Adult Separation Anxiety Disorder
Separation Anxiety Disorder is well recognized as a juvenile psychiatric disorder, but it appears to be rarely diagnosed in adulthood.[1] It has traditionally been characterized and assessed as a disorder that is unique to childhood. Yet the core symptoms of Separation Anxiety — excessive and often disabling distress when faced with actual or perceived separation from major attachment figures — may persist or even arise during adulthood.[2]
Fifteen years ago Adult Separation Anxiety Disorder (ASAD) did not exist, at least as far as the psychiatric community was concerned. ASAD has only been recognized as a specific mental disorder since the late 90′s, with the pioneering work of Vijaya Manicavasagar of the Psychiatry Research and Teaching Unit, Liverpool Hospital, New South Wales, Australia. He said in 1997 that:[3]
[A]dults may experience: wide-ranging separation anxiety symptoms, such as extreme anxiety and fear, when separated from major attachment figures; avoidance of being alone; and fears that harm will befall those close to them. … Separation anxiety disorder may be a neglected diagnosis in adulthood.
Katherine Shear, M.D. is a professor of psychiatry at Columbia University and the lead investigator of an important new study. She finds recent research setting ASAD apart from childhood Separation Anxiety Disorder unsurprising. She says:[4]
Our group in Pittsburgh, as well as colleagues in Australia and in Italy, has observed adult separation anxiety disorder in clinical populations for a number of years now. It is clear that this is an identifiable syndrome.
Just what is Adult Separation Anxiety Disorder?
Separation Anxiety Disorder is a psychological condition in which an individual has excessive Anxiety regarding separation from places or from people to whom the individual has a strong emotional attachment. In children, the strong emotional attachment is likely to a parent; in Adult Separation Anxiety Disorder, the attachment might be to a spouse or friend.
Separation Anxiety Disorder should not be confused with Separation Anxiety, which occurs as a normal stage of development for healthy, secure babies. Separation Anxiety typically starts at around 8 months of age and increases until 13-15 months, when it begins to decline.
If Americans were asked to give examples of ASAD, they might cite the classic Hollywood film “Casablanca,” where Ilsa (Ingrid Bergman) clings to Rick (Humphrey Bogart) shortly before they part forever. Or they might point to the Hollywood thriller “Psycho,” where lead character Norman Bates (Anthony Perkins) sleeps next to his mother long after she has died.[5]
A sample case of ASAD is that of “Stacy,” who was treated by Katherine Shear successfully (see “What is the treatment for Adult Separation Anxiety Disorder?” below, for more details on her treatment.):[6]
Stacy (not her real name) was an accomplished professional woman in her 30′s. But she couldn’t stand not knowing exactly where her husband was, or being away from him for long. She disliked golf, but accompanied him to every weekend game. It got so bad that if she couldn’t immediately contact him at work, she would leave her own office to find him, even though she knew she was behaving irrationally. She just couldn’t bear being out of touch.
Infant Separation Anxiety is one of the most strongly preserved behaviors in human beings. Given the importance of attachment relationships in adulthood, ASAD may be more easily elicited in adults than is commonly recognized, and might be the norm under certain extreme life circumstances.[7] (See “What’s in the future for Adult Separation Anxiety Disorder research?” below for more information.)
Separation Anxiety would appear to be a core form of Anxiety that is associated with anxious attachment. Nevertheless, as yet no research has examined the relationship of attachment styles to ASAD. In his research, Manicavasagar found that those with ASAD had a prominent Need for Approval and Preoccupation with Relationships attachment styles.[8]
What is the prevalence of Adult Separation Anxiety Disorder?
A new finding that rocks the boat is that ASAD is actually more prevalent than childhood Separation Anxiety Disorder. Katherine Shear and her colleagues produced a groundbreaking study of ASAD in 2006, based on thousands of respondents to the National Comorbidity Survey Replication, a national mental health survey taken between 2001 and 2003.[9][10]
Shear found that, while the lifetime estimate of childhood Separation Anxiety Disorder was 4.1 percent, the adult estimate for ASAD was 6.6 percent. [11] In the current American population, that’s 20,207,408 adults who will suffer with ASAD in their lifetimes! Shear believes these numbers are low:[12]
Because separation anxiety disorder is only rarely diagnosed among adults in treatment, documentation of nontrivial prevalence and clinical significance would point to a problem of low recognition and treatment.
Approximately one-third of adults (36.1 percent) had a childhood case of Separation Anxiety Disorder that persisted into childhood. However, the vast majority (77.5 percent) of adults with ASAD had its first onset of the disorder in adulthood. The ages of onset of ASAD are ranked as follows:[13]
- 30-44 years at onset
- 18-29 years at onset
- 45-59 years at onset
- 60+ years at onset
The accompanying chart shows that most childhood cases of Separation Anxiety Disorder begin the illness in early or middle childhood. Adult-onset cases of ASAD begin in late teens or early 20′s, with 80 percent of all first onsets occurring by age 30.[14]
More women than men suffer from ASAD[15]. And Separation Anxiety Disorder, both the adult and the childhood versions, seems to run in families. Manicavasagar states the results of one of his studies showed that:[16]
Sixty-three percent of children diagnosed with juvenile separation anxiety disorder had at least one parent who suffered from the putative adult variant of the disorder. Affected parents reported high levels of separation anxiety in their own childhoods.
What are the diagnostic criteria for Adult Separation Anxiety Disorder?
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) of the American Psychiatric Association is the standard used in the US and UK for diagnosing mental disorders. Since it was published last in 1994, it does not treat ASAD as a separate diagnosis. It only mentions obliquely that adults may have a disorder similar to childhood Separation Anxiety Disorder.[17]
The ICD-10 Classification of Mental and Behavioural Disorders (ICD), published by the World Health Organization in 1992, is the standard in some other parts of the world. Its entry on Separation Anxiety Disorder does not mention adults at all. Its diagnostic criteria are roughly the same as those of the DSM-IV.[18]
The diagnostic criteria for Separation Anxiety Disorder in the DSM-IV are as follows:[19]
A. Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, as evidenced by three (or more) of the following:
- Recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated.
- Persistent and excessive worry about losing, or about possible harm befalling, major attachment figures.
- Persistent and excessive worry that an untoward event will lead to separation from a major attachment figure(e.g.; getting lost or being kidnapped).
- Persistent reluctance or refusal to go to school or elsewhere because fear of separation.
- Persistent and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings.
- Persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home.
- Repeated nightmares involving the theme of separation.
- Repeated complaints of physical symptoms (such as headaches, stomach aches, nausea, or vomiting) when separation from major attachment figures occurs or is anticipated.
B. The duration of the disturbance is at least 4 weeks.
C. The onset is before age 18 years.
D. Part 1 OR Part 2
- Part 1. The disturbance causes clinically significant distress.
- Part 2. The disturbance causes clinically significant impairment in social, academic (occupational), or other important areas of functioning.
E. The disturbance does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and, in adolescents and adults, is not better accounted for by Panic Disorder with Agoraphobia.
Associated Features:[20]
- Depressed Mood
- Somatic [bodily] or Sexual Dysfunction
- Anxious or Fearful or Dependent Personality
Differential Diagnosis:
Some disorders have similar or even the same symptoms. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which he needs to rule out to establish a precise diagnosis.
Pervasive Developmental Disorders:
- Schizophrenia, or other Psychotic Disorders
- Generalized Anxiety Disorder
- Panic Disorder with Agoraphobia
- Agoraphobia Without History of Panic Disorder
- Conduct Disorder
- Developmentally appropriate levels of separation anxiety.
Who is most affected by Adult Separation Anxiety Disorder?
There are more women than men with ASAD. However, men are more likely than women to have the first onset of ASAD in adulthood.[21]
The odds of being not married are elevated both among those who had childhood Separation Anxiety Disorder and those with ASAD. This suggests that childhood Separation Anxiety Disorder might be a risk factor for subjects remaining unmarried and, once married, for marital instability. The marital status of adults with ASAD are ranked as follows:[22]
- Separated, widowed, or divorced
- Never married
- Married or cohabiting
Education seems to play a large role in an adult’s susceptibility to ASAD. Those with fewer years of education are more likely to suffer from ASAD than those who have more years. The number of years of education among those with ASAD are ranked:[23]
- 0-11 years of education
- 12 years of education
- 13-15 years of education
- 16+ years of education
ASAD plays havoc with employment, with a large portion of ASAD sufferers being unemployed or employed in a non-traditional manner. It is not known whether ASAD caused the unemployment, or if the ASAD was triggered by the unemployment. The following list shows the employment status of ASAD sufferers in rank order:[24]
- Unemployed or non-traditional employment
- Employee
- Homemaker
- Retiree
- Student
How does Adult Separation Anxiety Disorder affect your life?
ASAD takes a dreadful toll on a person’s life and on the lives of those around them. For the person with ASAD the recurring distress, worrying, fear and sleep disturbances make every day a confusing and torturous experience.[25] For those who are the “subject of attachment” — the spouse, friend, parent, etc — the continual clinginess, neediness, and drama of life with a person with ASAD can be almost more than one can take.
ASAD is extremely hard on relationships. Many people cannot handle such neediness in a partner. Those with childhood Separation Anxiety that persists into adult life may not be able to form stable romantic relationships at all. As noted above, people with ASAD are much more likely not to have been married or to be divorced or separated.
The suffering of ASAD can take many faces: Adults may endure ASAD when dealing with a marital separation, a rocky relationship, or the death of a loved one. Occasionally, a parent may struggle with ASAD as a child becomes more socialized and less dependant upon mom or dad for companionship.[26]
ASAD is often linked to personal and social impairment. As noted above, ASAD is associated with roughly doubling of the odds that a sufferer will have low (0–12 years) education, be unemployed, and be unmarried or experiencing marital disruption. This is consistent with the findings of several studies that ASAD can be seriously damaging to one’s life.[27][28]
The following table shows the personal and social impairment experienced by people with ASAD:[29]
Housework
- Any personal and social impairment: 56.1 percent
- Severe personal and social impairment: 21.1 percent
Work
- Any personal and social impairment: 51.6 percent
- Severe personal and social impairment: 21.7 percent
Personal relationships
- Any personal and social impairment: 66.6 percent
- Severe personal and social impairment: 28.0 percent
Social relationships
- Any personal and social impairment: 66.4 percent
- Severe personal and social impairment: 31.5 percent
Maximum impaired performance in any role area
- Any personal and social impairment: 73.4 percent
- Severe personal and social impairment: 45.0 percent
Those with two or more simultaneous mental disorders often report significant impairment in their daily roles. Nearly half of the respondents in Shear’s study experienced severe role impairment if their ASAD was associated with another mental disorder.
But “pure” ASAD can be debilitating, too: One-fourth of those with ASAD alone reported severe role impairment. Because this is the case, the question arises whether co-occurring ASAD accounts for some of the impairment previously attributed to other Anxiety, mood, or substance use disorders alone. None of the many studies that estimated the societal costs of these co-occurring conditions included ASAD as a possible contributor to impairment.[30] (See “Adult Separation Anxiety Disorder and other mental disorders” below for more information.)
Adult Separation Anxiety Disorder and other mental disorders
ASAD often occurs along with other psychiatric conditions, especially other Anxiety Disorders or mood disorders. Research findings indicate that up to 91.1 percent of people with ASAD could be classified as meeting the criteria for at least one other mental disorder found in the DSM-IV.[31][32]
People with ASAD are nearly three times as likely to become addicted to illegal drugs, compared to those without the disorder. They are nearly five times more likely to have an additional Anxiety Disorder and four times more likely to have a mood disorder.[33] Katherine Shear, lead author of one of the most important ASAD studies to date, says:[34]
I think that separation anxiety disorder is a vulnerability factor for all kinds of mental health problems.
There is a question that has not been fully answered by research up to this point: Which comes first, ASAD or other mental disorders? There is compelling research that indicates that ASAD predates other DSM-IV Axis I disorders,[35] which include depression, Anxiety Disorders, bipolar disorder, and schizophrenia.[36][37] This means that the ASAD could actually cause other mental disorders.
In addition, a significant proportion of people with Anxiety Disorders tend to relapse, or remain significantly symptomatic, despite improvements in medications and psychiatric therapy. Theorists have proposed that untreated attachment anxieties and Separation Anxiety Disorder occurring along with other mental disorders contribute to the ineffectiveness of treatment.[38] In other words, if co-occurring ASAD is untreated, it tends to cause the treatment to be ineffective or fail entirely.
The following table lists the most common co-occurring mental disorders that appear with ASAD:[39]
Anxiety Disorders
- Panic Disorder: 14.8 percent
- Agoraphobia without Panic Disorder: 5.8 percent
- Generalized Anxiety Disorder (GAD): 16.1 percent
- Specific phobias: 35.8 percent
- Social Anxiety Disorder (SAD or Social Phobia): 34.5 percent
- Post Traumatic Stress Disorder (PTSD): 23.7 percent
- Obsessive-Compulsive Disorder (OCD): 9.9 percent
- Any other Anxiety Disorder: 65.6 percent
Mood Disorders
- Major depressive disorders: 40.8 percent
- Dysthymia: 8.9 percent
- Bipolar disorder: 19.4 percent
- Any mood disorder: 61.7 percent
Substance Abuse
- Alcohol abuse: 33.1 percent
- Alcohol dependence: 20.1 percent
- Drug abuse: 22.5 percent
- Drug dependence: 12.6 percent
- Any substance abuse disorder: 35.9 percent
Any mental disorder: 88.5 percent
It has also been found that adults with borderline personality disorder (BPD) have higher rates of Separation Anxiety Disorder than others — around 31 percent. The relationship is not explained by the presence of Panic Disorder, Post Traumatic Stress Disorder (PTSD), or multiple Anxiety Disorders. It was found also that the duration of ASAD was longer than in borderline personality disorder patients without ASAD.[40]
Why has Adult Separation Anxiety Disorder not been studied before now?
There seems to be a number of factors at play in the reason why ASAD has not been recognized as a separate diagnosis from childhood Separation Anxiety Disorder. First, psychiatry’s diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), only mentions it in passing as a part of the childhood disorder. Katherine Shear says that:[41]
…part of the problem is that it’s not highlighted as a separate condition for adults [in the DSM-IV]. In the book, the entry on the childhood diagnosis notes that it can continue into adulthood, and the diagnostic criteria for some other anxiety disorders suggest ruling it out. But ASAD does not have its own entry.
In defense of the DSM-IV, it was published in 1994, well before research began that clearly showed a separate diagnosis was needed for ASAD. And the ICD-10 Classification of Mental and Behavioural Disorders, mostly used in Europe and Asia, was published in 1992. These publication dates are long before research indicated that ASAd was a separate diagnosis.
Another reason is that ASAD is often mistaken for other Anxiety or mood disorders, particularly Panic Disorder with Agoraphobia.[42] This is especially true if childhood Separation Anxiety Disorder persists into adulthood, where its symptoms may be overlooked, or obscured by other mental disorders.[43] Notably, it was only in early 2009 that research was completed that:[44]
…finally dispel the notion that separation anxiety and anxious attachment are relevant to panic disorder with agoraphobia, suggesting instead that that constellation is confined to a separate group, namely that of adult separation anxiety disorder.
What is the treatment for Adult Separation Anxiety Disorder?
Due to the recentness of the separate diagnosis for ASAD, there is no standard treatment for the disorder. Most therapies treat it similarly to other Anxiety Disorders with a combination of medication and therapy, especially a form of cognitive behavioral therapy called exposure therapy. Exposure therapy is often used to treat phobias. It involves slowly increasing the person’s ability to tolerate a stressful situation.
The person named Stacy, whose story was told above in the “Just what is Adult Separation Anxiety Disorder?” section, was treated successfully by Katherine Shear. She used an antidepressant similar to Prozac that also helps reduce obsessive thinking. In addition, Shear used cognitive behavioral therapy, along with exposure therapy, to slowly increase Stacy’s tolerance of separation from her husband. Working with the couple together, Shear gradually helped Stacy learn how to cope with longer and longer periods without her husband by helping her see that each increment didn’t result in catastrophe. When one situation or time period was no longer stressful, another would be tackled.[45]
Sadly, the majority of people with ASAD remain untreated, even though many obtain treatment for co-occurring mental conditions such as Anxiety Disorders or depression. The vast majority of patients are treated for co-occurring conditions rather than for ASAD. Less than one-third of patients with ASAD (31.9 percent) report that ASAD was ever a focus of their treatment. This suggests that treatment providers often fail to recognize ASAD in the context of other co-occurring mental conditions.[46]
Although those age 60 and older represent the smallest group of adults with ASAD, the number is still significant. This age group is subject to more separations from friends and loved ones due to moves to another city to be close to children, moves to a nursing home, and deaths. Clinicians working with the elderly need to routinely explore ASAD as it may complicate how other Anxiety and affective disorders appear in the patient, and require specific forms of intervention.[47]
The upshot of all the new research on ASAD means that psychiatrists and other mental health care professionals need to be much more vigilant about the condition. Katherine Shear says:[48]
They need to be aware of the occurrence, prevalence, and comorbidities [co-occurance] of this syndrome, which could be confused with agoraphobia and which could complicate another Axis I disorder [such as Anxiety Disorders and depression], since it is co-occurring with so many. Following the principle of measurement-based care, it will be very important to follow these symptoms in patients who are treated for adult separation anxiety and/or co-occurring conditions.
What’s in the future for Adult Separation Anxiety Disorder research?
As mentioned, ASAD started being recognized as a distinct disorder in the late 1990′s. Since then research has proven that it is very different from childhood Separation Anxiety Disorder. Still, the absence of research on the treatment of ASAD suggests that researchers have largely overlooked this disorder, along with psychiatrists and other mental health care professionals.[49]
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is currently being revised, and the new edition is due out in 2012. The committees working on the revision must take into account the distinctness of ASAD from childhood Separation Anxiety Disorder in the new edition. As it stands in the current edition, the diagnostic criteria mention ASAD only in passing, concerning itself almost entirely with the childhood disorder.[50][51] In considering the possible revision of diagnostic criteria for adults, it would be useful to focus on issues of symptom overlap with other mental disorders, and the differences of ASAD with a number of the disorders mentioned above.[52]
The treatment of ASAD is only in its infancy. It relies on treatments for other Anxiety Disorders and the intuition of psychiatrists and other mental health professionals. Therapies specific to ASAD need to be developed, especially the modification of conventional exposure-based cognitive-behavioral treatments, to provide better strategies that address ASAD.[53]
Other directions for future research are:[54][55]
- The extent that dependence of family members and others on each other is culturally determined and acceptable, and when it is pathological.
- When the pain of separation from a loved one during war, natural disasters, or other dire circumstances is to be expected, and when it is not.
- What are normal and abnormal responses to the loss of a loved one through death?
- Whether co-occurring mental disorders involving ASAD are because of overlapping symptoms, imprecision of diagnostic criteria, or other factors that confound evaluation and treatment.
- Whether the mental disorders involved in co-occurrances with ASAD cause it, and if so, whether early successful treatment of Separation Anxiety Disorder in childhood and early adulthood would lower the rates of secondary ASAD.
- Whether adult separation anxiety disorder has any effect on the persistence or severity of other co-occurring mental disorders.
Updated April 13, 2009
FOOTNOTES
1. Manicavasagar, Vijaya; Silove, Derrick; Curtis, J. (1997, September). Separation anxiety in adulthood: a phenomenological investigation. Retrieved April 6, 2009 from http://www.ncbi.nlm.nih.gov/pubmed/9298320?dopt=Abstract ↑
2. Cyranowski, Jill; Shear, Katherine; Rucci, Paola; Fagiolini, Andrea; Frank, Ellen; Grochocinski, Victoria; Kupfer, David; Banti, Susanna; Armani, Antonella, Cassano, Giovanni. (2001, December 27). Adult separation anxiety: psychometric properties of a new structured clinical interview. Retrieved April 1, 2009 from http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T8T-44SHD6X-2&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=30c67985bd9fb567c38bdfd342440796#_jmp0_ ↑
3. Manicavasagar, Vijaya; Silove, Derrick. (1997, April). Is there an adult form of separation anxiety disorder? A brief clinical report. Retrieved April 1, 2009 from http://www.ncbi.nlm.nih.gov/pubmed/9140640 ↑
4. Staff of Insight Journal. (2007). Adult separation anxiety often overlooked. Retrieved April 1, 2009 from http://www.anxiety-and-depression-solutions.com/articles/news/071706_sep_anxiety.php ↑
5. Arehart-Treichel, Joan. (2006, July 7). Adult Separation Anxiety Often Overlooked Diagnosis. Retrieved April 1, 2009 from http://pn.psychiatryonline.org/cgi/content/full/41/13/30 ↑
6. Szalzvitz, Maia. (2006). Pathological Clinginess: Study: Adult Separation Anxiety Disorder is prevalent yet poorly understood. Retrieved April 1, 2009 from http://health.msn.com/health-topics/articlepage.aspx?cp-documentid=100235522 ↑
7. Shear, Katherine; Jin, Robert; Meron Ruscio, Ayelet; Walters, Ellen; Kessler, Ronald. (2006, June). Prevalence and Correlates of Estimated DSM-IV Child and Adult Separation Anxiety Disorder in the National Comorbidity Survey Replication. Retrieved April 1, 2009 from http://ajp.psychiatryonline.org/cgi/content/full/163/6/1074 ↑
8. Manicavasagar, Vijaya; Silove, Derrick; Marnane, Claire; Wagner, Renate. (2009, February 2). Adult attachment styles in panic disorder with and without comorbid adult separation anxiety disorder. Retrieved April 1, 2009 from http://www.informaworld.com/smpp/content~content=a907922151~db=all~jumptype=rss#_jmp0_ ↑
9. Staff of Insight Journal. (2007) ↑
10. Arehart-Treichel, Joan. (2006, July 7).↑
11. Shear, Katherine.(2006, June). Table 1 ↑
12. Shear, Katherine.(2006, June).↑
13. Shear, Katherine.(2006, June). Table 2 ↑
14. Shear, Katherine.(2006, June). Figure 1 ↑
15. Shear, Katherine.(2006, June).↑
16. Manicavasagar, Vijaya; Silove, Derrick; Rapee, Ronald; Waters, Felicity; Momartin, Shakeh. (2001, May 2). Parent-child concordance for separation anxiety: a clinical study. Retrieved April 1, 2009 from http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T2X-42YDM3K-D&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=0b88db10b139bd52283a4a2d3efc2007 ↑
17. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Arlington, VA: American Psychiatric Association. 1994. ↑
18. The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: World Health Organization. 1992. ↑
19. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.↑
20. Staff of PsychNet-UK. (2000). Separation Anxiety Disorder. Retrieved April 6, 2009 from http://www.psychnet-uk.com/dsm_iv/separation_anxiety_disorder.htm ↑
21. Shear, Katherine.(2006, June).↑
22. Shear, Katherine.(2006, June). Table 2 ↑
23. Shear, Katherine.(2006, June). Table 2 ↑
24. Shear, Katherine.(2006, June). Table 2 ↑
25. Staff of Depression Perception. (2006). Separation Anxiety Disorder. Retrieved April 1, 2009 from http://www.depressionperception.com/anxiety/anxiety_conditions/separation_anxiety_disorder.asp#_jmp0_ ↑
26. Staff of All About Life Challenges. (2009). Is adult separation anxiety disorder and generalized anxiety disorder the same thing? Retrieved April 1, 2009 from http://www.allaboutlifechallenges.org/adult-separation-anxiety-faq.htm ↑
27. Shear, Katherine.(2006, June).↑
28. Staff of Insight Journal. (2007) ↑
29. Shear, Katherine.(2006, June). Table 4 ↑
30. Shear, Katherine.(2006, June).↑
31. Shear, Katherine.(2006, June).↑
32. Wijeratne, Chanaka; Manicavasagar, Vijaya. (2002, September 11). Separation anxiety in the elderly. Retrieved April 1, 2009 from http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VDK-46RCS0B-6&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=2d783326f3f9f29f343c838507b168cd ↑
33. Szalzvitz, Maia. (2006).↑
34. Szalzvitz, Maia. (2006).↑
35. Staff of PsyWeb.com. (2009). Axis I. Retrieved April 13, 2009 from http://psyweb.com/Mdisord/DSM_IV/jsp/Axis_I.jsp ↑
36. Manicavasagar, Vijaya; Silove, Derrick; Curtis, J. (1997, September).↑
37. Manicavasagar, Vijaya; Silove, Derrick; Wagner, R. (2000, January). Continuities of separation anxiety from early life into adulthood. Retrieved April 1, 2009 from http://bases.bireme.br/cgi-bin/wxislind.exe/iah/online/?IsisScript=iah/iah.xis&src=google&base=ADOLEC&lang=p&nextAction=lnk&exprSearch=10770232&indexSearch=ID ↑
38. Kirsten, Laura; Grenyer, Brin; Wagner, Renate; Manicavasagar, Vijaya. (2008, March). Impact of separation anxiety on psychotherapy outcomes for adults with anxiety disorders. Retrieved April 1, 2009 from http://www.informaworld.com/smpp/35862073-66953207/content~db=all~content=a790668570~tab=content ↑
39. Shear, Katherine.(2006, June). Table 3 ↑
40. Aaronson, Cindy. (2001). Separation anxiety disorder in adults with borderline personality disorder. Retrieved April 1, 2009 from http://academiccommons.columbia.edu:8080/ac/handle/10022/AC:P:4570 ↑
41. Szalzvitz, Maia. (2006).↑
42. Arehart-Treichel, Joan. (2006, July 7).↑
43. Manicavasagar. (2000, January).↑
44. Manicavasagar. (2009, February 2).↑
45. Szalzvitz, Maia. (2006).↑
46. Shear, Katherine.(2006, June).↑
47. Wijeratne. (2002, September 11).↑
48. Staff of Insight Journal. (2007).↑
49. Shear, Katherine.(2006, June).↑
50. Manicavasagar. (2009, February 2).↑
51. Shear, Katherine.(2006, June).↑
52. Shear, Katherine.(2006, June).↑
53. Kirsten. (2008, March).↑
54. Staff of Insight Journal. (2007).↑
55. Shear, Katherine.(2006, June).↑
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What a courageous set of people ! I read all the stories with interest and heartfelt empathy. At the age of 58 yrs old I recongise that I probably have ASAD. I am encouraged that the psychiatric health care community have made the distinction and connection with the symptoms associated with infant separation anxiety.
What I understand about my own history is that my past doesn’t need to my future.I need to be brave and intelligent and see myself as having worth & value so that I will persevere in learning how to live with /be free of this .
There is a phrase that says,”embracing the truth will set you free.”
However the truth is often a collection of painfull memories and lack of clear understanding of the developmental/generational lack that we learnt and used to make sence of our world. As adults we are still using those memories as though they are still real in our lives. They are not the real me just apart of what I learnt. The brain is plastic so It can be challenged to re think ideas. WOW what a thought, but thats what I’ve read. I’m not saying its easy to change but the possibility is there. With professional help I believe I dont have to live with the threats of forebodings that blight my dreams and cause my body to react so badly. Un- resolved childhood stress ( death of father at 4 yrs old & overprotective mothering) and other environmental triggers have caused my thyroid to burn-out and the combination of that and my mother’s eventual death (she’s 89yrs old and having treatment for skin cancer) is overwhelming me with anticipatory separation anxiety. But I will get a handle on this so that the rest of my life is lived threw the eyes of understanding and different choices. How complex we humans are and how disserving of help and a future. Well done to Prof Shear for her insight and research into this common but not well enough diagnoised adult dis-ease and I hope more will be done for all the suffers who remain trapped without understanding of the disorder. Just having a label is a step forward in the right direction I think.
What a courageous set of people ! I read all the stories with interest and heartfelt empathy. At the age of 58 yrs old I recongise that I probably have ASAD. I am encouraged that the psychiatric health care community have made the distinction and connection with the symptoms associated with infant separation anxiety.
What I understand about my own history is that my past doesn’t need to my future.I need to be brave and intelligent and see myself as having worth & value so that I will persevere in learning how to live with /be free of this .I urge you “get proffessional help, self help, relaxation, tia chi exercises and for my bornagain faith has been a great source of comfort and enlightenment.
There is a phrase that says,”embracing the truth will set you free.”
However the truth is often a collection of painfull memories and lack of clear understanding of the developmental/generational lack that we learnt and used to make sence of our world. As adults we are still using those memories as though they are still real in our lives. They are not the real me just apart of what I learnt. The brain is plastic so It can be challenged to re think ideas. WOW what a thought, but thats what I’ve read. I’m not saying its easy to change but the possibility is there. With professional help I believe I dont have to live with the threats of forebodings that blight my dreams and cause my body to react so badly. Un- resolved childhood stress ( death of father at 4 yrs old & overprotective mothering) and other environmental triggers have caused my thyroid to burn-out and the combination of that and my mother’s eventual death (she’s 89yrs old and having treatment for skin cancer) is overwhelming me with anticipatory separation anxiety. But I will get a handle on this so that the rest of my life is lived threw the eyes of understanding and different choices. How complex we humans are and how disserving of help and a future. Well done to Prof Shear for her insight and research into this common but not well enough diagnoised adult dis-ease and I hope more will be done for all the suffers who remain trapped without understanding of the disorder. Just having a label is a step forward in the right direction I think. I hope this will catch on in England because I had never heard about this adult condition.
I am 49 years old, and suffer from( depression, O.C.D and P.T.S.S) I was doing research on the possibilities of what causes me to freak out every time my fiance’ leaves or is gone a bit longer than usual. I stumbled across Separation Anxiety. My history has been a roller-coaster. My father died when I was very young and my Mother died emotional.then 18 years after she did die of cancer. I was left alone a lot from the age of 8. My history of failed relationships is lengthy. In all of my marriages, and relations I have had outburst of aggressive behavior when left alone for to long. I say hateful things and accuse my mate of affairs that he is NOT having. I have exhausted him drastically. I know I am wrong in how I react, however it is so hard not to react. I also had years of alcohol and cocaine abuse, but have been clean for years. I will go to my doctor and see what treatments are available.”knowing is half the battle”, Doing something about it is the other half.
It’s good to read stories of others with ASAD. Only cuz it makes me feel less alone and less of a freak. I’m also self diagnosing here. I have horrible anxiety. To the point of frantic panic where I text my partner at work and I tell him I think I am having a heart attack. He knows about anxiety, since he has had panic attacks himself, so he will remind me that I am just panicking.
I don’t work out anymore. I do art at home and sell online. I can’t be social. I try, but I just can’t.
I moved to Iowa 4 years ago and my grown kids stayed in Los Angeles. I had mad separation anxiety when I moved, I thought it would just go away, I mean, other kids and parents live apart in other states. It gets worse every year. Especially after a visit with them, it starts all over again.
I will be 47 next month, October. I feel like there is always someone stepping on my chest, I have a hard time getting motivated, I sit sometimes for hours and stare into space as my mind races, sometimes I can write, I keep a private blog that only I have access to. I freak out when I don’t hear from each of my kids at least once a day. My daughter is better about it, but my 2 boys are not and I get very annoyed with then When they don’t check in.
I live in constant fear that something is goingbto happen to one of them. My only relief is when my partner is home from work, I feel a bit, safer. But I am mostly alone all the time. I live in a town of 300 people and I only go out to check my PO box. I am so scared all the time. Not having insurance now for 2 years, it’s how long ago I quit my regular job, I can not afford to go to a doctor or counselor or anything. My partner can’t put me on insurance cuz we are not married. Did marriage twice, don’t want to do it again a third time.
My ex-husband dies two years ago unexpectantly and we were good friends even during and after divorce. That’s a whole other long story.
I don’t know how or where to find relief. I’ve had thoughts of suicide, but I could never do that yo my kids. I don’t have any friends and I have 2 sisters who I haven’t spoken to in a long time. I really feel completely alone. I actually have thoughts of leaving my partner to gw near my kids again, but I can’t do that to him, plus the thought of not being with him makes me sick. We have been living together for 11 years.
I drive all my feelings deep down so I don’t drive him crazy or away, but when I am alone, I am terrified, sometimes to the point of immobility. Cleaning house helps, drawing helps sometimes, but lately I feel un-creative and unmotivated so I don’t draw as much. I feel I will die feeling this way if I can’t get help. I don’t want drugs if I can help it. I did Paxil for awhile and I hated it. Then coming off of it was horrible. It’s the only time I actually attempted suicide, but was not sure so I called my partner for help and he stopped me, never told my kids.
I just wish I knew what it felt like to be normal. I feel helpless and alone. Writing this just to share and cuz talking about it helps a little. I just can’t talk about it to people I know cuz I don’t want to burden them.
I am cuious to know if those who have been studying adult anxiety disorder, have observed it in certain category: those adults previously very independent, now homebound and helpless because of a medical condition. I am the caregiver for my husband and he suffers from a rare fatal neurological disorder. He says he suffers from such anxiety disorder related to my absences and I think this makes sense given his increasing inmobility and lack of vision and dependence on me to interpreation his speech for others, etc. I take this seriously and not sure what options there might be to deal with this.
Tm – a very long response for you and other similar because I can absolutely empathise with what you’re experiencing. The symptoms you describe are VERY familiar to me, and my advice comes from what I’ve gleaned over the years and what I’ve found works. Anything that sounds like a criticism of your thought processes, by the way, is nothing more than me being straight about how I see it, having seen exactly the same processes at work in my own mind.
IMHO, having been through all this, I think what you’re doing at the moment won’t help – let me explain. Your anxiety levels are obviously through the roof, and when they’re this high it’s practically impossible to think of anything else but the object of the anxiety. I too have done the whole compulsive phoning, texting etc etc thing, even calling the police when someone’s a bit late, as if some force was making me do it, I was so anxious and irrational. Constant fear from the moment I woke up that something awful was going to happen to someone I loved, that I wouldn’t be able to get in touch with them. This then led to depression, as you just can’t keep this cr*p up day in day out without folding. Familiar? You’ve clearly made certain outcomes and ideas obsessive, for example something awful will have happened if they don’t contact you. You’ve built up a complex of behaviours in yourself (and others, which is just what I did) which reinforce these thoughts, albeit unintentionally, and only because they seem to offer the hope of stopping the symptoms. But if they did this, you wouldn’t be anxious all the time, so they don’t work, obviously, and they never do.
How and why your anxiety levels got so high I clearly can’t say. With me, it was my parents’ utterly unexpected divorce when I was 22 – I found myself suddenly stopped from following the postgrad academic career I’d wanted and instead unemployed and living in my mother’s home while all the sh*t went on around me. I’m sure that the devil finds work for idle minds, especially minds which are already creative and which tend towards anxiety, and I quickly became neurotic about my health and about my mother’s safety. You mention a previous husband’s death and imply there’s a whole back story there – perhaps this could have been a shock that jolted your anxieties into overdrive. Just a guess – maybe, maybe not, these things aren’t a science.
So, what to do? From your posting you’re clearly intelligent. I’d recommend a few things, which together I’ve found have slowly changed the way my mind (and body, no less importantly) works. First of all, as the easiest and most achievable, is to stop drinking anything with caffeine in. I know it sounds like a drop in the ocean, and your heart might sink when I say it, as though this will solve the problem, but you won’t do yourself any favours by adding to your anxiety with a chemical which directly raises anxiety levels. I used to drink LOTS of strong tea and coffee, and after years and years of thinking it was helping the anxiety I realised that this was just the caffeine receptors saying thank you for giving them their drug. Cut down slowly if you want (I went cold turkey and felt like death for a week! :) ), but do cut it out 100% if at all possible. Try camomile tea instead, which gradually relaxes over a period. I also gave up alcohol a couple of years ago, having used it as a way to block the anxiety – God only knows, it works, but it just kicks the can down the road and never solves the problem, and has a long-term effect of increasing overall anxiety and depression. Giving up alcohol, especially if it’s the one drug which definitely ‘cures’ the anxiety in the short term, can be a terrifying thought to contemplate, but I don’t regret it a bit (I used “Easy Way to Control Alcohol” by Alan Carr, which I found utterly overturned my ideas about alcohol and addiction and made giving up the easiest thing I’ve ever done).
But neither of those will stop the complex and neurotic thought processes, even if they do soften the physical, gut-wrenching anxiety that kicks in when your mind so much as gets a sniff of the thoughts that cause these reactions. My next recommendation would be meditation. Again, I suspect your reaction to reading this might be “Here we go again, this Brit’s got a load of wishy-washy things that he says will cure me, when what I need is a specific answer to my problems!” But I’ve really found that by training my mind to relax on a regular basis I’ve managed to divert my thought processes from the anxious rut they were in to one which is much much calmer. Meditation, eg the Transcendental or Buddhist version, does actually slowly change your brain chemistry and teaches your mind to think outside itself rather than obsessing about the things that obsess it. This is a medium or long-term thing, and won’t show results overnight, but it will show results. You say that getting treatment is too costly – I’d recommend doing some online research into TM, which can be learned through CDs etc. If possible, sign up for a regular class – I’ve never been to Iowa (I live in a small town in the English midlands – I can’t even imagine what Iowa’s like!), and I don’t know if there’s any organisation nearby you which offers classes in meditation, but please do look for any, even if it means driving somewhere for a retreat for a few days to learn how.
You might have already looked into CBT. I found that it gave me insights into the irrationality of my thought processes but didn’t ultimately calm that little neurotic voice that said “Yes, your fears are irrational, but something MIGHT happen, so you STILL need to worry!” If you haven’t come across it, do try to get a self-help book (cheaper than therapy) to at least get those insights. You might find some of their exercises of practical use, eg keeping a diary of actual experiences to allow you to reset your anxious assumptions about events/outcomes. For example, you don’t get a call from X, so you think X is dead. But your diary records that X didn’t call when you expected on days A, B, E, F, H, K etc, and they’re still okay, so your jumping from the missed call to the death is unsupported by past experience. Just an example.
Get out more. This has been very important for me. I found that, inside four walls, the anxieties pressed in on me in a way that didn’t happen when I was in the open. I never got into exercise (I’m just too lazy!), but long walks in the countryside or even the town helped. Do things. Meet people. I think you’re making things worse by staying in and avoiding going out, even if you’re occupied with art. I did it myself, and it doesn’t work, only gives your mind more time to chew over its obsessional thoughts. If you have for example a church nearby that offers social services in any way, call them or drop in and get involved in things. It forces you to think outside your head. If they have a drop-in centre for the homeless, go help hand out meals. If they need someone to drive things to elderly people, volunteer. It’s much harder for anxious thoughts to thrive when your mind is unavoidably focussed on doing something for someone who’s right there before you.
Stop getting your children to call on a regular basis. The very regularity only makes it worse – you’re expecting a call today, but it hasn’t come yet… still hasn’t come… maybe in a couple of minutes…? I’ll just give them until 2pm, then I’ll call…. They haven’t picked up – they said they’d call!!!! See what I mean? Try explaining to them that you’d LIKE it if they called SOMETIME next week, but ONLY if they’re not busy and they WANT to call, though you’d be HAPPY to hear from them anytime. If they don’t call, you all knew the score beforehand – they knew that they’d call if they had time and wanted to; you knew you weren’t expecting a call any specific time.
Now here comes the “but”. But you won’t go right out and do these things, and that observation is made with all sincerity and love as I’ve been through all this myself. You’ll find it very very hard, and the anxiety will keep saying that should stay in and make people make the calls, and do your texts, and then you’ll feel safe, even though the anxiety and the fear still have the upper hand. That’s perfectly normal, and it’s just what I spent years doing. I even know why I did it, why I had all those misgivings about how it could ever be better. Terrified inertia that stops you trying anything is normal, but it’s just the anxious neuroses wanting you to feel they’re in charge.
Hope this helps. If there are specific ways to tackle things you need advice on, and you think I’m talking sense about your specific problems, I’ll keep an eye out for posts.
God bless, take care.
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So, I just want to say I am still unsure if i have this specific disorder or not……
I am 17 years old, and i live a somewhat normal life, i guess you could say. But I have always had huge depression issues and have always had a hard time thinking about losing the ones i love. When i was little, my mom took me to babysitters all the time, and i just vaguely remember crying and crying and crying when she would drop me off, to the point where people didn’t want to watch me. Although I don’t cry anymore when my mom drops me off somewhere, I am getting almost the same way with my boyfriend. He spends a lot of time with me (but not too much! we give eachother SOME space now and then), but it’s super hard to say goodbye, or know that i won’t see him for a while. Whenever he comes over and leaves, I’m always clinging and in tears at the door, or when i’m dropping him off at his house, I just am washed away with this gut feeling about how i won’t be able to see him again for some reason, even though i know i’ll see him within the next couple of days. We have a pretty serious, healthy, functional relationship, so i know he isn’t going to randomly leave me anytime soon (I am lucky he is so….patient with me and all my issues). But i don’t know if i should classify this under a seperation dissorder, or just plain crazy…And my mood swings/ emotions get more and more dramatic with the increase of time between visits. And this isn’t the first time I’ve felt this way about somebody other than my mother. It always a single person in my life though, and when i was 14, i went through a very tramatic experience with the person i loved and ever since it’s been worse when i’m forced to be seperated from a loved on.
I would just love some feedback on all this, and maybe some advice on what i could do to get help…
Hi Kaitlyn, I am not a professional, but I myself have had to have some extensive help to deal with my anxiety problems. If you have suffered from this since childhood, I am wondering if you have ever had any kind of professional help for you depression and anxiety, as well as the trauma you went through at 14 years old. Also, have you had support within your family to deal with this?
If you have not had any professional help, I would personally recommend seeking out help from a social worker, or psychiatrist who specializes in treatment of anxiety disorders and depression…including trauma issues. If you want to find a trauma therapist from a reliable source, I would recommend checking out the site of the Sidran Foundation which is a very sound non-profit resource and publishing company for people who are living with trauma after-effects. They have a place on their website where you can search for a therapist in your area. You can also email them and they will answer you personally. They also have a list of guidelines for recognizing who is a good therapist for you.
The website is: http://www.sidran.org
My heart goes out to you…I have been through a lot of what you are describing..and I know how painful and stressful it is.
Kathy
Im 16 years old and i have this ASAD to my boyfriend. Is it normal for me to have this at such a young age ?
Milly Star – I wouldn’t start thinking in terms of whether you’re ‘normal’ or not at the age of 16 – the entire adult world is abnormal in the sense that every person is individual and none is perfect. At your age it’s not at all out of the ordinary to feel extreme emotions in relation to people, especially boy/girlfriends or just people you have a thing for. You might have a problem with separation anxiety, or it might just be normal teenage feelings of fear of losing someone’s affections. My advice as a grizzled old 40 year old would be to please try to avoid pigeonholing your feelings into clinical diagnoses at an age when you’re still bang in the middle of getting to know how you fit in to the world. You’ll likely find, as you grow older and (possibly inevitably?) grow apart from this boyfriend and move onto different relationships, that your emotional reactions change too – the way you feel with regard to one person changes with time, often in ways that unexpectedly liberate you. You might on the other hand find that you keep repeating a pattern of emotional behaviour, and if this becomes or remains a problem in future then perhaps it might be worth looking into ways to challenge it.
As an aside to people like Tm especially (a few posts ago): after a recent increase in my overall anxiety I asked my GP to prescribe something to help and started taking beta-blockers (propranolol), first as 40mg/day and now 80mg modified release per day (to avoid the peaks in its effect), taking an extra 40mg if I’m going to be facing a particularly anxiety-inducing event like an anticipated phone call. Early days yet, but it’s drastically reduced the physical effects of my underlying anxiety, and as a result has allowed my mind to break free of the obsessional downward spiral that leads to uncontrolled panic. I plan to carry on using it to test how much it solves the really bad panic episodes – if it passes the test and can reduce those symptoms to a bearable level then I’ll make it a permanent fixture and then move on to how to change my thought processes using the space that the drug gives me.
Hi. I am a man of 38yrs old, married with two young boys.
I have been off from work for 2 days because of my anxiety. I have only been 2 months in this job and I have been getting problem with someone whom I reporting to (not my manager). The way he speak can be very cynical and he often criticized me, which really knock out my confident. I am an engineer with PhD and I was so full of confidence in my previous job. Shortly speaking, I am under stress, and this triggers my anxiety to come back.
The anxiety in me starts when I was in year 4 or 5. I refused to go to school by making a lot of excuses to my parents. I was not clear what was the cause at that time, but maybe because I was thinking the day at school was too long (starts at 7 finish at 4, I think). I have an asian background so this is the school back in my country.
My parents moved from one city to another because of my father’s job, with me coming along. When I was at year 10, my parents moved to this city while I moved to another city with my sister (we live with our aunty). I found no problem separating from my parents. Then when I go to uni, I moved to another city on my own, again no problem.
In 1998 I got married and I got a scholarship to do my PhD in Australia. Having not much money in my pocket, I arrived in Australia first, while my wife was going to join me in one month time after I got everything ready (accommodation). On my first day in Australia, I got my anxiety again, very severe such that I did not want to eat, having difficulty trying to sleep at night, afraid that I would never see the sunlight again during sunset (so I go out and see the sun until it dissapear). Perhaps there was some culture shock at that time that made me stressed, combined with guilty feeling of leaving my parents.
I graduated in 2005 and in 2007 (two years in my first job) I felt not happy with the job and dissapointed, and stress. My wife and our son left me for a holiday back to our original country, and I had a ticket to join them in 3 weeks time. The day they left me, I came back from the airport to an empty house, made me feel crazy and the anxiety came back again. I could not sleep at night, did not want to eat. For the first time in my life, I went to see a doctor (GP) and he gave me a some pills to relieve the anxiety. I did take the pills but not regularly, only when I felt I had to, because I was so afraid of the side effect. I met my family in two weeks time after I reschedule my flight, but that anxiety only dissapeared after 2 to 3 weeks after that. I moved to another job after that. However, the anxiety did not dissapear completely, it came back everytime I was away from my family for business trip, in which I had difficulty in sleeping at night.
An now on my third job, it is happening again, it is not as severe as in 2000 and 2007 but for the last two days I had a mixed feeling whether I should go to work or not. On both days I have been off, I have boarded the train, but then I got out and came back home. I went to see a GP yesterday, who recommended me to see a Psychologist/Psychotherapist, but this requires me to take another 2 days off from work because the Psychologist is only available during work hour. I can not take another 2 days off from work since I am still under probation, because I am afraid that this will give a negative impact to my report card. So today I am going to go to work, with a thought that maybe someday I can seek help from this Psychologist or other counselor.The GP prescribed me valium and I took one last night.
Can someone out there please advice me what to do. I have been reading books and internet articles about anxiety and panic disorders. I believe my anxiety is triggered by stress, and when it is happening, I got panic disorder – I may be wrong, though.
hi,
i’m a student at a university in the uk and have had ASAD (i think) for as long as i can remember. Now that i’m 19 the pressure for me to move away from home is building and tensions are getting worse at home as my parents think i’m not trying hard enough to move out. Last year it got so bad that on the first day of moving into halls at uni i had to come home (it panicked me to the extent that i was a snivelling mess and incoherent, completely the opposite of me, i’m not normally a ‘fragile’ person) i ended up having to drop out of that university because the commute wasn’t feasible from where i lived. Now i’ve started as an undergrad at a new university closer to home, and basically had the same thing (minus dropping out ) happen this year with halls. Its becoming harder for me to even think about moving out, and my parents patience is running out. I don’t like the idea of living with other students , but don’t think that living at home will be a possibility either. I just feel more and more trapped and like i’m generally disapointing to other people as the rest of my friends from home move on to other univeristys. In a wierd way its quite nice to know that i’m not completely mad and that there are other people who also suffer from this. Thanks for setting up the blog, its really helped
I am 18 years old and about to graduate from highschool. I think I might have ASAD because I have a consent fear of being away or not hearing from my girlfriend. I have shortness of breath and racing thoughts, unable to consentrate, and unable to stay in one place whenever I think about something happening to her or even thinking about her at all. What are some ways I can get over this anxiety? And do I have ASAD?
Im a 20 year old female. I think I have a seperation anxiety towards my mother. Me and my mom never had a great or close relationship up until when I was maybe about 16 or 17.
My now fiancé who was just my boyfriend at the time, moved into an apartment and I soon followed. Moving in wasn’t a struggle, emotion wise. Everything was fine with my parents and everything, but me and my fiancé were constantly fighting and I would cry to my mom about our fights and she even helped me move out.
We got back together within a month and during that month I was living with my mom. I don’t really remember when I started feeling the way that I do, up until recently I guess.
I feel guilty when I am away from her. I panic when I don’t hear from her. I can’t go a day without talking to her. I’m scared that something might happen to her while I’m not there. If she died while I was away, I seriously don’t think I’d be able to live with myself knowing that I wasn’t there and that I could’ve done something to save her. I feel guilty when I leave. Before I go anywhere I have to give her a kiss and tell her I love her and say bye or else I will be uneasy and tense.
I view my mom as a strong person. The strongest woman ever. I think of myself as very introverted, shy, quiet, nervous, awkward. My mom is the complete opposite. I know she can take care of herself and she’s very independent and does everything for herself, but I still can’t help but worry.
My therapist says this could also be because of my post traumatic stress disorder because I was molested by a family member at the age of 5 for 3 years straight and my mom confronted my abuser when I was 16.
I don’t really know what else to say, I can’t think straight. I can barely eat or sleep. I think about her every day and every night even if I stay the night there.
She has no idea that I feel this way. I’m afraid if I tell her, then I’ll be embarrassed.
Up until now, I was only reading about children not being able to be away from their mom or a spouse not being able to be away from their spouse. But I’m an adult with obsessive thoughts about my mother’s emotional and physical well-being.
Does anyone else have a story similar to mine? What do you guys do to calm yourself down? How should I explain to my mom my feelings? She’s very stoic. Any bit of advice will help, thanks so much.
I have always felt the need to be with my children 24/7 or for some reason I didnt think they were safe enough. If someone wanted to take them to the beach or something involving water I would be on the verge of panic the entire time and find myself calling them a few times to make sure they were ok and being watched. If they went into public places like the mall without my being present, same thing. I would be worried sick and have to call and check on them even though the person they were with was very capable. As infants and toddlers I was always near them, very seldom ever needing a sitter. My spouse left and I was all they had and we have always had a very tight bond. Physical contact was a very big thing also whether it was cuddling up to watch tv or just holding my hand. We also said I love you and kisses and hugs good morning and good night. Now, CPS took my kids saying my house was not clean enough almost 2 years ago and I have been fighting to get them back ever since. At first I could not stop crying for the first few months. I can not be in silence at all or my mind races and I cant sleep or think. I am always wondering if they are safe and not injured and find myself panicing again. I cant think straight, I am always depressed, I dont want to go anywhere or do anything, I cant concentrate on anything, I am very forgetful, I cant sleep very well or I dream and wake up feeling exhausted and with migraines, I have even contemplated suicide. If they terminate my rights because I cant seem to get my life together since they have been gone, I dont think I can handle it. I go to court Jan. 5th to find out. And I am just terrified. What is wrong with me????
To those people who’ve recently posted, but especially to Kali (simply because, Kali, I know exactly what you’re describing, to the very last detail):
My first recommendation would be to find a way to reduce your anxiety, and then start on thinking yourself out of these thought patterns – it’s all very well trying to do it the other way around, but when your head is bunged up with racing, anxious thoughts and you simply can’t think straight you’re pretty much on a non-starter in my personal experience.
I’ve previously recommended meditation, giving up caffeine and alcohol and trying other off-the-peg relaxation techniques in other posts, but I’ve also recommended the use of anxiolytic doses of antidepressants and betablockers. I still recommend especially the meditation and caffeine ones, as simple and cheap options, if only to get the ball rolling. However, I think that drug therapies have a major part to play if other things don’t work. Right now, I’m taking 4x40mg of propranolol a day, having started about 10 weeks ago, and this has had a really marked effect on my general anxiety. It’s reduced my anxiety to a level where I can very comfortably think my way out of the rising tide of separation panic that I’m sure you all recognise.
Just the other day I encountered one of my triggers for ASAD, and yes, it did give me a pang of anxiety, the kind which pre-drug treatment would have grown into an uncontrollable, obsessive urge to call to check that my mother was safe (which would, of course, have only got a million times worse if she hadn’t been in). Now, though, I was calm enough to reason my way through the irrationality, and for the first time in many years I subdued that rising panic and was able to forget about calling to check up on her for two whole days, after which time I’d said I’d call anyway – this is a real breakthrough, as I’m sure you’ll be able to empathise! My system has taken a couple of months to get used to the effect of the betablockers (initially I felt a bit tingly and confused my words now and again, and had a nap in the afternoon once or twice) but now they’re very well bedded in and I can’t honestly notice any side-effects. I simply feel much much calmer.
Kali – I found that admitting all these feelings was the best bet. For a start, being honest to the person you’re anxious over allows the light to flood in to how irrational these thoughts are. Broach the subject, admit you need their help, and explain that for some reason or other you’re having these anxiety problems. Talk through your fears for their safety, and allow them to reassure you that they’re a capable adult who can look after themself. I found it very useful just the other day to tell my mother that I needed to know that she was aware that when I didn’t call it wasn’t because I didn’t care about her. This freed me to NOT pick up the telephone without feeling guilty: I think I’d got it into my head somehow that by not checking up on her I was not loving her, and that if anything did befall her then I knew I’d feel guilty. I circumvented this thought process by explaining that, yes, sometimes I did feel an urge to call to check on her, but that if I fought that urge I then felt guilty for not checking, and so I asked my mother (who’s very understanding about this but a bit bemused, to be honest!) to reassure me that she was totally happy not to be called up – there was no reason for my guilt, once she’d freed me of the need to call.
I could bang on and on, but I’m a writer not a psychotherapist and have work to do! As an aside here – have you noticed how almost all the posts on this site are from particularly articulate, reflective people (me aside!). I think there’s a strong link between these traits and the kinds of introverted anxiety we’re talking about.
My summing up for this post – talking openly and honestly is good, and I’ve personally found that betablockers have calmed the anxiety enough for me to have the head-room to think straight.
Hi all — I have ASAD, anxiety and phobias. It comes in waves, and at the moment I’m going through a period of being very anxious about my health, and panicking when I’m alone at home and my partner goes to work (what if something happens to me and there’s no-one around to help?).
I want to recommend The Work of Byron Katie to everyone here. It’s a system of questioning the validity of your stressful thoughts, and it works really well for me. It’s free and you can do it alone (or with a friend or family member facilitating). You can find out more about it here. I’ve been using the technique on and off for 6 years and my anxiety has got SO much better, to the point where I go for months without experiencing any anxiety. Before I started doing The Work I was anxious almost constantly.
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