What is Separation Anxiety Disorder (F93.0)?


By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is Separation Anxiety Disorder (F93.0)?
Photo courtesy of Pixabay.

Separation Anxiety Disorder used to be strictly a children’s condition.

In the past Separation Anxiety Disorder was listed in the section of the Diagnostic and Statistical Manual (DSM) under the category of Disorders First Diagnosed in Infancy, Childhood, and Adolescence.  Recently in the reorganization of the DSM, this disorder was moved to the chapter on anxiety disorders.

Increasingly we recognize that there are adults who suffer from Separation Anxiety Disorder.  In children, if they have the symptoms for four weeks or more, that meets the criteria.  But when we see this disorder in adults we expected it to last at least six months.  This is a disorder which may come and go throughout the lifespan.  It is likely to begin after, or to be triggered by, stressful events.

Separation Anxiety Disorder is about a fear of losing the major attachment figure.

In Separation Anxiety Disorder there is a fear of leaving home or being separated from a major attachment figure.  This is very different from people who are simply afraid of going out of the house, being around crowds, or meeting strangers.  In Separation Anxiety Disorder it is the fear of losing that significant person which causes them extreme distress.

This fear is clearly far more than life circumstances would warrant.  People with this disorder need to know where that important person is it all times.  And they may have an excessive need to stay in constant contact with their major attachment figure.  These people may be given to constantly texting, and may become quite upset if they’re communications are not immediately responded to.

You may also fear being taken away.

Separation Anxiety Disorder is also the fear that something will take you away from that major attachment feature.  People with this disorder worry about an illness, kidnapping, or being forcibly taken from a major attachment figure. Some people with this disorder are unable to be in a room by themselves.

Separation Anxiety Disorder can make you refuse to leave home.

The classic example of this is the child who is terrified of leaving their mother to go to kindergarten on the first day of school.  In normal children, if we expect them to get over this fear after a few days.  But in those with Separation Anxiety Disorder that fear continues for long periods of time. We may continue to see this behavior as children get older.  They may have frequent illnesses which keep them at home with their important attachment figure.

Like most other anxiety disorders, Separation Anxiety Disorder typically begins in childhood, but it may well continue throughout adult life.  In diagnosing this disorder the professional looks at the developmental stage of a person to see if what they are going through is appropriate.

Some adults are so afraid of leaving their significant family members that they are unable to venture out into society alone.  They will only be willing to go outside the house, to the store or an appointment, if that major attachment figure accompanies them.

That huge fear of being alone maybe Separation Anxiety Disorder.

An abiding characteristic of Separation Anxiety Disorder is the extreme level of fear of being alone.  Any time this person is separated from their major attachment figure, they become anxious and may even become terrified.

In children, the attachment figure is likely to be their parents or caregiver.  In adulthood people with this disorder are likely to become very anxious when separated from their spouse, partner, or their children.

If that important person is not home, then you can’t sleep.

People with Separation Anxiety Disorder find that they are unable to sleep when the major attachment figure is not in the house.  They may stay up all night on those occasions when that person they’re attached to needs to be gone overnight.

The person with Separation Anxiety Disorder will have a constant need for reassurance.  This need may result in frequent phone calls or other efforts to contact the attachment figure who is not there.  This constant need for reassurance may begin to interfere with their partner’s ability to work.

Separation Anxiety Disorder causes nightmares about being separated.

In this disorder, the content of the nightmare is that the important person will be taken from you or you from them and that you will never ever be able to see them again. These nightmares can be recurrent and play a role in maintaining the other symptoms.

Separation Anxiety Disorder can make you physically ill.

Symptoms of this disorder can look just like a physical illness.  These symptoms may include headaches, inability to eat, nausea, or even vomiting if there’s a chance that you’ll be separated from this major attachment figure in your life.

People with Separation Anxiety Disorder are likely to be described by others as needy and insecure.

There is help for Separation Anxiety Disorder.

While this condition often begins in childhood and may continue well into adulthood, someone with this issue does not have to continue to suffer.  There are treatments available.  If you or someone you love suffers from this condition, consider getting professional help.

More on this and other anxiety disorders see:  Anxiety

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

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