Mental Health

What is Separation Anxiety? Fear of Abandonment?


Separation Anxiety is actually a disorder found in the DSM 5. In previous DSMs this could only be diagnosed in children, but recently they have realizes that this can occurs in adults as well, and have expanded the diagnostic criteria, which is as follows:
Developmentally inappropriate and excessive fear or anxiety concerning separation from those whom the individual is attached, as evidenced by at least 3 of the following:
1. Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures
2. Persistent and excessive worry about losing major attachment figures or about possible harm to them such as illness, injury, disasters, or death.
3. Persistent and excessive worry about experiencing an distressing event (like getting kidnapped, being in an accident, etc) that causes separation from a major attachment figure
4. Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere for fear of separation
5. Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings
6. Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure
7. Repeated nightmares involving the theme of separation
8. Repeated complaints of physical symptoms (headaches, stomach aches, etc) when separation from major attachment figures occurs or is anticipated.
The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults.
The disturbance causes clinically significant distress or impairment, and makes it hard for us to function in our life. And it cannot be better explained by another mental disorder (like Autism Spectrum Disorder, Agoraphobia, generalized anxiety disorder, etc).
Separation anxiety is really a survival technique that keeps us safe when we are a baby. If our caregiver leaves us, we will cry and become extremely distressed so that they come back and care for us. But after the age of 2, most children know that even if their caregiver leaves, they will come back. They may cry a bit at the beginning, but will easily be soothed and go back to playing or whatever they were doing. For that reason, the key feature in diagnosing separation anxiety disorder is that the level of distress or anxiety we experience is much greater than what is expected at that developmental stage.
Also, I think it’s important to note that separation anxiety disorder is often referred to as fear of abandonment in adults. And as far as I can read and research about it, these two terms are used to describe the same symptoms.
Treatment!
For children, slight changes in parenting techniques can help. You can communicate that you have to leave (give an idea of how long) and remind them a few times that you will be back. You can also practice short separations (like walking to the corner to drop some mail off) and then come back. Or even just leaving the room for a bit, only to reappear a few seconds later can help a young child understand that separation is just temporary and nothing to be scared of.
For adolescents or adults, psychotherapy helps! Talk therapy can help us uncover where this fear or anxiety comes from and what triggers it. Then we can try out our own techniques to self soothe, or distract when we need to. Since this can be caused by loss, grief counseling or even trauma therapy (EMDR, Somatic Experiencing, Attachment Based Therapy, etc) can help a lot too.
Medication like SSRI’s & SNRI’s have been shown to help as well.

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