Separation anxiety disorder is a type of anxiety disorder, often neglected but has been shown to be quite prevalent when studied. We often associate separation anxiety as a childhood condition; however, it does impact adolescents and adults.
It is characterized as age or developmentally inappropriate fear of separation from an attachment figure. There is fear of losing an attachment figure, reluctance to be separated and a high degree of distress when experiencing separation. Separation Anxiety Disorder is a chronic, long term difficulty.
There is quite a bit of overlap between Separation Anxiety Disorder and other anxiety conditions. There appears to be a hereditary pattern to separation anxiety disorder, at least according to one study. Also, parental overprotectiveness appears to be a contributor to separation anxiety whereas other forms of anxiety are associated with uncaring parenthood.
Of importance, the presence of separation anxiety seems to predict a poorer response to the treatment of general anxiety and depression. What this means, is that if separation anxiety is a presenting feature CBT is less likely to help people with anxiety and depression.
The anxiety in terms of drivers and presentation, how it comes out is similar between adult and child separation anxiety disorder. In adults, separation anxiety arises from being away from their children or spouses. Issues arise with adults leaving home to go shopping or to work.
It seems that the greatest risk factor for developing separation anxiety as an adult is having it as a child. Moving away for university, having a significant death in the family can also trigger separation anxiety. Adults who grew up with overbearing parents are also at risk.
Concern for close friends and family is normal. However, people with separation anxiety disorder fear being apart and their concerns manifest in different ways:
- Heightened anxiety or panic attacks
- Social withdrawal
- Sadness, distress or agitation at being away from a loved one
- Deep fear of losing or having a loved one taken away.
- Difficulty sleeping away from their loved one
In adults to get a diagnosis of Separation Anxiety Disorder, the symptoms should have been going on for 6 or months and impair the ability to function at home or in the community.
Unfortunately, separation anxiety is often missed and underdiagnosed, and the research supports this. It is easier to identify with, notice panic attacks and phobias compared to separation anxiety.
Diagnosis requires exploration or interviewing by your doctor or therapist. It may take a few sessions before you feel completely comfortable to share; that is ok.
A more complete assessment may involve speaking with a family member or partner. It’s important that you are aware of your right to privacy. Discuss that with your doctor or therapist prior to them speaking with others.
Most guidelines for treating separation anxiety comes from work with children and new parents. How we treat older clients is often based on what we have learned about treating children with separation anxiety.
Principles when treating Adults and Teens with Separation Anxiety Disorder:
- Start or intervene early.
- Education about anxiety is key. Learning about why it occurs, how to recognize treat it.
- Therapy often involves identifying thought patterns that contribute to anxious feelings.
- The use of thinking and or behavioural strategies to manage the anxiety and cope with emotions.
- Graded separation with oversight from a therapist
- Keeping to routines and not lumping separation activities with other stressors.
- Similar to the management of other anxiety conditions; relaxation strategies play a part. Learning deep muscle relaxation techniques, breath work or guided meditation may help.
- As with mental health conditions in general good lifestyle and wellbeing choices are important. Sleep, exercise and a good diet have a part in overall mental health care.
Facing up to separation anxiety, challenging notions of safety can be hard. At Epsychiatry our health professionals are aware of this. Our friendly support team welcome inquires about our service. Contact us either via email, phone or webchat to learn more about how we can help.