For Charbit, the thoughts began within seconds of waking up each day. “You have a few seconds of peace,” she says. “Then it all comes flooding: The anxiety, the dread … It's that constant nagging. You never reach a point where you're satisfied.” Even now, after years of treatment, “I would rather throw something out and buy it again than keep it.” The medication helps, she says, but it hasn’t stopped her from discarding and re-buying a food processor three times. “And don’t even tell me to recount how many books I tossed, only to go to Amazon and repurchase them.”

The author Helen Barbour, who blogs at The Reluctant Perfectionist and wrote The A to Z of Normal, a novel about OCD, believes the cultural embrace of decluttering makes it harder for those who do it compulsively to seek help. “[People] see my tidy home and sigh about the fact that theirs is a dump,” says Barbour, who was diagnosed with OCD in 1995. “What they don’t realize is how long it has taken me to order everything with millimeter precision, or the anxiety I feel at things being even slightly out of position.” Barbour lives alone, in part, she says, because her long-term partner is “the king of stuff.”

Barbour also found a supportive community online when she wrote a blog post about her compulsive decluttering last February. “Sorting and rearranging helps a little,” she wrote, “and getting rid of just one or two things can also temporarily alleviate the feeling.” Commenters responded with their own experiences: “I get a physical sensation as though I’m being crushed when I have too many things around me,” one wrote. “To say I hate clutter is an understatement … it literally feels like gears grinding in my head,” said another.

Lesley Turner, a 58-year-old woman from Wales, can relate. “I have to do these things,” she says, “or my head is in turmoil.” In 2013, she and her daughter Tuesday, now 25, appeared on the U.K. reality show Obsessive Compulsive Cleaners, in which people who suffer from compulsive decluttering clean the homes of people with hoarding disorder. Lesley says that the show’s producers pitched it to her and her daughter, both of whom suffer from OCD, as a chance to “push our boundaries,” but both women were dismayed with the episode that ultimately aired. “It made it look like a nice, fun, quirky thing to have, not the serious, completely life-consuming illness that it is,” Tuesday says. Earlier this year, after Lesley told the British newspaper Metro that the experience left them “traumatized,” the advocacy-organization OCD U.K. released a statement condemning the show and calling for its boycott.

All pathologies have a spectrum from normal to symptomatic, Diller says, and decluttering is no exception. Barbour considers herself on the “mild end of the spectrum.” Charbit, now married and the mother of a 2-year-old and a 4-year-old, says she’s able to cope with her family’s possessions by “creating little compartments in my life [that] are exactly as I want them to be,” like her closet: “I always, at any one time, have just three pairs of shoes,” she says. “One pair of sneakers, one pair of flats, and one pair of sandals.”