Separation Anxiety

What is Separation Anxiety Disorder?

In 2013 numerous changes were made to Diagnostic and Statistical Manual of Mental Disorders (DSM–5), a classification of mental disorders used by medical and psychiatric professionals in many areas of the world. One of these changes was the inclusion of adults in struggling with a condition previously assumed only to effect children and adolescents- Separation Anxiety Disorder. Separation anxiety disorder occurs when the individual “…experiences excessive fear or anxiety concerning separation from those to whom the individual is attached…” The person to whom the anxious individual is “attached,” is typically a close blood relative, a spouse or intimate partner, or roommate. As a result of these routine periods of separation, the adult may experience constant worry about being apart from their spouse or family, have nightmares, be unable to leave the home to go to work, struggle with physical complaints, and other symptoms all of which significantly impacts their life. Although this type of worry is more common in younger adults as they separate from their nuclear family and adjust to living independently, adults later in life can be effected as well, sometimes prompted by a major life event such as when children leave home, a spouse dies, or family move away.

Why Does Separation Anxiety Disorder Occur?

It is normal for young children to sometimes feel worried or upset when faced with routine separations from their parents or other important caregivers, and for older children and adolescents to experience mild anxiety when away from their families such as on school trips or when leaving home for the first time to attend college, university, or a job. Although less common, some adults also may have mild anxiety or fear when a boyfriend/girlfriend/spouse/parent goes away for a period of time such as on a vacation or business trip. This response is part of the fight-flight-freeze system designed to protect us from threat and danger, and in small doses is useful. However, we expect that as these situations unfold, continue, and repeat, that the individual gets used to these separations. As a result, s/he discovers there is no danger, and becomes less and less anxious and learns to cope successfully. Yet, for some adults their response to actual or anticipated separations becomes far more extreme than would be expected, and continues each and every time a separation happens. In essence, they fail to adapt and appear unable to cope. For these adults, it is possible that they may have separation anxiety disorder.

While there is no single cause for adult separation anxiety, many adults with this type of anxiety report that they always were slightly anxious when faced with time apart from their loved ones, struggling in childhood with school attendance and often worrying about the wellbeing of their family when apart. They may describe themselves as physiologically and emotionally sensitive. Finally, as they matured into adulthood, they note that their difficulties and fears tended to grow rather than shrink, transferring from parents or family members, to romantic partners or roommates. 

How Does Separation Anxiety Disorder Effect Adults?

Separation anxiety disorder can significantly interfere with or limit an adult’s daily life functioning in a variety of ways. Work attendance and performance can drop, or fail to launch, as the adult feels unable to cope with time away from their loved one who becomes their secure “home base.” The anxious individual can become isolated from peers and coworkers, fearful of engaging in routine social activities if these require time apart from their loved one. In addition, s/he may have difficulty in romantic relationships, either failing to date at all, or being overly dependent on a romantic partner or remaining in relationships long after s/he recognizes they are no longer compatible. Finally, it can a lead to missed opportunities for job promotions if workplace advancement requires travel. Adults with separation anxiety disorder can appear depressed, withdrawn, and apathetic, and understandably so given the ongoing anxiety they must face.

Signs & Symptoms

Thoughts:

  • What if something bad happens to my parents/spouse?
  • What if I get lost or something bad happens to me?
  • What if my spouse forgets to pick me up after work?
  • What if I get attacked or mugged?
  • What if I my boss asks me to stay late or to go away to that conference?

 

Physical feelings:

  • Stomachaches
  • Nausea
  • Vomiting
  • Racing heart
  • Headaches
  • Shortness of breath

 

Emotions:

  • Anxiety/worry/fear
  • Shame
  • Embarrassment
  • Helplessness
  • Sadness
  • Anger

 

Behaviors:

  • Reluctance to apply for a job, or to seek a promotion
  • Avoidance of participation in new activities or going places without a loved one
  • Refusal to spend time alone
  • Nightmares
  • Excessive use of sick time from work
  • Cannot go to events alone

Common Situations or Affected Areas

  • Work absenteeism
  • Romantic relationships
  • Inability to make and maintain friendships due to fear of being away from primary attachment figure (e.g. parent, boyfriend/girlfriend, spouse, sibling)
  • Lack of independence in a variety of domains (e.g. taking trips, attending college or university, seeking a job promotion that will lead to travel or long work hours, socializing, dating, etc.)
  • Increased dependence among family members

My Anxiety Plan for Separation Anxiety

For your Separation Anxiety MAP click here.

Malik's Story

Malik is a 23-year-old university graduate who has just moved to a new town to work in the information technology sector. Until recently he lived at home with his parents to save money, but always planned to move out as soon as he had some financial stability. However, a strange thing has happened now that his “dream” has finally come true- he finds that he constantly is afraid that something terrible will happen to his parents, and he calls and texts them multiple times a day. At first they were happy to hear from him, but now they seem irritated, telling him to make new friends and start his life. This only makes him worry more. Most recently his sleep has become affected, and he has several nightmares a week with themes of harm befalling his parents like their getting into accidents or dying. As well, Malik finds it hard to concentrate at work, and has been getting headaches on a regular basis. He realizes things are getting worse and he is exhausted by his worry, lack of sleep, and physical strain. Malik has just made an appointment to see his doctor to figure out what might be wrong with him.