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What is OCDRelated Symptoms & ConditionsCan separation anxiety be a mental health concern? 

Can separation anxiety be a mental health concern? 

10 min read
Erica Digap Burson

By Erica Digap Burson

Reviewed by April Kilduff, MA, LCPC

Nov 28, 2023

Our loved ones are important to us, and it can be hard being away from them for any extended period of time. However, if the idea of being apart from your parents, child, relationship partner, or other important person in your life makes you extremely anxious and fearful, there may be something else at play. 

In this article, we’ll talk about why you might get separation anxiety when you’re apart from your loved ones, when it might be time to seek help, and what options you have for feeling more comfortable facing the world without them by your side. 

What does it mean if you’re uncomfortable with separation? 

There are plenty of reasons that you might not want to separate from your loved ones, ranging from the general uneasiness of facing the world alone to diagnosable mental health disorders. 

Do you have a general fear of being abandoned or being lonely? 

You could be dealing with Generalized Anxiety Disorder (GAD) or abandonment-related trauma. 

It’s no secret that the world can be a scary place, and this can make it very difficult for people to be apart from their loved ones out of fear of something bad happening to them. So if you suffer from a generalized anxiety disorder or are even just more anxious by nature, it might make being apart from your loved ones harder and scarier. 

April Kilduff, MA, LCPC, LMHC, explains that she often sees this kind of anxiety after major devastating events. “I always think of what happens to parents because of all the school shootings,” she says. “There’s typically a bout of separation anxiety after a recent shooting, and parents are often terrified to be apart from their kids and not know what’s happening where they are and if they’re safe.” 

This kind of general fear can also sometimes be seen in young adults when faced with the realities of adulthood. “Some adolescents learn the world can be a dangerous place. When you’re out of that childhood bubble, you might have difficulty separating,” says Kilduff. 

Another potential explanation for a general fear of being lonely may stem from trauma. A fear of abandonment can be linked to many different traumas like abuse, neglect, or the death of a loved one. People who suffer from this kind of fear of abandonment may be more anxious to be apart from their loved ones out of the fear of losing them. 

Are you frequently worried about handling things on your own?

If you don’t want to be alone out of the fear of having to handle things on your own, your anxiety might stem from your relationships themselves.  

Not wanting to be apart from an attachment figure in your life may also be due to the nature of your relationship with the people around you or your dependence on them. 

Romantic partners are a good example of this specific kind of anxiety. For example, if you are dealing with relationship issues and are feeling insecure, you might not want to be apart from them out of the fear that the time apart could affect your relationship or even lead to its failure. 

This doesn’t just apply to romantic partners, either. You could be anxious about leaving your loved one’s side for any number of reasons—for example, you might be afraid of leaving a family member or loved one whose health isn’t good or who is struggling with successful independent living. 

On the other side of the coin, you might also be anxious and nervous about separating from your family or caregivers if you have historically depended on them to help you. Kilduff explains that she sometimes sees this happen in autistic people who have otherwise relied on their parents or caregivers to help them communicate or navigate social situations. 

In addition, she explains that she most often sees this kind of anxiety in young adults. 

“There was a generation of parents who were very overprotective and just took care of things and didn’t want their kids to feel distressed,” she explains. “Now, those kids aren’t prepared to be adults and be in the real world and take care of their own lives. Separating from that built-in comfort zone can be really scary for them.” 

Are you having repetitive intrusive worries? 

If you’re persistently experiencing thoughts like “Are they okay?” or “What if something bad happens to them or me?” whenever you’re not around others—or will be separated from them soon—then your fears might be related to obsessive-compulsive disorder ( OCD). 

OCD is a condition that is defined by two main groups of symptoms: obsessions and compulsions. Obsessions are repetitive thoughts, worries, images, urges, sensations, or feelings that can generate intense anxiety and fear. Compulsions are mental and physical actions that are carried out to temporarily alleviate the anxiety and distress brought about by those obsessions. 

In some cases, the fears that are related to OCD might center around your loved ones, making you scared to be apart or even generating a fear of abandonment. For example, Relationship OCD (ROCD) is a kind of OCD in which people have recurring and distressing thoughts about their relationship, their partner, or both. In some cases, someone with ROCD might fear that they aren’t a good enough partner, or that their partner might cheat on them, and might then insist on being around their partner at all times to avoid something bad from happening. Unlike general relationship issues, people with ROCD are stuck in a constant cycle of these obsessions and compulsions, in search of a certainty that doesn’t exist. 

Kilduff has also seen similar themes with Health Concern or Contamination OCD. “I saw this coming up with COVID a lot, where people didn’t want to be apart from their loved ones because they wanted to make sure everyone was safe and didn’t get sick or to maximize time together in the event of an unfortunate early, sudden death,” she explains. 

Do you get extremely anxious at the idea of separating from someone or your home? 

If you refuse to leave particular people or places as a result of your anxiety, it’s also possible that you are dealing with another diagnosable condition called separation anxiety disorder. 

Separation anxiety disorder is a condition in which you feel an exaggerated anxious response to being apart from an attachment figure or from your home. 

Separation anxiety is commonly seen in children, and it is in fact a normal stage in their development that usually happens before a child turns one year old and progresses until they are about three years old. However, separation anxiety disorder is a diagnosable condition that extends further than the age of 3. The distress and fear that people with this disorder have is often long-term and debilitating, and it extends beyond the age-appropriate anxiety seen in young toddlers. 

While separation anxiety disorder is most commonly associated with children, it is not uncommon in adolescents and adults as well. 

What are the signs and symptoms of separation anxiety disorder? 

In order to be diagnosed with separation anxiety disorder, you need to display at least three of the following signs according to the DSM-5:  

  • Recurring and extreme distress from separating from your home or attachment figure (or even just the idea of separating) 
  • Recurring worries that you will lose your attachment figure or that they will have something bad happen to them like illness, injuries, disaster, or death  
  • Persistent worries that your separation from your attachment figure will be prolonged or permanent 
  • Reluctance or refusal to go out because of fear of separation
  • Refusal to be alone  
  • Refusal to sleep alone without the attachment figure 
  • Repeated nightmares about separation
  • Physical symptoms like nausea, stomachaches, or headaches when separated from the attachment figure

While separation anxiety disorder primarily involves intense fear and anxiety when faced with the idea of separating from a loved one or caregiver, it can manifest in different ways when it occurs in children versus adolescents and adults. 

The first difference is that children are most often attached to a parent or a caregiver, while adults are most often attached to their own children or their significant other. 

As a result, the way that they deal with this intense anxiety will also differ between parents and children. 

“For kids, it often means a lot of difficulty getting them to school. They might melt down before going, or get sent to the nurse and call a parent several times throughout the day to get picked up,” explains Kilduff. But on the other end, “It could be the parent that’s anxious to separate from the kid at school. They might give the kid a phone so that they could text or call 9-1-1 if something dangerous happens. It might involve putting an AirTag in the kids’ backpack so that they can track it constantly throughout the day.” 

How is separation anxiety treated? 

Separation anxiety can be hard, both on the person who has it and on the person who they are attached to. It can make it difficult to establish any independence on both sides and significantly impact their ability to live life to the fullest. Luckily, there is help out there. 

There are a few potential treatment options for separation anxiety—one of the most effective is actually a form of cognitive behavioral therapy that was developed for OCD treatment, known as exposure and response prevention (ERP) therapy.

ERP therapy is considered the gold standard for OCD treatment, and is also highly effective for children and adults dealing with separation anxiety disorder. ERP involves confronting one’s triggers and anxieties in a controlled, intentional manner, working to sit with the discomfort rather than engaging in compulsive or unhelpful behaviors. 

ERP works best when done with a licensed therapist who has ERP-specific training. These mental health professionals can help you gradually face your fears and learn to better cope with the distress and anxiety that they bring, ultimately helping you break out of a cycle that only serves to reinforce the fears. 

So what might this process look like for adolescents with separation anxiety? “Depending on how severe it is, you might start by asking the kid to go check the mail by themselves,” begins Kilduff. Then, “You might ask them to walk around the block by themselves, maybe go to the grocery store by themselves, and start building in increments of being away for a little bit of time and then slowly growing that until they are feeling more comfortable and can be out in the world without such intense anxiety.” 

In addition to easing the symptoms of separation anxiety, it’s also worth noting that treating separation anxiety can be helpful for the attachment figure as well. Having to stay with their child or loved one can be taxing and demanding. What’s worse, it can even reinforce those fears if the person is accommodating for their loved one’s separation anxieties. 

As a result, treatment is often especially effective when it also involves the person whom the patient is anxious about separating from. “That person probably needs some good education about separation anxiety,” Kilduff explains. “They can also give you good information about what happens when there’s a potential separation since you want to know if accommodations are being made.” 

It’s also important for everyone involved to understand the difference between supporting their loved one through their treatment and enabling their anxieties. Being an active participant in your loved one’s treatment means learning how to better support them without accidentally reinforcing their fears. 

“You can support the person without supporting the disorder,” says Kilduff. 

She goes on to explain, “Enabling would be doing things that support the separation anxiety, like allowing the child not to go to school or walking the child to the car and waiting there for thirty minutes so the child can come back to you if they want to.” 

On the other hand, “Supporting and encouraging someone is saying, ‘I’m here for you and to help you get better. I am not here to help your separation anxiety. I believe in you, I trust that you can do this, and I’m going to be here to support you even though that might mean that you don’t like some of the things I am going to have to do.’” Knowing the difference can make a huge difference in the treatment of the person with separation anxiety disorder. 

You can live with freedom and confidence, starting today

Separation anxiety disorder, other forms of anxiety, and OCD are all highly treatable conditions—and the right approach can make a life-changing difference for anyone whose life is affected by separation anxiety. 

If you think that your struggles with separation may be a sign that you’re struggling with any of these conditions, I strongly encourage you to learn more about NOCD’s evidence-based, accessible approach to treating OCD and anxiety disorders. NOCD therapists are all licensed and receive ERP-specific training to help you regain control of your life from OCD and anxiety disorders. 

Learn more about ERP
April Kilduff, MA, LCPC

April Kilduff is a NOCD therapist who has exclusively treated OCD and anxiety disorders, as well as their intersection with the Autism spectrum, for over a decade. Her path to this career started with her own journey dealing with panic attacks, perfectionism and a couple phobias. When not working on exposures with members, you can find her at home reading books and hanging out with her two cats or out taking pictures and traveling the world.