Separation Anxiety

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Diagnostic and Statistics Manual of Mental Disorders expanded the definition to include adult diagnoses. This post is going to focus on the adult side of Separation Anxiety as there is an estimated prevalence of just over 6% for this disorder with over 75% of those patients reporting an adult onset of their symptoms. Separation Anxiety is not just for children, and deserves to be understood.

Separation Anxiety Disorder Symptoms in Adults

DSM-5 defines Separation Anxiety Disorder as an official Anxiety Disorder that involves the following:

Excessive fear and anxiety involving separation from a person you’re ‘attached’ to in at least three of the following ways.
- May be experienced in anticipation of you being away from home or your ‘major attachment figure’ leaving home, even for short periods of time.
- May be experienced with fears of your attached figure falling ill, being injured, caught in a disaster or them dying.
- May be experienced with fears of you getting lost, kidnapped, being in an accident or falling ill and being separated from your attached figure.
- You may refuse to leave home for work, school, etc. as the perceived risk is too great.
- You may experience excessive fear when left alone or without your attachment figure.
- You may be reluctant or refuse to sleep either at home or away without the presence of your attachment figure.
- You have repeated nightmares about being separated from your attachment figure.
- You may experience headaches, stomach issues, nausea or vomiting during episodes of separation or in anticipation of them.
These feelings need to persist for four weeks in children and adolescents, but must last six months or longer in adults for a diagnosis.
Your distress causes too much stress on your ability to function at school, in a work setting or in other areas of your life and warrants a clinical diagnosis.
Your symptoms cannot be better described by a different mental health concern or diagnosis.

Another sign of Separation Anxiety is impulse control problems. When you feel anxious, it may be difficult to restrain yourself from seeking comfort and so a learned maladaptive pattern of behavior(s) develops.

Causes of Separation Anxiety

There isn’t much known about the exact causes of Separation Anxiety, however, there are several potential contributing factors.

Being raised by an anxious or depressed parent
- Genetics could play a key role in causing your anxiety.
- Behavior modeling could explain why you become so distressed by normal life functions.
Untreated childhood Separation Anxiety
A low functioning prefrontal cortex (thought, action and emotion regulator) and anterior cingulate cortex (learning, cost-benefit calculations and conflict monitoring) have been associated with the emotional regulation and cognitive functioning problems found in people with anxiety.
Conditioned neural centers that cause greater reactions to low stimuli events.
Chemical imbalances in your brain that can send confusing messages in the presence of stimuli or when stimuli are absent.
Trauma that took place away from a caregiver and so conditioned you to become hyper-fearful and hyper-vigilant for the potential repeat of said trauma, even when you have identified with a new ‘attachment figure’.
Unhealthy attachment patterns from childhood.
- Avoidant
- Ambivalent
- Disorganized
Unhealthy relationship dynamics from current or past relationships
- Especially where sexual abuse was/is present

Dealing with Separation Anxiety in Relationships

Separation Anxiety vs. Borderline Personality Disorder

I guess that it shouldn’t come as a surprise that Separation Anxiety can wreak havoc on your relationships. If you have a partner with Separation Anxiety, their anxieties and needs may feel overwhelming or controlling to you. It should be stated, however, that Separation Anxiety and Borderline Personality Disorder, a condition where your partner may not value or respect your need for boundaries are two different experiences.

A partner with Separation Anxiety will feel anxious or distressed when parted from you or in anticipation of being parted from you to the point where they may become physically ill.

A partner with Borderline Personality Disorder will constantly check up on you via text, calls, showing up unannounced, and won’t care about any boundaries you attempt to put in place. BPD can manifest as a highly controlling and manipulative form of behavior within relationships and should be taken seriously.

Ways to help Separation Anxiety

First off, ask questions. The more you try to understand what triggers your Loved One’s Separation Anxiety, the better equipped you’ll be to understand and meet your LO’s needs.

Second, encourage them to seek professional help. Group Therapy sessions and Family Therapy, (both highly recommended for treating Separation Anxiety) might be a good way to get them in the door for therapy if they know they aren’t going alone.

Third, encourage them to practice stress reducing activities and manage their well-being through self care. The better their overall mental health, the less drastic their symptoms of Separation Anxiety will be. Since the goal is to get their anxiety to within a manageable level or to completely overcome their anxiety, this is just as crucial step as the ones listed above.

Fourth, encourage your LO to continue seeking help, especially if initial treatments with medications, or therapy aren’t producing as much of a result as they’d like. Different types of medications used to treat Separation Anxiety may take time to become effective and finding the right balance between therapy and medications, pharma-based or natural, can take time.

Overcoming Separation Anxiety

Because the symptoms of Separation can be so debilitating and involve the life of a loved one, it is crucial to approach this anxiety disorder with as much knowledge and expertise as possible. Anyone who suspects they, or their partner, may be dealing with Separation Anxiety should seek professional help as this type of Anxiety can not only be difficult to deal with, but is also highly treatable.

Therapy Options

Cognitive Behavioral Therapy is a common treatment for this form of Anxiety and involves teaching yourself how to reframe your thoughts around anxiety inducing scenarios or people.
Dialectical Behavioral Therapy focuses on how to deal with difficult emotions by asking you to journal your emotions and their resultant behaviors so you can come to understand your own behaviors better, but also identify areas to improve.
Group Therapy Sessions allow you to develop emotional understanding and coping mechanisms around others who also struggle with intense emotions.
Family Therapy Sessions will provide a way for you and your loved ones to talk about your behaviors and how they affect everyone so you can be more aware of yourself and recognize what skills still need to be worked on.

While you attend therapy, the goals will be to:

Help you focus on the present, instead of worrying about the past or future.
Help you build up tolerance to situations you find distressing so you don’t act out.
Learn how to manage your emotions despite stressors.
Communicate your needs and boundaries.
Learn how to better respect other peoples’ needs and boundaries.
Be more aware of your emotions in general.

Medications

Anti-depressants or SSRI’s are commonly diagnosed for this type of disorder.
Benzodiazepines can help manage your symptoms of anxiety.

Not everyone will find an ideal medication right away, while others will need to consider using nutritional supplements to either replace or supplement their current medications for the most effective outcome. Make sure you discuss your options with your chosen medical professional, and if you feel a need to seek a second opinion from someone who is open to different treatment options (not all doctors understand naturopathic medicine) then don’t be afraid to explore your options.

Conclusion

No matter where your Separation Anxiety stems from, it is a highly treatable form of anxiety that involves significant distress and anxiety over being left or without your attached figure. Separation Anxiety should be treated not only for your sake, but for those you love in order to ensure ongoing healthy relationships. There are multiple types of therapy, medications and stress management that can help you find a positive balance to overcome Separation Anxiety. Stay open to the idea of a healthier version of you!

May God Bless and Keep You.