What is separation anxiety disorder in adults?

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Separation anxiety is an anxiety disorder. Other examples of anxiety disorders include agoraphobia and panic disorder.

The American Psychiatric Association’s diagnostic manual for mental health conditions, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), defines separation anxiety as when a person has several of the following symptoms:

• excessive distress before and during separation
• excessive worry about losing the attachtment figure
• excessive worry about events that may cause separation from the attachment figure
• reluctance to leave the separation figure
• persistent and excessive fear of being alone
• reluctance to sleep away from the attachment figure
• repeating nightmares about separation
• recurring physical symptoms during real or anticipated separation

These symptoms can cause significant distress that affects social, occupational, or academic functioning.

An adult’s separation anxiety can stem from many life events, such as the loss of an attachment figure, either from moving away or being separated even for a relatively short amount of time.

Their anxiety may also be related to another underlying mental health condition. For example, anxiety conditions are common in autistic people.

On occasion, people may categorize an adult with separation anxiety disorder as controlling or overprotective. However, their actions are often an adult’s way of expressing their fears in regard to separation.

Those with obsessive-compulsive disorder are more likely to experience separation anxiety as an adult, according to an article in the journal Personality and Mental Health.

Those with separation anxiety often have other co-existing conditions, such as social phobias, panic disorders, or agoraphobia. Agoraphobia involves fear and anxiety of being in spaces where it may be difficult to escape or receive help.

Other risk factors for separation anxiety, in addition to pre-existing mental health conditions, include:

• childhood adversity, such as the death of a family member
• history of childhood traumatic events, such as abuse
• being prone to worry or stress
• significant life changes, such as moving away from a family or support structure

According to The American Journal of Psychiatry, an estimated 43.1% of people who experience separation disorder (other than as children) develop the condition after 18 years of age.

A doctor will diagnose separation anxiety by asking about the symptoms a person is experiencing. A mental health expert will use the criteria, including those used in the DSM-5, to make a diagnosis of separation anxiety in adults.

For a diagnosis of separation anxiety, a person must exhibit three or more symptoms that significantly impair day-to-day life for at least 4 weeks.

Doctors may recommend treating separation anxiety through psychotherapy, medication programs, or a combination of both.

Cognitive behavioral therapy (CBT)

CBT is often the first line of treatment for separation anxiety. This therapy aims to help people identify their thoughts and behaviors that make their separation anxiety worse. Parents may also learn additional parenting techniques that can reduce their separation anxiety.

Learn more about CBT here.

Anti-anxiety medication

Doctors may also temporarily prescribe anti-anxiety medications to help a person through their most acute symptoms of separation anxiety. These will typically include selective serotonin reuptake inhibitors (SSRIs)

Learn more about serotonin and SSRIs here.

These drugs, however, are not always long-term solutions to the underlying disorder, and doctors will typically recommend gradually reducing dosage medications after 6 months.

A combination of CBT and SSRIs is often most effective in treating separation anxiety.

Support groups

A person may also wish to seek out a support group for those with anxiety and separation anxiety. People who join these groups can gain help with learning techniques for reducing separation-related anxiety.

While adult separation anxiety is not as common as when a child experiences this condition, it is still possible that a person can have separation anxiety as an adult.

The anxiety can be so intense that it is hard for someone to function in daily life due to fears and worries about separating from another person.

People should see a mental health professional if they are not sure if their fears are related to separation.

Through therapy and, in some instances, medications, people can reduce their separation anxiety symptoms.

Read this article in Spanish.