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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so after reading some..most of these post I too felt compeled(sorry in advance for errors /sp?) to write. I am a 25 year old mother , wife, daughter, and sister all to men who just don’t understand. I truly feel like I am on an island even though I am surrounded by all these people that love me. hmmm I don’t even know where to start. I have “something wrong” and have been on many differant meds. and some counseling, wich I don’t currently do because instead I put it off or make excusses my fear of knowing what’s wrong is dibiltating it’s self along w/ everything else I feel.
I have had issues sense a child that have only seem to get worse as more events occur in my life.
I was very suicidal as a child and preteen even befor my mother abandonded us. so I think my “seperation issues started at a young age.. I remeber flipping out when my mom would leave on her parting binges chasing the car pleading her not to go. It only got worse.. at 14 she went grocery shopping and never came back after years of being over protective and obsessed w/ us I assume from her own mental dissorders. At the time it was my step father and brother who she had turned me against so I felt ALONE and still do even though I am not. I still have no relationship w/ her and know dealing with the hate would be half the battle but the other half leads me to writting here… my husband mine as well already left me cause i have manifested every seneraio in which he will, if we agree he is going to go somewhere as soon as he leaves I feel FEAR, I become uneasy my thoughts raise my palms sweat I pick fights I put beg for him to come back I attack him I always creat a senerio where he is letting me down and I can feel bad all over again,If he doesn’t answer I call over and over presumming he is lieing or w/ someone. I don’t go out w/ friends, I always have to be home or I feel uneasy almost manic at times, I love him and my family and want more then anything to believe they are going to stay, as my children get older I fear they to will turn on me and leave me as soon as they are old enough…as I write I feel like I sound crazy because it makes no sense… I am missing out on my life I have now worring about what may never happen!! I can’t imagen a life w/o worry and panic. I need help, copeing tools I am willing to use meds. but wish I didn’t need to, I want to feel NORMAL!! I am so tired of crying and feeling lonely in a room full of loved ones. I am open to anything.
In the context of this subject matter, my role would be that of the emotional attachment. My fiance and I have had a long distance relationship going on 2 years now. We are very close to finally being together for the long term. She has been exhibiting many of the behaviours described in the article and I’m really hoping that things will immediately improve upon reuniting.
I appreciate everyone sharing their experiences here to help us understand the various ways this disorder can disrupt our lives. Having a partner suffering from this has helped me discover I have much more patience than I ever thought.
Most comments here are written by those afflicted by the disorder; although I do not have ASAD, I am suffering as well and I’m sure many others close to everyone posting here suffers too. I wish everyone involved the best and I hope you are strong enough to stay beside each other and not give up.
I am working with a female client, who i now recognize as having ASAD. She is progressivelly getting better. I have been using different modalities to diffuse past trauma. EFT, DOYLETICS, DIANETICS. Homoeopathy and diet. Just finishing a update on a revolutionized way of using Homoeopathy by Grant Bentley. I know this will help put her back on track . Just finished watching dvd sybil who has 13 personalities by joanne woodward sally field.
Its helped me to see the need for her to continue to diffuse past trauma that is acting as a catalyst in her life now. I have her on natural neurotransmitters, which are slowly changing the brain chemistry so she will be able again to get off her depression drugs. Its been four years now and great to see the light at the end of the tunnel. Gary
i lost my father 18 months ago & have been depressed since that day, i have been on 30mg of citalapram for over a year, i have had therapy & have now found work after a year out, the anxiety i felt when he died was unbearable, my whole body hurt in ways i never felt possible, i have diazapam for the worst days but rarely use it for fear of becoming addicted, i have come to the conclusion that i have ASAD, as i seem to be relapseing & the anxiety is taking over again, i dropped my dose of citalapram from 30mg to 20 mg 6 weeks ago & thought i was gradually getting better but am always tired & fearful of everyday duties, can anyone help me PLEASE
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I just wanted to add my experience to those that have gone before. I can really relate to ‘Cry’. As a child my home-life was very insecure and turbulent. I felt very unsafe and developed anxiety at an extremely young age. I remember my mother going out and my not wanting to be left at home as I was scared of my dad. I remember banging on the window crying after her. I remember asking her at night if I was going to have a good day tomorrow as I was so traumatised by the goings on around me. My parents never really comforted me or explained anything and I was left to my own devices.
I remember being left alone in the house and feeling anxious that something had happened to my parents and going into a terrible panic about it.
As an adult,I have experienced severe anxiety and it is always when someone leaves and I am left alone. I feel like I can’t cope on my own, I feel intense fear and just want to attach to someone who can calm me down and whose presence comforts me. All of this stems from childhood trauma and reliving anxiety experienced very early on. I don’t know how to make it any better – my anxiety is currently ruling my life.
I have been suffering from some kind of anxiety disorder for about 4 year’s now. I do recall having some kind of anxiety as a child too but it never lasted, it just came and went then stopped as a teenager, then returned as I reached adulthood after I had my daughter. I remember as a child I was okay until bed time, then when it was time for bed I remember feeling this FEAR of being alone?! As an adult it is the same fear. I believe that alot of my experiences are similar to ASAD symptoms. It is hard to be away from my significant other. Not bad like when he is gone at work I freak out but things like when he has to work out of town for a few days or if I think about leaving him I get that fear again. I can be totally unhappy in a relationship and still not leave that person because I am terrified of this anxiety. It is a horrible feeling. When I get the “attack” or “wave of anxiety” I can’t breathe because it feels like my chest is tightening, I can’t be in a dime lighted area when I have the attack, I want friends around me talking to me and trying to act like I am being fine. It is just really frightening. I can even explain all that happens to me. I have tried talking to a few Dr’s but most of them didn’t know what to tell me, would just give me a med that made it worse and send me on my way. I have started to be able to kind of control it myself but there are still time where it is very difficult. It was nice to read the stories above and know that there are other’s out there that share the some feelings that I do…
Having read this article and your comments i realise i am not so alone, i have suffered for many years with separation anxiety partiularly when my husband leaves on business trips. I get very desperate and feel out of control, i have been in therapy and have found it has not worked. I just want to be normal and be able to say goodbye to my husband when he leaves without begging and pleading for him to stay.
I am so relieved to have found this website as well as postings from others I can relate to. Unfortunately, for me, I realize today that I have been suffering from ASAD for years. They say not to self diagnose yourself on the web, but heck, all the symptoms describe me to a T.
I too can relate to 1 cry, growing up in the military and moving constantly was traumatic, particularly when my dad would leave for long periods (year or more) back in the ’60’s to go fight overseas in the Vietnam war. Saying goodbye to him in the airport was a solemn occassion with my mom and sister crying. I was too young to cry but can remember the sense of loss when leaving Buffalo (International) Airport. In my 20’s is when all the symptoms of ASAD became intense, even with my parents both present. It affected my college life and ability to socialize at that time. Do I have a handle on it now? No, an awareness, yes. But reading others, such as Neil, made me cry. I know when the day comes for my father, I am not sure how I will handle it, having to say goodbye once again….
Relationshipwise, yup, it has always affected me for sure. The insecurity worrying about my partners safety when not together, anxiety attacks at times, the dread of being alone after a happy time together. I don’t want to take medicine, but rely on clonazepam (Klonopin) to stay calm when the anxiety attacks hit.
Like 6 Cats says I can relate, my unpredictable ASAD associated anxiety is ruining my life and I am SICK of it!
Perhaps writing about it here will help, plus reading the feedback of others. Like 7 Autumn says, I agree that most Doctors will just prescribe medicine and send you on your way. Dealing with the Adult Separation Anxiety I guess is exposure therapy as this site says. In my long distance relationship I am having to practice that already. Is it helping? I don’t know. But finding this site and hearing from others helps. Plus recognizing the childhood trauma of my dad always leaving for war and moving constantly in the military has made me this way…..If only the anxiety attacks would not happen…I can deal with the past and the future!
Hi,
I guess I had a couple of questions for Larry.
I too suffer from ASAD (undiagnosed, in a way, since I was diagnosed with -but not really treated for- Separation Anxiety Disorder as a teenager.) Now, at 31, I find myself in a long distance relationship with a great guy and ever since the relationship started, about five months ago, all I do is suffer. Being together is amazing but the minute we are apart, I crumble. If he doesn’t respond to a phone call, I assume it’s because he’s broken up with me, etc. I haven’t shared most of my worries with my boyfriend for fear of putting too much pressure on him and the relationship, since we’ve only been together for a few months.
Larry, you mention that you’re in a LDR with someone who suffers from ASAD. How did you find this out? Do you have any ideas on how to bring it up to him? You talk about being patient; what other ways have you found to effectively reassure her? At times, I resent my boyfriend for not doing more/caring more, but then I realize that he has no idea how I’m feeling and thus no way of really making me feel better. However, I feel likei can’t just dump all of this on him so soon. Any advice would be welcomed. Thanks!
To FemaleMoonDweller,
Regarding your questions, honestly, my partner and I were both inclined to research about what was going on and we independently found information on ASAD. She then sought help from a psychologist and we’ve been working through this since.
Some keys to our survival has been consistency, focus, calmness, reassurance, and confidence.
When we are apart for extended periods, every few days a vicious cycle starts with her unloading seemingly baseless pent up suspicions and assumptions. To an outsider, this may seem like she is making a mountain out of molehill (big deal over nothing), but it is this disorder that is causing her to behave in a way that is so inconsistent with how she is when we’re together. I have to keep this in mind consistently and not let it get to me when she becomes borderline verbally abusive towards me over something that seems like a small misunderstanding.
Consistent communication will help keep misunderstandings, suspicions, and assumptions to a minimum, although not completely eradicating them. I must consistently understand where she is coming from so I don’t lose focus on what is important which is the long term success of our relationship.
That brings me to focus. Sometimes when we are having a long dialogue with the goal of helping her stabilize mentally and the conversation starts to veer down a dark path such as thoughts of calling it quits, I need to refocus the conversation on something more positive and constructive towards helping the situation.
Usually, focus will lead to calmness. Taking deep breaths, a short walk, have some water, etc. Talking about happier times in the past or things to look forward to in the future will help her realize things may be difficult at the moment, but hope is not lost.
Once the conversation is calm again, reasssuring each other with commitment and honesty about everything will help solidify her stabilization. I send her emails, we use skype, text messaging, magicjack, video instant messaging. We play online games, send each other songs, jokes, stories, articles, or anything we can think up to show we are thinking of one another. I interact directly with her family to show that I’m dedicated to not just her, but to those she cares for. She responds well to this.
We have come to refer to the ASAD feeling as ‘heavy’, so I try to lighten things up and keep things positive. Perhaps you can initiate doing some of these things and he’ll respond to it.
This cycle is not easy and we are working to curb this, but as many of those affected by ASAD know, it is VERY challenging. Back to your email, you cannot feel like you are dumping things on him. I doubt you can keep this hidden from him for the duration. Once he’s exposed to ASAD, he needs to know what is going on so he can help you. If he doesn’t want to help you through a difficult period, then he probably isn’t the partner you are looking for. That being said, if he is out of the loop, resenting him for not doing more is not justified. Resenting him at all will not help the situation, just make things worse. Open communication has been a key to us getting through this.
I commited to my girl a long time before ASAD came into the picture. Getting through challenges together has made us stronger and we’re going to get through this. We are very close to ending the LD part of our LDR.
I find great comfort in relating to the posts here. I hope you all do, too. We are not alone. I found this article/site via a web search for ASAD. I did know for certain if the term/disorder existed, but I felt that I did suffer from a separation disorder. I first mentioned this to my new therapist last week. It had been six months since my last therapy session. Previously, I had been receiving treatment for Major Depressive Disorder. It appears true that ASAD is associated with a co-existing illness. Additionally, I believe there is a lot of truth to ASAD being a predecessor for other illnesses. I was separated from my parents at an early age and placed in an orphanage for more than six years. I also lived in foster homes, etc. Similar to the post from the Military Child, moving around a lot creates a lot of broken bonds. Anxiety sets in when you feel yourself getting close to some one or some place….deep down you know that it probably won’t last for long. This deeply affects your love life, especially if someone in your past has suddenly left you or hurt through deception. Thank you all for sharing your experiences here. For today, I will have a better day. Just one more step in the right direction. I would love to talk more and form a support group. Perhaps we could do so on twitter. If interested, follow me there…my ID is LooneyBen2. HUGS!
i am 21 years old and have been dealing with anxiety issues for about 3 years now. it started after i graduated from high school and prepared to move away for school. i spent the summer very excited and eager to leave, as i was the first in my family to have a traditional college experience. about a week before i left home, i began experiencing anxiety attacks, and they only got worse as the time came for me to move into my dorm. i used to see myself as an independent person, but i felt a hard reality check after moving away from my family. i never felt fully comfortable at school, and with the recurring anxiety, i dropped out and moved back home. for months, i had almost daily panic attacks, even while attending a community college just 3 blocks away from my house. i transfered to a university close to home, and commuted daily, but the attacks started up again after about a year of having none. they intensified to the point where i couldnt even stand the thought of going to class, even though i knew that i would be home in a few hours. again, i dropped out, and ive been out of school for about a year now. i went from idealizing my future career to fearing becoming a lifelong hermit in my parents’ home. even though im on medication and attending therapy, i feel like any type of improvement is quickly followed by a steep relapse. i want to WANT to go back to school, but for the moment it just terrifies me. what can i do? i just want to be normal again. please help me.
I am 39 years old & both myself and my husband are both experiencing ASAD. He is in the military & has just spent a year away, come back for 3 months & now has to go away again. We both feared for his life during the year separation and although this shorter one separation is safe we are both increasingly showing signs of increasing anxiety. Any advice on how we can both help each other would be appreciated .
I can’t believe it, after years of being thrown to one direction to another by several different therapists, I truly believe this disorder is the route cause behind my major bouts of clinical depression, morbid jealousy, anger issues and why at 28 years of age I today have and still am balling my eyes out because my mum has gone to India for 3 weeks, I do not live at home I have 2children of my own, it’s always been a long standing joke in the family that I would cry my self sick if my mum even attempted to leave the house when I was a child realising that now, I would often run away from school or try to stay home just to be with her, I come from a family of 7 children and am the only one who is like this, strangely enough I don’t have any issue with my own children being away from me, maybe the odd twang of “I want them back right now” but in a normal parent way, I have found that I have also formed this attachment with my partner of 2 years, much to his annoyance and last year found myself crying when having to drive 180 miles away from him, I don’t sleep when he isn’t around I will sit up till 2 or 3 in the morning till I know it’s closer to him being awake again ( we don’t live together) until now I just thought I was a weird obsessive gf now I realise I have formed this attchment to him, and the saddest thing is I only feel ok about being away from him if I’m with my mum. And visca versa, I plan to arm myself with as much info as poss and beat this life controlling mental block I have!
Follow up to my last post, reading further into the article I realise it mentions border line personality disorder, in my medical notes I was about 3 years ago diagnosed with this, it says that a higher number of ppl associated with BPD are linked to ASAD, does anyone else suffer from both? Also I’ve shown this to my partner and it’s opened his eyes to all the problems we have as a couple are down to ASAD, last night things were fine we were in bed talking and as if by magic I had an overwhelming panic he had cheated on me, and then went on to tell him I would attack to kill him if I ever had evidence of the fact, as you can imagine that went down like a lead balloon, the anticipation of my mum leaving today must have been the fuel behind the fire for that verbal attack, but patient as he is bless him he waited till I had calmed down today and then as usual forgave me, now we know what the problem is I think he will know how instantly to stop it getting out of hand, one other thing I realised is when we argue over the phone or by text he wants me to leave it so he can calm down but I can’t I will ring and text at the speed of light, and I now realise it’s because for me no contact is more distressing than bad contact, I also find that after these episodes I am absolutely drained :-(
Fiona -
You wanted to know if anyone deals with both, I do. I self diagnosed myself with BPD a couple of years ago. I have never found anywhere or anyone who quite frankly in my opinion ‘gets it’. I have what I have always said are ‘abandonment issues’ but no therapist ever seems to focus on that issue, it is seen as insecurity, which yes, it is, but as I am sure you are aware, is so much more intense than that. It’s loss, it is a feeling of great loss and also as you state when you get no response, you feel left and abandonded and getting angry and then getting a response is for some messed up reason, better than getting none. I’ve never really had to deal with the abandonment to the degree that I do now. My boyfriend has taken a job that causes him to travel for 3 weeks to another country, show back up for one, then go away again. And his way of dealing with things is to shut down and avoid me….not helpful. Off on, close far, it’s hell to me and I get paranoid and insecure and it just upsets him and angers him that I accuse him of having a grand old time while hes gone. Yes, there is someone else out there that deals with both issues and unfortunately, that person is me.
It`s a releief for me to finally realise that I`m not the only one with this problem. And is also strange to see someone with my name writting a text that could almost be mine. I`ve had this problem since I was about ten years old and it has strongly affected my personal and professional life. I hope some day I can enjoy things a litlle bit like any other person. I`ve done therapy but I feel it has not help much. My daugther is startting to show the same symptoms and I do not want her to go throught the same thing as me so it is very rewarding to finally find articles on the net explaining my problem so I can try and help her as well.
Wow, this article is amazing, but the comments even more so. For so long I have felt like a freak, or the only person in the world who deals with this – at least with issues like depression, there are thousands of others who have recovered and written publicly about their experiences and strategies…for ASAD there is no precedent. It’s also interesting to see my “theory” proved correct, that most of the people who’ve commented had turbulent childhoods…for me, my parents divorced when I was an infant, leading to me living just with my mother for weeks at a time and then being shipped off to visit my dad in another state for a weekend. Every time I settled into a routine at home, it got disrupted again – this went on for about 14 years. This led to me becoming extremely anxious and emotional about any kind of separation from my mom or my home. I have learned strategies to deal with it since, but now, after just moving away to college I am feeling the full force of it and it is so good to know that I’m not the only one. I wish there were more information and that it was more prevalent so everyone who experiences this enormous anxiety could realize there are others out there. For me, I’ve found that being extremely distracted, EFT, taking St. John’s Wort, and not holding back tears all help me to feel a bit of relief. What works for you?
Hi, I was one of the very earliest to comment on this article and have continued to follow the posts. In the meantime I went back to University and studied Early Childhood development at a post grad level. As you can imagine it was both informative and depressing.
My studies confirmed what I had already began to understand, it is that most, if not all, of the damage or conditioning for many of the modern ’social’ mental health problems have their roots in very early childhood and/or infancy.
Much of the work done in the Carolina Abecedarian Project (http://www.fpg.unc.edu/~abc/) and also the work of Alice Miller (http://www.alice-miller.com/index_en.php) are key indicators to this period.
Much of the abuse and subsequent mental health problems I believe, are, in many cases, directly related to war and post war periods and the social upheaval that they cause – in other words why we still keep sending troops to war, the damaged returned soldiers will still keep fathering children that suffer their legacy – a father suffering PTSD is in years to come a new father or mother suffering ’social’ mental health problems.
” All we are saying is give PEACE a chance.”
My suffering continues, one day I will end it, when I am brave enough to commit suicide.
I have absolutely no doubt that my wife suffers with ASAD and has I believe from her early years. Business trips of 1-3 days (heaven forbid anything longer comes up!) are a prime trigger for the most significant episodes. On a day a to day level any discrepency on arrival time home particularly is cause for question as is not being able to reach me by landline/cell phone during the working day. ASAD is extremely frustrating and suffocating as the object of the anxiety but I know from many personal experiences that it is extremely painful, stressful and debilitating for the sufferer too. My one wish is that this does not pass to either of our children and I would not wish it upon any relationship theirs or otherwise. We have tried councelling on a couple of occasions but neither session has lasted long enough to see any tangible benefit. I would love nothing more to be able to release our family from the shackes of ASAD. Any suggestions as to where begin for the third time around would be gatefully received?
Hi Andy, if its any help I have 5 kids and none of them have shown signs of ASAD. I think as you may have read from my prior post it is a psychological issue and not genetic in origin. Having said that I do have a few other theories that would indicate a genetic propensity to many of the ‘common – current’ mental health problems, however this is not a forum for speculation.
Xanax, works well with me. I certainly don’t recommend it on a daily basis but as an “as needed” adjunct for those times when it gets too hard to cope. By using it like this I still manage to get good effect from 0.25mg .
One area of research I have been looking at is Grapefruit; this has a direct interaction with the adrenal system and from personal trials I did feel more relaxed. This of course will be very individual and care must be taken if using other drugs and even birth control pills.
Encourage her to go day tripping, it acts as a “cognitive rehearsal” and helps with her independence and self reliance. I use the phone a lot to ring friends or support groups when I get panicky – I find chatting (talking) for 45 – 60 mins seems have a calming affect and stops the worrying.
CBT is possible but I believe that ASAD is very deep seated and would need many hours of therapy for and significant gain. Work on the self-concept too. I do voluntary work and this has worked wonders with my self esteem and consequently my ASAD tends not to be so debilitating. I hope this helps. Regards Jasmine.
I’m 24 years old, married for almost 3 years. I’ve just been recently separated because of my behavior and emotional outbursts. My husband and I have a son together. I have not gone to the doctor about any of the symptoms I’ve had but from reading this article is coming very close to home. Although, I should probably get a full examination from my physician about this. But from reading this article, I have realized that I remember when I was younger being completely upset every time my parents left me with my grandmother. And whenever my mother left me with my dad, I’d get completely upset as well. In the back of my mind I knew they were coming back for me and my siblings but I wouldn’t take it as well as they my siblings did. I would cry and try to grab my mom to stay. I feel that now it has stemmed back into adulthood because every time my husband left the house I would try to call him until I reached him. He has found my behavior unbearable and has decided to separate from me. And every time any of my family want to take my son out, I try to not panic but a majority of the time I just tell them no and they respect my decision. But a majority of the time I don’t want to be left at home but I also don’t want to leave the house. I am currently unemployed and looking for work. I feel like what I have may be ASAD because of the traits I feel like I have portrayed. A lot of my family have been telling me that my behavior has gotten too irrational. I didn’t want to my husband to leave so I did hid his clothes and his car keys. It has gotten to the point where I’ve been doing a lot of irrational things and don’t understand why I do them, but the last few things I’ve done have been because I don’t want my husband to leave. I have hid his keys and hid his clothes. When I last went to the doctor, she said that I may have anxiety disorder. But I’ll have to go back again and see if I really do have ASAD.
Jasmine – I agree with you on the self-concept point, and on doing voluntary work that brings us out of ourselves and makes us focus on others. This does really seem to get ASAD-type minds out of that anxious rut. I also suspect that many of us have considered the advantages of ending it all, the anxiety can get so bad sometimes, but I truly hope you enjoy the good bits enough to stick with it and try to banish the bad bits. I utterly sympathise with you.
If anyone’s been following earlier posts, they’ll know I’ve posted a few very long ones with my own thoughts on what gives us these symptoms and how to counter them. Andy – you wanted suggestions on where to start once again on controlling this. Your wife’s symptoms and triggers seem very similar to mine, and I know exactly how terrifying they can be, but they can get better. I’ve blethered on before, and people can see what I’ve suggested, but I just wanted to simplify things down now I’m in a better place regarding these problems.
I’d strongly recommend some form of daily meditation – not just closing her eyes and making ‘om’ noises for ten minutes (!) but a structured course, stuck to, preferably initially learned from a proper practitioner. This will help to alter the tendency for her mind (if she’s at all like me) to cling obsessively to negative thoughts that spiral downwards to worst-case scenarios. The idea of ‘mindfulness’ is useful here, as it draws the focus away from possible futures to definite nows. Like I think I’ve said before, I’m a Christian who has a lot of time for Buddhist and Daoist ways of understanding the world.
Which leads me on to… After I gave up booze a year ago, I’ve found myself far less prone to negative obsessive thoughts. I’ve also been free, with my newly-sober mind, to reflect on all the hoary old spiritual questions about God and existence. I won’t go into them, you’ll be pleased to read, but I have truly found that having a faith, albeit changeable and unsure of many things, that there is a greater purpose beyond what I understand has made me instinctively more able to bear what anxiety I do still occasionally create in my head. It hasn’t been easy, it isn’t a miracle cure even for a person who has a faith, and I’d stress that being anxious despite a faith doesn’t make one less of a believer or in any way unfit in God/Whoever’s eyes. If anybody’s interested in specific details of how I’ve come to look at my ASAD problems from a Christian perspective, I’d be happy to go into detail some time if it’d help.
The meditation won’t work straight away, and it won’t, I don’t think, ever completely remove those ASAD tendencies, but from my personal experience of it it can change the landscape of an anxious/neurotic mind in the long term and reduce the symptoms we get to a bearable minimum.
Tell your wife from me, if you want, that I know exactly what she’s suffering, but that I’m far better now than I was a couple of years back, and things can and do improve.
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