Lee Shuer's hoarding began a decade ago as he began collecting Atari video games then progressed to vintage art work and musical instruments.
But soon, his apartment was overflowing with bobble heads, collectibles and anything he could get "free or a good deal."
"It got to the point where more is better," said Shuer, now 37, of Easthampton, Mass. "Eventually, they spilled off the shelves, onto the floor, down the hall, into the bedroom, off the bed -- you could see the tide flow."
Shuer's acquisitions became part of his identity and self-esteem.
"If I had more fun and more toys, people might actually like me," he said. "If I had enough things to play with, they might come hang out."
When he finally met his future wife and they had to clean out the clutter to move in to a new home, she was horrified by the volume of things and begged him to call for help.
Shuer did, and this week he is one of the key presenters at the 14th Annual Hoarding and Cluttering Conference, sponsored by the San Francisco Mental Health Association. There, both clinicians and hoarders will attend an array of workshops on best practices and new treatments.
"I give my wife a lot of credit," he told ABCNews.com. "If it wasn't for her, I wouldn't be talking to you now."
After participating in a study at Smith College in 2005 with pioneering hoarding expert Randy O. Frost, Shuer joined a hoarding task force and began to help others.
"Hoarding has been around a long time, all the way back to the 14th century," said Frost, psychology professor and co-author of the 2011 book, "Stuff: Compulsive Hoarding and the Meaning of Things."
In one of the most famous cases in the 1940s, the Collyer brothers were found dead in their New York City apartment under 100 tons of trash, including human pickled organs, the chassis of an old Model T, 14 pianos, hundreds of yards of unused silks and fabric, the folding top of a horse-drawn carriage, and more than 25,000 books.
Frost identified the three features of hoarding: excessive acquisition, difficulty discarding and disorganization. He developed the "Buried in Treasures" self-help program that gave Shuer his life back.
Compulsive hoarding is strongly associated with obsessive compulsive disorder (OCD), a condition that affects about 4 million Americans, according to the OCD Foundation. About 25 to 40 percent of those with OCD have hoarding symptoms.
Psychiatrists are now hopeful that hoarding will get its own category in the Diagnostic and Statistical Manual of Mental Disorders V this year, distinguishing it from obsessive-compulsive disorder.
Hoarding can lead to serious health or safety dangers and threaten relationships with family and friends.
The disorder is diagnosed when a person experiences significant distress and/or impairment as a result of their hoarding.
Homes on television shows like TLC's "Hoarding: Buried Alive" can have infestations of rodents or insects. Hoarders are unable to entertain guests, prepare food or find their possessions.
"It's difficult to actually get an estimate of how many people are hoarders," said Julie L. Pike, who has appeared on the show and is a psychologist at the Anxiety Disorder Treatment Center in North Carolina.
"There is so much shame and so much hiding around it," she said.
Often hoarders do not seek help until it is too late -- when they have lost their children, their home or a spouse.
In one of the most serious cases of hoarding on the reality show, Pike helped a woman whose home was infested with a nest of black widow spiders and cockroaches. Uncapped insulin needles and dirty incontinence pads were strewn everywhere.
"The exterminator said it was the worst infestation he'd seen in 23 years," said Pike.