Did you know that separation anxiety
is more common in adults than it is in children?
I'm going to explain what causes it
and what it looks like in children and adults.
I'm Dr. Tracey Marks, a psychiatrist,
and I make mental health education videos.
Separation anxiety goes beyond a child missing their parent.
Stranger anxiety is a normal phase of development,
but children grow out of it between 18 months
and two years of age.
And if it continues past that point, it becomes a disorder.
Here are eight signs of separation anxiety
that correspond to the criteria
in the "Diagnostic and Statistical Manual
"of Mental Disorders, Fifth Edition".
Number one.
You're excessively distressed when you anticipate
or experience separating from home
or important attachment figures.
As an adult, your attachment figures can be your partner,
your children, parents, or even close friends.
It's normal to miss someone
or pine for them in their absence,
but with this sign,
you may have intense anxiety and worry.
For example, let's say
your spouse travels every month for work.
You may have a really bad three to four days each month
before the trips where you fret, cry,
or have trouble sleeping and eating.
Number two.
You always fear something bad happening to the person,
like them getting into a car accident
or dying from an illness.
And it may not be that you only worry about this
when they aren't in your presence,
like a spouse traveling for work.
You can be working from home with them,
sitting side-by-side every day,
but then you still have these days where you wake up
with a sick feeling, like a premonition,
that your partner is going to die.
Number three.
You worry about something happening to you
that would pull you away from your loved one.
You may drive to the grocery store
and worry about someone abducting you in the parking lot
before you can get home.
I use this example,
because the harmful thing that you worry about
isn't always something typical,
like the possibility of a car accident.
You can concoct any scenario that can separate you,
like having a sudden fugue state,
where you get confused and travel somewhere
and not be able to remember who you are.
If that did happen to you,
you'd have a bigger problem than being separated,
but you're not concerned with what
a dramatic incident like that says about your health.
Your concern is about something happening to you
that makes you unable to get back to your loved one.
Number four.
You refuse to go to essential places, like school or work,
or are reluctant to leave home because of the separation.
At least with the person who worries
about falling into a fugue state,
they allow themselves to at least venture out alone.
They're anxious when they go out unaccompanied,
but they still do it.
With this symptom, you won't go anywhere alone.
You always need someone to go with you.
A mother who always has her kids with her
can hide this symptom for years, until the children grow up
and don't go out with her all the time anymore.
And not having children available can unmask this anxiety
that wasn't apparent before,
because mom always had her kids.
Another way this can look is the person who won't get a job
unless they can work from home.
Pre-pandemic, that requirement was pretty limiting.
And if that was you, you could just end up not working.
And you probably wouldn't say to yourself,
I'm not working because I can't manage
without my family with me.
That's the real reason,
but that's not acceptable for a grown person
to remain unemployed because they can't tolerate separation.
So instead, you tell yourself that the job just never seems
to feel right or the environment feels toxic.
You rationalize that it's the job and not you.
But now, post-pandemic,
when many companies are allowing people to work from home,
this sign is easy to mask or accommodate
because there's more opportunities to stay home.
Number five.
You're afraid to be alone without attachment figures
in the home or with you.
This is a little different from number four.
With four, you wouldn't leave your home
or go places that you needed to go
unless someone was with you.
But with this sign,
you need someone at home with you.
So even if you got a work-from-home job,
you still need to have someone at home with you.
Or, if you were invited to a barbecue at a friend's home,
you'd need to be accompanied
by someone in your inner circle,
even though you're visiting someone familiar to you.
Number six.
You won't sleep away from home or go to sleep
without having your attachment figure nearby.
And this can be a problem if you have to travel for work.
Another example is not being able to go to sleep
until your partner comes to bed.
And this can really cramp your style
if you have different sleep schedules.
Let's say you're the one with separation anxiety
and you like to go to bed around 10 PM.
Your spouse likes to stay up
and watch movies until midnight.
You don't like watching horror flicks right before bed,
so your spouse has to lie in bed with you, in the dark,
without the television on, until you fall asleep.
Number seven.
You have recurrent nightmares about the theme
of being separated.
With these dreams,
the separation theme can be obvious,
like you or your loved one dies, or it can be disguised,
like you bought tickets for a basketball game
and you find out when you get the tickets
that the seats aren't together.
And number eight
is you experience distressing physical symptoms
like headaches, stomachaches, nausea, or vomiting,
just from anticipating the separation.
For a diagnosis of separation anxiety disorder,
you need at least three of those signs
that last at least six months.
So this is something that can come and go.
It can start in childhood and never leave
or appear for the first time in late teens
or early adulthood.
Young children may not want to go to school
or even sleep in their own beds.
Older children may be very anxious around unfamiliar people,
and because of this,
their anxiety can be mistaken for social anxiety
or being very shy.
Young adults may not want to go away to college
and prefer to do it online.
Parents with separation anxiety toward their children
may be over-protective and controlling.
And any parent can be over-protective of their children,
but the parent with separation anxiety will take
on the same over-protective nature with their spouse,
and that usually doesn't go over very well.
Researchers have found a relationship
between separation anxiety and anxious attachment style.
I talk about insecure attachments in this video.
You can develop separation anxiety after a traumatic
or stressful event, like someone's death, divorce,
or even becoming a parent.
And in this case,
you may have had childhood anxiety that went undercover
as you got older,
but then having a child triggers this intense fear
of losing your child.
And you develop an anxious attachment to that child
that makes you worry about their welfare
and overprotect them.
Separation anxiety in adults is an underdiagnosed condition.
And because of this,
we don't have standard treatment protocols for it.
And I think the reason for this
is that separation anxiety often goes along
with other disorders that get more attention,
like social anxiety, panic disorder,
and post-traumatic stress disorder.
People with separation anxiety can feel too embarrassed
to talk about their problems with others,
so they may never get help.
If they have another problem,
like social anxiety, for example,
they may get help for that,
but still never really discuss the separation issues.
I think a very basic approach to this is first recognizing
that the anxiety you have is in your mind
and your body's overreaction to the situation.
When you feel anxious,
the tendency is to do whatever you can
to escape the anxiety.
You can use poor coping skills for this, like overeating
or excess checking of things to reassure yourself
that people are safe.
But you have to recognize your maladaptive coping skills
and then replace them with adaptive ones,
like first sitting with the anxiety rather than escaping it.
Recognize that it's a false alarm
and find something constructive to do
to take your mind off of the worry.
Watch this video for ways that you can use your vagus nerve
to calm yourself,
and then this video on attachment styles.
Thanks for watching.
See you next time.