Adult Separation Anxietyby Anne Windermere Patient Advocate
One of our most popular member posts was written by a fellow named Joseph who wrote in to Anxiety Connection to ask for help and support for what he deemed as "adult separation anxiety." Joseph's inquiry elicited 42 responses from other members who were experiencing the same thing and wanted to know more about this type of anxiety. Some talked about having heard about childhood separation anxiety but not when once reaches adulthood. Hopefully my post will shed some light on this difficult to deal with adult disorder.
What is Adult Separation Anxiety Disorder?
Adult Separation Anxiety Disorder or ASAD has been unrecognized as a diagnostic mental disorder until the late 1990's. The symptoms of ASAD are very similar to childhood separation anxiety and may include:
Extreme anxiety and fear when separated from major attachment figures. This anxiety may manifest in the form of full blown panic attacks.
Avoidance of being alone.
Fears that something bad will happen to their loved ones.
An example of how Adult Separation Anxiety Disorder may manifest is through the story of "Stacey" who was successfully treated by one of the lead researchers of this disorder, Dr. Katherine Shear, a professor of psychiatry at Columbia University.
"Stacy (not her real name) was an accomplished professional woman in her 30s. But she couldn't stand not knowing exactly where her husband was, or being away from him for long. She disliked golf, but accompanied him to every weekend game. It got so bad that if she couldn't immediately contact him at work, she would leave her own office to find him, even though she knew she was behaving irrationally. She just couldn't bear being out of touch."
Some have described such feelings as almost like an addiction but to a person. Whereas children may feel anxiety over a parent or caregiver leaving, the adult with separation anxiety disorder may feel extreme fear and distress when their romantic partner is out of sight.
Who develops ASAD?
One would think that adults with a history of childhood separation anxiety might continue on as adults with this same issue. In about a third of childhood cases this is true. But the majority (77.5%) of respondents classified as having adult separation anxiety disorder will experience their first symptoms as an adult.
Another surprising discovery reported by Psychiatric News is that the adult version of separation anxiety disorder is more prevalent than the childhood kind. Approximately 7% of adults may be afflicted with separation anxiety in the U.S. as compared with only about 4% of children.
The profile of the adult who has ASAD is an individual who may have multiple co-morbid mental health issues. The majority of people suffering from ASAD will present with some other psychiatric disorder. Some of the anxiety related co-morbid disorders to adult separation anxiety disorder include panic disorder, agoraphobia, and social anxiety disorder. People having ASAD are also at more risk for having depression and/or a substance abuse problem.
Dr. Katherine Shear, one of the lead researchers investigating the prevalence of adult separation anxiety disorder in the American population, reports that: 'People with ASAD are nearly three times as likely to become addicted to illegal drugs, compared to those without the disorder. They are nearly five times more likely to have an additional Anxiety Disorder and four times more likely to have a mood disorder."
The patient who has ASAD is more likely to be seen by a therapist or mental health clinician for their co-existing psychiatric conditions than for their adult separation anxiety disorder. The majority of people with ASAD are never treated for their condition.
What effect does ASAD have on everyday life?
Not surprisingly, this type of disorder can wreak havoc upon a relationship or marriage. The partner who has to constantly cope with their partner's fears and anxieties over their going to work or simply leaving the home to go about their day can grow to feel resentful. Reassurance may do little to assuage their loved one's extreme worry. After time the constant clinginess can ultimately destroy the relationship and ironically this is one of the worst fears of the partner with separation anxiety. The person having ASAD will most likely have significant problems sustaining relationships with a romantic partner. And if married, the risk for separation and divorce are high.
It seems that underemployment or unemployment is also an issue for people having ASAD. It is not known whether occupational difficulties precede the onset of their adult separation anxiety or whether this disorder helps to undermine one's employability.
One can surmise that adult separation anxiety disorder can greatly disrupt one's life but is there anything which can be done about it?
Are there any treatments for Adult Separation Anxiety Disorder?
In the example given about "Stacey" who was in treatment under Dr. Katherine Shear, the patient was said to be successfully treated for her ASAD. In an MSN Health article about ASAD, it was reported that Dr. Shear used an antidepressant similar to Prozac to help reduce Stacy's obsessive thoughts. In addition to medication the doctor also used a form of cognitive behavioral therapy called exposure therapy. This type of therapy exposes the patient to what they fear the most in short increments of time and then gradually increasing the length of time the person is exposed to their source of anxiety. In the case of Stacey, the doctor would separate her from her husband and help her to work through her fear to see that nothing disastrous was going to happen. Eventually Stacey was able to tolerate her husband leaving without her feeling of dread and anxiety.
Aside from this case example there is not much in the literature to suggest any viable treatments for ASAD. There is a lack of research on this disorder in general and so information about how to effectively treat ASAD is also noticeably absent.
We are very eager to hear from our members on this topic. Do you feel that you may suffer from Adult Separation Anxiety Disorder? How has this anxiety disorder affected your life? Have you sought any type of treatment for your ASAD? Can you provide any suggestions, tips, or words of encouragement or support to other members who may be suffering from this? We rely upon your input and participation to make this site become a strong community. We want to hear what you have to say
Manicavasagar V, Silove D, Curtis J: Separation anxiety in adulthood: A phenomenological investigation. Compr Psychiatry 1997, 38(5):274-282.
Shear K, Jin R, Ruscio AM, Walters EE, Kessler RC: Prevalence and correlates of estimated DSM-IV child and adult separation anxiety disorder in the National Comorbidity Survey Replication. Am J Psychiatry 2006, 163(6):1074-1083.
Szalzvitz, Maia. (2006). Pathological Clinginess: Study: Adult Separation Anxiety Disorder is prevalent yet poorly understood. Retrieved June 20, 2010 from http://health.msn.com/health-topics/articlepage.aspx?cp-documentid=100235522