the case of a pronounced messie syndrome. Here constructive support is a positive prognostic factor.


A manifest, real messie syndrome can be prevented by mental stability. This stability can open up psychotherapy in situations of mental challenge.


Because messie syndrome is due to severe emotional distress, the condition usually requires lifelong follow-up care. A new outbreak is possible both shortly after the first therapy and years to decades later. In the follow-up care of this disease, the patients themselves are asked to observe themselves critically and to register emotional imbalance sensitively.

Those affected must decide for themselves when to seek professional help again. However, it is advisable to contact the previous psychotherapist as a preventive measure if necessary. This is useful, for example, in the case of major changes or stressful life situations. Fate can also affect the emotional stability of those affected.

The patient’s confidants often recognize better whether there is a renewed need for therapy. Basically, a stable living environment is advantageous for former messie syndrome patients and helps to prevent new outbreaks.

You can do that yourself

Strategies that the person concerned has developed together with a therapist or counselor should generally also be used in everyday life. Behavioral therapy approaches in particular can only really work if developed strategies are put into practice. Throwing things away can make messies nervous and anxious. In everyday life it is therefore often necessary to endure this fear – similar to an alcoholic who has to resist the cravings of his addiction. The more often an affected person remains steadfast and does not comply with the wish for storage, the easier it becomes to throw it away over time.

Messies often look for ways to circumvent rules that family members or themselves have set up or that have been worked out together with a therapist. This search for excuses can be very exhausting for the person concerned as well as for roommates and relatives. Here, too, a consistent attitude is usually required. Unwarranted compromises can result in persisting messie syndrome or slow progression in treatment.

In practice, the urgency of action can vary greatly. Hygiene and health risks can arise directly from dirt, mold or faeces, but also from the risk of fire or the blocking of escape routes. Eliminating these hazards has a very high priority as they are a health hazard.