What is attachment disorder in adults? And how to treat it in adulthood

Collaborative Post | Attachment disorder is officially recognized as a mostly childhood condition. It appears in diagnostic manuals as a maldevelopment in early childhood and as something that affects children who experienced neglect or inconsistent caregiving. But what happens when those children grow up? Do the symptoms simply disappear at 18?

Not quite. While diagnostic manuals rarely recognize symptoms of attachment disorder in adults, it never fully disappears, especially if it's unaddressed. In adulthood, attachment-related difficulties rarely look like a "disorder." They might show up as personality traits, such as hyperindependence, lack of trust, clinginess, etc.
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This article explores what attachment disorder can look like in adults, even when there are no official guidelines.

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Signs of attachment disorder in adults

According to the most trusted research on attachment styles conducted by Mickelson and Shaver, around 36% of adults have insecure attachment [1]. It means they experience difficulties with relationships, especially trust, dependence, loneliness, etc.

DSM-5, a reputable guidebook for psychiatric and neurological conditions, differentiates two types of attachment disorder. An attachment disorder quiz can help you differentiate whether you have:

• Reactive Attachment Disorder (RAD) is mostly diagnosed in kids who have experienced neglect and/or abuse.
• Disinhibited Social Engagement Disorder (DSED) is common in older kids and teenagers who grew up in unstable environments.

Here is how these conditions can present in adulthood.

Signs of Reactive Attachment Disorder (RAD) in Adults

Emotional detachment from others
A symptom of insecure attachment style is that a person always feels alone and misunderstood. No relationships can convince them that other people can understand you. It's highly likely that it happens because this person didn't have a positive reinforcement model for connection in childhood.
Feeling uncomfortable with dependence
Neglect and abuse can teach the brain that relying on others is unsafe. This discomfort and desire to do everything on your own is a coping strategy.
Trust issues
Insecure attachment styles increase the probability of anxiety by 6 times [2]. Overthinking, combined with negative experiences in the past, convinces you that other people are unreliable or that they don't care about you, even if it's your family, significant other, or closest friends. Even when someone proves they are reliable, your instinct may still be to keep a distance.
Emotional dysregulation
Social Biofeedback theory claims that children learn to identify and manage their feelings from their parents. If parents were absent or abusive, there are no positive examples to follow. Hence, a child may repeat unhealthy emotional indulgences they observed in childhood.
Strong need to control everything
This symptom can start as early as 12 months and persist into adulthood if left unaddressed. Although control needs to be beneficial for work, it may sometimes harm relationships or mental health.
​Freezing during conflict
"Turning off" during conflict, so withdrawing, losing trace of thoughts, crying easily, are all protective mechanisms learned when fights earlier meant physical or emotional danger.
Preference for being alone​
Children with RAD often grow up to be independent and love loneliness. There are numerous reasons for it: it's simpler to navigate emotions when you're alone, fear of rejection, shame for your interests and routines, etc.

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Signs of Disinhibited Social Engagement Disorder (DSED)

DSM-5 describes children with DSED as "overly friendly." They can easily approach strangers, neglect set boundaries, and throw tantrums when they don't get what they want. In adulthood, signs of DSED can look slightly different:  

Over-trusting others too quickly
Every person who shows signs of affection or kindness is a safe person. Adults with DSED may trust such people without identifying their intentions and also attach to them quickly. When this connection disappears, they feel intense waves of frustration and betrayal.
Oversharing
When a person over-trusts others, they can share intimate details or secrets without realizing they are doing that. One reason people with DSED do it is that they seek validation and connection that they lacked in childhood.
Difficulty maintaining boundaries
It works both ways: it's hard to maintain boundaries with other people because it feels like "you wish them the best" when you enmesh in their lives. It may also be hard to set your own boundaries because the brain has internalized the idea that saying "no" immediately means rejection.
Strong fear of being alone
DSED in children develops when they grow up neglected. Hence, they seek comfort and support from anyone who seems willing to give it. Being without connection then feels distressing, leading to staying in unhealthy relationships.
Dependence on external validation
Studies have found years ago that self-esteem heavily depends on a person's attachment style. For example, this study found that self-worth was highest among those with secure attachment and decreased in the following order: preoccupied, dismissive, and fearful attachment styles [3].
Ignoring red flags in relationships
The desire for connection and validation may override your ability to notice unhealthy dynamics. This, in combination with self-esteem, makes people who had DSED in childhood more likely to stay in abusive/narcissistic relationships.

Attachment Disorder vs Insecure Attachment Style

Why your attachment style is important

Attachment style shapes far more than romantic relationships. Attachment is so important, it influences mental health [2]:

• Any insecure attachment or attachment issues are linked to a double risk of depression.
• Avoidant attachment (RAD in childhood) is associated with a double risk of anxiety.

In relationships, attachment style defines every interaction. People with anxious attachment might motivate their actions by a need for reassurance and heightened sensitivity to rejection. Avoidant attachment is so uncomfortable with vulnerability that they will use anything, sarcasm, hyperindependence, intimidation, etc., to set a distance with other people.

Attachment issues are so deep that they also affect work. Since attachment is at the heart of communication, it can also influence performance. Anxious individuals may overwork to avoid criticism, while avoidant individuals may struggle with collaboration.

What to do when you notice symptoms of attachment disorder in yourself

The first step you should take after noticing attachment-related challenges is to seek help from a mental health professional. In adulthood, you are unlikely to be diagnosed with RAD or DSED, as these are childhood diagnoses. Instead, a specialist will look at differential diagnoses (depression, CPTSD, anxiety, BPD) and insecure attachments broadly to find the best treatment for you.

What else can you do?

Engage in psychotherapy
Therapy, especially attachment-based or trauma-informed approaches, helps you explore how early experiences shaped your current behaviors. But a good therapist won't only concentrate on your past; they will also try to address your negative beliefs and build healthier coping strategies.
Build relationships with safe people
Healing attachment wounds requires connection to other people. Rely on consistent, safe relationships. This can be a partner, friend, or even a therapist. The key is experiencing connection, where you feel welcomed and validated.
Practice healthy relationship skills
Learn practical skills to maintain healthy relationships. Here are a few suggestions: set boundaries, practice active listening, take responsibility for your reactions, use "I" statements, avoid formulations like "you always" or "you never," etc.
Develop self-awareness
When do you withdraw? When do you become anxious or overwhelmed? Very effective practices for improving self-awareness include journaling, mindfulness, and psychoeducation.


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Sources:

1. Adult attachment in a nationally representative sample. Journal of Personality and Social Psychology. November 1997. 
2. Comorbid depression and anxiety: Integration of insights from attachment theory and cognitive neuroscience, and their implications for research and treatment. Frontiers in Behavioral Neuroscience. December 2022. 
3. To explore the effect of adult attachment styles on levels of self-esteem among young Indian adults. World Journal of Biology Pharmacy and Health Sciences. July 2024. 

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`Disclaimer: this is a collaborative post.