Children with separation anxiety disorder are excessively anxious about separation from family members or from home. As a child grows and becomes autonomous, SAD usually disappears. Left untreated, it may lead to panic disorder, agoraphobia, or a mix of anxiety disorders. In the psychiatric community, SAD was once considered a disorder unique to childhood.
According to pioneering research by Vijaya Manicavasagar of Psychiatry Research and Teaching Unit, Liverpool Hospital, New South Wales, Australia, “adults 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.” Providing further insight into separation anxiety disorder in adults he states, “Separation anxiety disorder may be a neglected diagnosis in adulthood.”
Katherine Shear, M.D., professor of psychiatry at Columbia University, makes two important observations in her research on Adult Separation Anxiety Disorder (ASAD):
1) ASAD is more prevalent than SAD.
2) The vast majority of adults with ASAD had the first onset of the disorder in adulthood.
According to the Diagnostic Manual of Mental Disorders, the diagnostic criteria for separation anxiety disorder are:
1. Excessive distress from anticipating or being away from home or away from major attachment figures.
2. Extreme worry that an unwanted event will lead to separation, or about something negative happening to a loved one.
3.Extreme reluctance or refusal to go to sleep without being near a loved one. The inability to sleep away from home.
4.Repeated worries and nightmares involving separation.
5.Physical symptoms such as headaches, stomach aches, nausea, and vomiting when faced with separation from loved ones.
Separation anxiety disorder treatment:
In addition to causes such as genes, environment, and family history, studies suggest that anxiety disorders are the result of an imbalance of certain neurotransmitters such as serotonin, dopamine, epinephrine, or gamma-aminobutyric acid (GABA).
Separation anxiety disorder medication is part of the standard treatment for most anxiety disorders. Treatment generally involves a combination of antidepressant medications and exposure therapy. Exposure therapy is a form of cognitive-behavioral therapy (CBT), where a patient is exposed to stressful situations under controlled conditions.
Top separation anxiety disorder medications that work:
There are no FDA-approved, specific medications for SAD. However, prescribed separation anxiety disorder drugs that seem to work are
selective serotonin reuptake inhibitors (SSRIs). If patients don’t respond to SSRIs, tricyclic antidepressants are prescribed. Benzodiazepines are recommended as a last resort.
SSRIs enhance the amount of serotonin in the brain. Serotonin is responsible for generating happy or calming feelings. Examples of SSRIs include: Fluoxtine (Prozac®), Fluvoxamine (Luvox®), Paroxetine (Paxil®), Sertraline (Zoloft®), Citalopram (Celexa®), and Escitalopram (Lexapram®).
Tricyclic antidepressants are prescribed if patients do not respond to SSRIs. TCAs work on norepinephrine levels in the brain synapses. They may also affect serotonin levels. Examples include Amitriptyline (Elavil®), Desipramine (Norpramin®), Nortriptyline (Aventyl®, Pamelor®), and Imipramine (Tofranil®).
Benzodiazepines:
The use of benzodiazepines is generally a last resort in treating separation anxiety disorder. The drug works as a calming chemical on the brain. Examples include Alprazolam (Xanax®), and Clonazepam (Klonopin®).
A combination of CBT and separation anxiety disorder medication, along with a healthy lifestyle that includes good nutrition, adequate rest, and regular exercise, can help patients bear the impact of anxiety disorders.
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