The “diagnosis” of separation anxiety disorder has been around since DSM-III. In DSM-IV it is defined as “…excessive anxiety concerning separation from the home or from those to whom the person is attached.” (DSM-IV-TR p 121). The APA’s prevalence estimate is 4%.
This “diagnosis” is listed under the heading: “Other Disorders of Infancy, Childhood, or Adolescence.” One of the criteria is that the problem must begin before age 18, and in practice the “diagnosis” was generally confined to children under the age of 10 or so.
The “diagnosis” of separation anxiety disorder can be critiqued along essentially the same lines as most of the other DSM labels, e.g. lack of identifiable pathology, arbitrariness, fallacious circularity, vagueness in definition and criteria, etc… It can also be pointed out that there are more valid, and incidentally more helpful, ways to conceptualize fears and anxieties. In addition, giving a child (and his parent) the message that his fear is an illness for which he must take pills rather than a life hurdle to be overcome by effort and encouragement is stigmatizing and disempowering. Back in the fifties there were always a few kindergarteners who cried and carried on when being dropped off at school, but they were all “cured” (or apparently so) within the first week.
“TREATMENT” OF SEPARATION ANXIETY DISORDER
The University of Rochester Health Encyclopedia (here) has this to say on the “treatment” of separation anxiety disorder.
“Treatment recommendations may include cognitive behavioral therapy for the child, with the focus being to help the child or adolescent learn skills to manage his or her anxiety and to help him or her master the situations that contribute to the anxiety. Some children may also benefit from treatment with antidepressant or antianxiety medication to help them feel calmer.”
In practice, of course, the cognitive behavioral therapy recommendation is ignored and the child eats pills. The Wikipedia article specifically mentions SSRIs.
All of this is bad enough, but coming shortly in DSM-5 we will have separation anxiety disorder for adults!
So adults who are excessively anxious on being separated from their children or from other significant figures are now mentally ill. And this change is based, not on some recent scientific discovery or insight, but simply because the APA say so. And who, you might wonder, decides how much anxiety is excessive? The psychiatrists.
It’s business as usual. More “diagnostic” creep; more stigmatization; more disempowerment; and of course, more drugs! If you were thinking that the psychiatrists might be having second thoughts concerning their marriage to pharma, you were wrong. The marriage is thriving.
Gone is the notion that fears are to be conquered through application, effort, and social support. Gone is the notion of families and friends rallying around a member in trouble and helping him through a rough patch. Because today there are no rough patches. What we, naively, used to think of as rough patches have been transformed by the wisdom of psychiatry into mental illnesses.
And so it goes. These people will never stop until everybody has a “diagnosis” and everybody is taking drugs. Psychiatry, with its pathetically naïve and simplistic handbook of human problems and its pill-for-every-problem philosophy is a destroyer of people. Please speak out. Stop the madness.