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Dr. Elspeth Bell has traversed canyons created by shoulder-high piles of everything—from newspapers and magazines to bags of clothing and garbage.

These narrow walkways — "goat paths" to Bell — aren't found in alleyways or warehouses, but in the homes of compulsive hoarders Bell tries to help. And the canyons can be found right here in Gaithersburg.

Hoarders accumulate vast quantities of possessions, but are unable to throw any of it away, experts say. Local officials say increased news media attention nationwide has brought to light more cases of hoarding in Montgomery County.

Two task forces, one in Gaithersburg and the other in the county's Department of Health and Human Services, have formed in the past year to help hoarders, as well as their families and friends.

Bell is a member of both task forces.

The county task force, formed about four months ago, also includes Bonnie Klem, supervisor of Adult Protective Services for the county's HHS; Uma S. Ahluwaliacode, director of HHS; and representatives from code enforcement and police.

The Gaithersburg task force formed a little more than a year ago, Roman said.

It includes representatives from the Gaithersburg Community Services and Neighborhood Services departments, several nonprofits, the county's HHS and County Fire Marshal.

 "We've seen an increased number of cases over the past few years, but that's probably because of better reporting," said Steve Rainone of Gaithersburg's planning and code department.

Bell, a psychologist with the Behavior Therapy Center of Greater Washington, said hoarding is an avoidance mechanism and often the symptom of another psychological disorder. It is not a medical condition, however.

"It's on the spectrum of obsessive-compulsive disorders, but it's not considered OCD," she said. Hoarding also can be the result of traumatic brain injury, depression or other psychotic disorders, Bell added.

County officials with the HHS estimate that between 50 and 60 cases are discovered in the county each year.

Kevin Roman, director of Neighborhood Services in Gaithersburg, said about a half dozen cases were discovered in the city in 2009; one has been found so far in 2010.

"Fifteen years ago, we'd go into a home and we didn't even call it hoarding," Klem said. "It was not considered an illness. It was considered sort of a lifestyle, and people are entitled to do what they want to do."

Attitudes about the causes and hazards of hoarding have changed.

The piles can be a fire hazard, violate housing codes and create generally unsafe living conditions for the hoarder, Bell said.

"They develop an emotional attachment to their stuff. They often feel ashamed of how their homes look, but their clutter makes them feel comfortable, at ease, secure. So they make up excuses."

The shame often leads to impaired social interactions, she said, such as not going out to socialize at friends' homes for fear of being asked to socialize in their own homes.

Horror stories abound.

When one house was cleaned out, Bell said, mushrooms were found growing in the carpet.

In another home, code enforcement officers said the weight of the accumulated clutter made the house so structurally unsound that the building had to be demolished.

Hoarders are often brought to the attention of the city by concerned friends or family, said Maureen Herndon with the city's Community Services department.

Herndon also is on the city's hoarding task force and was instrumental in its conception three years ago. "We modeled it on the Fairfax [County] task force" in Virginia, she said.

The task force allows officials to look at a case from all angles at the same time, at the same table, she said.

One broader goal of the task force is to educate medical professionals and the public to better recognize hoarding, she said.

Bell said hoarders often live alone, have trouble interacting normally with others in social situations and are articulate. The average age of a hoarder is mid-50s.

Bell said she uses cognitive-behavioral therapy to help hoarders declutter their homes, but they frequently relapse.  Drugs used to treat OCDs often do not work for hoarders.

"We don't have the right to tell people how to live," Klem said. "But we strongly encourage them that we can help them clean up."

For information or to report a case of hoarding, contact the Gaithersburg Neighborhood Services department at 301-258-6330 or plancode@gaithersburgmd.gov.

Contact the county's Department of Health and Human Services at 240-777-1245 or hhsmail@montgomerycountymd.gov.