By the clinical team at Next Step Psychiatry • Lilburn, GA
Separation Anxiety Is Not Just for Children
Most people associate separation anxiety with young children clinging to their parents. But adult separation anxiety disorder (ASAD) is a real, recognized condition that affects an estimated 6.6 percent of adults at some point in their lives, according to research published in the Archives of General Psychiatry. It was only added to the DSM-5 in 2013 as applicable to adults, which means many clinicians are still unfamiliar with the presentation. Adults with separation anxiety experience excessive fear or worry when separated from specific attachment figures, typically a spouse, parent, or child.
How It Presents in Adults
Adult separation anxiety looks different from the childhood version. Rather than crying at school drop-off, adults may experience persistent worry about harm befalling their loved ones, reluctance or refusal to leave home or go to work because it means separation, difficulty sleeping alone or needing a partner to be home, frequent texting or calling to check on loved ones, physical symptoms like nausea or headaches when separation is anticipated, and avoidance of travel, social events, or career opportunities that require being away from attachment figures. The anxiety must be disproportionate to the actual risk and cause significant impairment in functioning.
Causes and Risk Factors
ASAD can develop for various reasons. Some adults had childhood separation anxiety that never fully resolved. Others develop it after a traumatic event such as the death of a loved one, a serious illness, a natural disaster, or a significant loss. Relationship factors including insecure attachment styles, controlling or dependent relationship dynamics, and history of abandonment play a role. It can also emerge during major life transitions like having a child, getting married, or experiencing a divorce. There is significant overlap between ASAD and other anxiety disorders, particularly generalized anxiety disorder and panic disorder.
Treatment Options
CBT is the primary treatment for adult separation anxiety, focusing on gradually increasing tolerance for separation, challenging catastrophic thinking about harm to loved ones, and developing independent coping skills. Exposure therapy involves systematic practice of being separated from attachment figures for increasing durations. SSRIs can reduce the overall anxiety burden and make therapeutic exposure more tolerable. For patients with co-occurring panic attacks during separation, addressing the panic component specifically may be necessary. Family or couples therapy can also be helpful when the condition affects relationship dynamics.
Seeking Support
If excessive worry about separation from loved ones is limiting your independence, career, or quality of life, you deserve help. At Next Step Psychiatry, we understand that adult separation anxiety is a legitimate condition, not something to be embarrassed about. Our clinicians can provide accurate diagnosis, appropriate medication when needed, and referrals to therapists experienced in treating this condition. Recovery involves building confidence in your ability to function independently while maintaining healthy, close relationships.
Ready to Take the Next Step?
Our board-certified psychiatrists are here to help. We accept most major insurance plans including Medicare, Medicaid, Aetna, Cigna, Blue Cross Blue Shield, and United Healthcare.
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider. If you or someone you know is in crisis, call 911 or the 988 Suicide & Crisis Lifeline.