Understanding and Managing Adult Separation Anxiety: 8 Diagnostic Signs

Dr. Tracey Marks, a psychiatrist, explains that separation anxiety is more prevalent in adults than commonly believed, often going undiagnosed. She distinguishes it from normal stranger anxiety in children, which typically resolves by two years of age, and outlines eight diagnostic signs based on the DSM-5 criteria. These signs include excessive distress upon separation, persistent fears of harm befalling attachment figures, worries about personal incidents leading to separation, refusal to leave home or go to essential places alone, fear of being alone without an attachment figure present, inability to sleep away from home or without a loved one nearby, recurrent separation-themed nightmares, and physical symptoms like headaches or stomachaches anticipating separation.

The podcast highlights several nuances in how adult separation anxiety manifests. For instance, adults may rationalize their reluctance to work outside the home by blaming the job environment, or they might mask symptoms by always having children or a partner accompany them. The distinction is made between refusing to leave home (sign 4) and needing someone present *in* the home (sign 5). Dr. Marks also notes that the condition can start in childhood, appear in late teens or early adulthood, and can be triggered or exacerbated by traumatic events like death, divorce, or even becoming a parent, potentially leading to overprotective behaviors.

Practical insights focus on recognizing and managing the anxiety. Dr. Marks emphasizes that the anxiety is often an "overreaction" by the mind and body, a "false alarm." She advises against maladaptive coping skills like overeating or excessive checking, instead recommending adaptive strategies. These include consciously "sitting with the anxiety" rather than escaping it, recognizing its irrational nature, and engaging in constructive activities to redirect focus. She also references techniques for calming the vagus nerve and understanding attachment styles as complementary approaches.

Broader implications include the significant underdiagnosis of adult separation anxiety, partly because its symptoms often overlap with other conditions like social anxiety, panic disorder, and PTSD, which tend to receive more clinical attention. The embarrassment associated with discussing separation issues further prevents individuals from seeking help, even when they are being treated for co-occurring disorders. The pandemic's shift to remote work is also noted as a factor that can inadvertently mask or accommodate this anxiety, making it less apparent to both the individual and others.

Did you know that separation anxiety is more common in adults than it is in children?

You're excessively distressed when you anticipate or experience separating from home or important attachment figures.

You always fear something bad happening to the person, like them getting into a car accident or dying from an illness.

You worry about something happening to you that would pull you away from your loved one.

You refuse to go to essential places, like school or work, or are reluctant to leave home because of the separation.

You're afraid to be alone without attachment figures in the home or with you.

You won't sleep away from home or go to sleep without having your attachment figure nearby.

You have recurrent nightmares about the theme of being separated.

You experience distressing physical symptoms like headaches, stomachaches, nausea, or vomiting, just from anticipating the separation.

Separation anxiety in adults is an underdiagnosed condition.

I think a very basic approach to this is first recognizing that the anxiety you have is in your mind and your body's overreaction to the situation.

But you have to recognize your maladaptive coping skills and then replace them with adaptive ones, like first sitting with the anxiety rather than escaping it.