ANXIETY DISORDERS

Separation Anxiety Disorder

What is it?

13-year-old Jessica has a tantrum whenever she has to leave her parents, such as when her parents go to work or when Jessica has to go to school. 35-year-old Tom feels afraid when his wife leaves the house for work because he spends the whole time she is absent fearing for her safety. Both Jessica and Tom report “churning stomachs” and nightmares in which they were helpless to prevent harm from befalling their loved ones.  

Jessica and Tom are classic examples of what is known as a Separation Anxiety Disorder.

When we hear stories of separation anxiety, it often concerns children. However, separation anxiety disorder is in fact not limited to children, and can occur in adults as well. A person with a separation anxiety disorder may display some of the following symptoms: 

Ψ High levels of distress when anticipating or experiencing separation from home or from major attachment figures (e.g., parents).  
Ψ Constant worry about losing one’s major attachment figures or about possible harm occurring to them.
Ψ Worries about experiencing an unpredictable event (e.g., getting lost, being kidnapped) that causes separation from a major attachment figure. 
Ψ Persistent reluctance or refusal to go out, be away from home, to school, to work, or elsewhere because of fear of separation. 
Ψ High levels of fears or reluctance about being alone or without major attachment figures at home or in other settings. 
Ψ Persistent reluctance or refusal to sleep away from home, or to go to sleep without being near a major attachment figure.
Ψ Nightmares involving the theme of separation 
Ψ Complaints of physical symptoms (e.g., headaches, stomachaches) when separated from major attachment figures or when anticipating separation 

Risk Factors

Genetic risk factors:

Ψ Separation anxiety disorder has been found to be heritable, with heritability being higher in girls than boys.

Environmental risk factors:

Ψ Experiencing a stressful life event, particularly a loss (e.g., death of a pet or a loved one, changing schools, moving houses or even immigrating), can be a risk factor for developing separation anxiety disorder.
Ψ Overprotective parenting is another environmental risk factor for separation anxiety disorder.  

Therapy

People with separation anxiety disorder respond well to cognitive-behavioural therapy (CBT) and/or exposure therapy. CBT teaches individuals to recognise and overcome misconceptions or dysfunctional beliefs, which helps alleviate their anxiety concerning separation from major attachment figures. In exposure therapy, patients are given the opportunity to “practice” what they’ve been taught during CBT. Exposure therapy also helps to emphasise that the patient’s distressing thoughts are just thoughts, and not fact. The aim is to allow individuals to become more comfortable with unpleasant feelings or experiences by gradually increasing exposure to feared situations in a controlled and supervised environment. 

The key difference between therapy for adults and children with separation anxiety disorder is that therapy for adults primarily involves the client. When helping children, parents are usually involved, and therapy usually comprises training the parents on ways to tackle their children’s maladaptive behaviours.