Separation anxiety disorder — structured clinical viva

This presentation is classic adult separation anxiety disorder often mis-triaged as pure panic. Attacks occur in the context of attachment-figure absence; content is harm to partner and inability to cope alone; duration exceeds the adult typically-6-month threshold; impairment is clear. DSM-5 allows adult-onset without childhood proof.[1][2][3]

Panic interface. Childhood SeAD elevates later panic risk at group level, but current management still targets separation exposure and checking response prevention rather than only interoceptive work. If true unexpected multi-context panic exists, treat comorbidity — do not ignore separation.[4]

Why not chronic diazepam. Benzodiazepines risk dependence and can interfere with extinction learning; they are not first-line long-term disease modification for SeAD. Offer collaborative graded exposure framed as skill-building, not cruelty.[5][6]

SSRI if needed. For moderate-severe cases or partial psychological response, sertraline 25–50 mg orally daily titrated toward 50–200 mg/day with early activation/suicide review is a concrete exam-level plan within broader anxiety guidelines.[5][6]