Social Anxiety Disorder in Family Separations

Immigrants from Latin America have been migrating to the United States of America in recent years largely to escape violence in their home countries (Gamboa, 2018).  The unstable government is too weak to effectively combat violence from gangs, drug cartels, poverty, and crackdown on policies that better prevent and punish domestic violence.  Unfortunately, those that have come to America under the Trump Administration to escape these condition, have been met with cruel family separations where parents are separated from their children at the border–sometimes for months at a time.

After a long period of experiencing sustained toxic stress, children who were once crying uncontrollably in detention centers may now appear quiet or withdrawn (Santhanam, 2018).  This is because of the child’s cortisol levels becoming depressed. This is only one of the many physical effects of toxic stress.  Really, the long-term negative consequences of family separations can manifest in biological, psychological, and/ social spheres.  Children predisposed to anxiety disorders or other comorbid mental health problems such as Major Depressive Disorder are at a greater risk for Social Anxiety Disorder.

What is Social Anxiety Disorder?

According to the DSM-5, Social Anxiety Disorder is characterized by the following criteria.

  1.  Developmentally inappropriate and excessive fear or anxiety concerning separation from individual(s) to which the person in question is attached, as evidenced by at least three of the following:
  1. Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures.
  2. Persistent and excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters, or death.
  3. Persistent and excessive worry about experiencing an untoward event (e.g., getting lost, being kidnapped, having an accident, becoming ill) that causes separation from a major attachment figure.
  4. Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation
  5. Persistent and excessive fear or reluctance about being alone or without major attachment figures at home or in other settings.
  6. Persistent reluctance or refusal to sleep away from home or go to sleep without being near a major attachment figure.
  7. Repeated nightmares involving the theme of separation.
  8. Repeated complaints of physical symptoms (e.g., headaches, stomacheaches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated.
  1. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults.
  2. The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning.
  3. The disturbance is not better explained by another mental disorder, such as refusing to leave home because of excessive resistance to change in autism spectrum disorder; delusions or hallucinations concerning separation in psychotic disorders; refusal to go outside without a trusted companion in agoraphobia; worries about ill health or other harm befalling significant others in generalized anxiety disorder; or concerns about having an illness in illness anxiety disorder

(American Psychological Association, 2013).

If you recognize that you or your child may be experiencing these symptoms, consider seeking counseling.  Dr. Joseph Giardino has gained experience working with spanish-speaking and/ english-speaking immigrants that are experiencing toxic stress.  Weekly sessions help counteract the short-term and long-term effects of toxic stress. Mental health and physical health are inextricably linked, and working to improve one’s mental health also helps to improve one’s physical health. Call today to get started!

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