- Hey everybody, today, we're gonna talk
about separation anxiety. (mellow music)
What is it and how can we overcome it?
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But, let's get into this topic.
Separation anxiety is actually a disorder
that's found in the DSM-5.
In previous DSMs, this could only be diagnosed in children,
but recently, they've realized that this can occur
in adults as well and they have expanded
the diagnostic criteria, which is as follows.
Number one, developmentally inappropriate
and excessive fear or anxiety concerning separation
from those whom the individual is attached,
and as evidenced by at least three
of the following, okay?
So, we have to have that,
and then we have to have at least three
of the following criteria.
Number one, recurrent, excessive distress
when anticipating or experiencing separation
from home or from a major attachment figure,
so we have to just get really upset
if we have to be away from someone we really care about.
Number two, persistent and excessive worry
about losing a major attachment figure
or about possible harm to them,
such as illness, injury, disasters, or death.
Number three, having persistent and excessive worry
about experiencing a distressing event,
like getting kidnapped, being in an accident, et cetera,
and that distressing event will cause separation
from a major attachment figure.
So again, we just don't wanna be separated from them,
it makes us really upset.
Number four, persistent reluctance or refusal
to go out, away from home, go to school,
go to work, or elsewhere for fear of separation.
You can see how this is all, like,
"I just don't wanna be separated from them."
Number five, persistent and excessive fear of
or reluctance about being alone
or without a major attachment figure
at home or in other settings.
Number six, persistent reluctance or refusal
to sleep away from home or to go
to sleep without being near a major attachment figure.
And number seven, repeated nightmares involving
the theme of separation.
Number eight, repeated complaints of physical symptoms,
including headaches or stomach aches,
when separation from a major attachment figure occurs
or is anticipated.
Now, just to recap,
we need to have at least three
of those eight that I just listed off,
and so, just keep that in mind
as I move through the next portions of the diagnoses.
And the next is, the fear, anxiety,
or avoidance is persistent, lasting at least four weeks
in children and adolescents,
and typically six months or more in adults,
and that's important when we're diagnosing,
we need to know how long this has
to have been going on because following a trauma,
maybe, we might experience some of these symptoms,
but it typically wouldn't last for,
you know, more than a month or more than six months.
And finally, the disturbance has
to cause clinically significant distress
or impairment and make it hard
for us to just function in our life,
and it cannot be better explained
by another mental disorder, like Autism Spectrum Disorder,
Agoraphobia, generalized anxiety disorder, et cetera.
In truth, separation anxiety is really a survival technique
that kept us safe when we were a baby,
and if our caregiver leaves us,
we'll cry and become extremely distressed
so that they come back and care for us
because we need it,
'cause we can't survive on our own, right?
But, after the age of two,
most children know that even if their caregiver leaves,
they'll come back.
They may cry a bit at the beginning,
like if you're first dropping your child off at daycare,
they can fuss a bit, but they'll be easily soothed
and go back to playing or whatever they were doing.
They can integrate easily without
becoming completely overwhelmed.
And for that reason, the key feature
in diagnosing separation anxiety disorder
is that the level of distress or anxiety
that we experience is much greater
than what is expected at that developmental stage.
I just wanna pause for a minute
so that you can fully absorb that.
It doesn't always have to do with age, necessarily,
it's all about developmental stage
and what's expected for us
and our response to our attachment figures
at that stage.
Children who struggle with this
can cling to their attachment figures,
unable to be soothed by anyone else
and even report feeling physically ill
if they're separated from them.
Adults with this disorder may be uncomfortable
when traveling independently,
they can experience nightmares
about separating from attachment figures,
or even be overly concerned with their children
or spouse and continuously check up
on them about their whereabouts
and how they're doing.
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 were used to describe
the same symptoms.
Now, my guess is that we have these two terms
because they used to think separation anxiety
only happened in children,
and so, they had to come up with another term
for the same symptoms in adults.
But, that's just my hypothesis.
What do you think?
While we don't know the exact cause
of separation anxiety, we do know that children
who have dealt with loss, like death of a loved one
or a pet, change of schools, divorce, et cetera,
are at a higher risk for developing it.
We also know that overprotective
or anxious parenting can lead children
to developing separation anxiety disorder as well.
But, other than that,
there needs to be a lot more research done
because they're still looking into genetics
and they're not completely sure
which ones cause what.
But, the good news is that there are treatment options
to look into, and number one, for children,
slight changes in parenting techniques
can really, really help.
You can communicate that you have to leave,
telling them ahead of time so they
have a little time to prepare
and letting them know how long,
roughly, you'll be gone,
and remind them a few times that you will be back.
And make sure you don't tease them
or become upset about their anxiety,
just assure them that you will return
and remain calm while you're speaking
with them about it so that they
don't think you're anxious, too.
That can just make it worse, really.
Also, don't leave during naps
or try to sneak out.
I know a lot of parents try to do this
because it just makes it easier,
you don't have to be there when they're really upset,
but not giving them the time to be part
of the transition and given the opportunity
to be soothed can make it even worse
and it can make it last even longer.
You can also practice short separations,
like walking to the corner to drop some mail off
and coming back, or even just leaving
the room for a bit, only to reappear a few seconds later,
and this can really help young children understand
that separation, just because we don't see someone,
is temporary and is nothing to be scared of
because they will come back.
For adolescents or adults,
psychotherapy helps so, so much.
Talk therapy can help us uncover
where this fear or anxiety comes from
and what triggers it.
Once we know what triggers it,
then we can try out our new techniques
to self-soothe or distract when we need to.
Since this can be caused by loss,
grief counseling or even trauma therapy,
like EMDR, sematic experiencing,
attachment-based therapies, et cetera,
they can help a lot, too.
And third, medication like SSRIs or SNRIs
have been shown to help as well,
because if you remember, this is an anxiety disorder,
and anti-depressants are known
to relieve anxious symptoms.
So, please speak to your doctor
if this something that you're interested in.
I know doing hard work like this
can be overwhelming and often upsetting,
but trust me, if we find the right therapist to work with,
it can and will get better.
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You never know who it could help,
and last, did I leave anything out?
Treatment options or symptoms that you wished I'd mentioned?
What's been your experience with this?
Let us know in those comments down below
and I will see you next time, bye.