Reactive attachment disorder (RAD) is a mental health condition that originates in childhood that affects a child’s relationship with their caretakers. Often, the symptoms of RAD do not simply disappear in adulthood. Instead, they shift and morph into a collection of problematic symptoms that affect one’s mood, anxiety levels, and relationships. Acknowledging and addressing the effects of RAD will be the best way to limit the damage and promote wellness.
What Is Reactive Attachment Disorder?
Reactive attachment disorder (RAD) is characterized by a pattern of emotional withdrawal in children, especially when the child is in distress. Typically, symptoms of RAD stem from trends of insufficient care during early childhood. The child will appear disinterested during socialization and ignore or refuse support from caregivers.1 To be diagnosed with RAD, a child must be at least nine months old, and most children receive a diagnosis before the age of five. Unfortunately, RAD is a challenging condition to treat, because it is commonly linked to other mental and physical conditions.1
A child with RAD will display unexplained episodes of:
- Irritability
- Sadness
- Fearfulness
Some triggers of RAD include:
- A lack of attachment due to multiple caregivers
- Limited social comforting and stimulation
- Minimal contact with a loving parent/caregiver
A child diagnosed with RAD may also experience:
- Malnutrition
- Cognitive delays
- Language delays
- Repetitive behaviors
- Other mental health conditions like depression
- Avoiding eye contact
- Avoiding physical touch
- Throwing tantrums frequently
- Not showing emotions like joy or love when interacting with others/li>
The signs and symptoms of RAD will not disappear on their own as someone ages. Even with the best treatments, a person could continue to experience symptoms of attachment disorders that affect them for a lifetime. Because the person was unable to develop a secure attachment style in childhood, they may struggle with avoidant or anxious attachment patterns, which can influence their current and future relationships.
Reactive Attachment Disorder Symptoms in Adults
When a person does not receive the love, care, and attachment they need during their formative years, their life will be significantly altered. Again, while adults cannot receive an RAD diagnosis, many will have lasting symptoms from their childhood that lead to continued distress.
Many of the issues associated with RAD revolve around the concept of trust. Because a child did not receive the attention and love they needed from caregivers, they will struggle with developing a crucial sense of dependency. Without this, one will face many challenges including difficulties with attending school, getting a job, and maintaining long-term relationships.2
When a person lacks a foundation of trust and attachment, they may not be able to trust themselves. This could lead them to avoid taking risks in life, because the potential losses could be too great. Alternatively, they may feel untethered to their surroundings and engage in a series of impulsive behaviors.
Some of the most common reactive attachment disorder symptoms in adults include:1,2,3
- An inability to be emotionally vulnerable with someone
- Maintaining distance from others
- Isolating physically or emotionally from others
- An intense fear of being alone
- Feeling that other people will only disappoint them
- Underreacting to or minimizing their hurt and pain
RAD creates a great deal of discomfort in adults for a variety of reasons. One will long for personal connection with others, but quickly push people away or begin to isolate as a relationship becomes more intimate. With intimacy comes vulnerability, and someone with RAD will attempt to prevent any future emotional harm. Additionally, they may feel as though they don’t fit in or exhibit control issues in order to manage their discomfort.
Mental Health Diagnoses Linked to RAD
When a child with RAD enters adulthood, their residual symptoms may shift and develop into other mental health conditions. Some may experience alexithymia, a condition marked by a lack of emotional awareness.3 While it is not a diagnosable mental health disorder, alexithymia causes a person difficulty when expressing their emotions clearly, causing them to appear cold, distant, or not interested in social interactions. Other adults diagnosed with RAD as children may exhibit symptoms of autism spectrum disorder(ASD). Many RAD and ASD symptoms overlap, so receiving a proper diagnosis will allow someone to pursue the best care available.1
Some psychological conditions that may manifest from childhood RAD include:1,3
- Depression
- Bipolar disorder
- Anxiety disorders
- Certain phobias
- Certain eating disorders
- Substance use disorders
- Behavioral addictions
- Personality disorders (see personality disorder in teens)
Unfortunately, some may experience a combination of these disorders, which can prove challenging when formulating an effective treatment plan. Accurately diagnosing one’s condition and identifying the source of the symptoms can help someone have a more complete understanding of their situation.
Effects of Reactive Attachment Disorder in Adults
RAD is an incredibly impactful disorder that will leave residual effects on an individual. One’s relationships, housing opportunities, employment stability, physical and mental health, educational needs, and financial status may all be compromised.
The full effects of RAD can be challenging to pinpoint. For example, someone who is highly successful in their profession may lack emotional achievement. This can manifest as an absence of joy in their life, various addictions, or an eating disorder. Their mistrust and need for control could limit access to happiness. In contrast, another person may struggle in more apparent and evident ways. Perhaps they failed to complete their education, maintain a steady job, or obtain stable housing.
RAD in Adult Relationships
Some adults diagnosed with RAD as a child may choose to avoid serious relationships. They may prefer the quiet comfort of isolation and social withdrawal, which can influence both friendships and intimate relationships. Another person could pursue relationships that are very chaotic and intense. They may report feeling happy for short periods of time, before their trust issues inevitably result in suspicion or doubting of their partner’s intentions.
RAD in Parent/Child Relationships
Many who suffer with the effects of RAD may have never experienced consistent family relationships. Without an appropriate parental model, a person may feel unsure of their own parenting abilities or unworthy of parenthood. Moreover, they may project their strong feelings of resentment towards their parents onto their child.
On the other hand, someone may strive to provide a healthy and loving childhood for their own children. This could include attending parenting groups, actively engaging with their children, and pursuing therapy in order to become the best parent they can be. These differences help to illustrate the unpredictability of RAD in adulthood. The long-lasting effects of the condition can be polarizing.
Treatment for RAD in Adulthood
Treatment is necessary when addressing adult symptoms of RAD, as they are unlikely to improve on their own. The first-line method for treating RAD is psychotherapy, which can help a patient better understand their condition, learn effective coping skills, and improve communication styles.4 Therapy may be individual or include one’s friends, family members, and other loved ones to offer support throughout the healing process.
The best mental health treatments will provide a comprehensive plan to address a multitude of complications associated with RAD including:
- Addictions
- Poor physical health
- Employment/ financial difficulties
- Housing
- Transportation
- Education
- Mood and anxiety symptoms
- Interpersonal communication challenges
Currently, there are no medications specifically prescribed to manage the symptoms of RAD. Instead, a prescriber may offer prescriptions to help manage overarching disorders that have developed over time. For example, if one begins to experience anxiety or depression, they will likely be prescribed antidepressant or antianxiety medications. By treating these symptoms, therapy can more closely target and focus on tackling one’s attachment issues. If you or a loved one are experiencing the residual effects of RAD, you can easily find a therapist by asking for a referral from your primary care physician or a trusted loved one, or by using an online therapist directory.
Final Thoughts
Reactive attachment disorder is a challenging condition to manage, regardless of a person’s age. However, there is always hope for a brighter future. Pursuing treatment can help you process through your history of mistrust and find healthy ways to establish successful relationships.
For Further Reading
- Reactive attachment disorder – Mayo Clinic
- Quick Guide to Reactive Attachment Disorder – Child Mind Institute
- Attachment Disorders in Children: Causes, Symptoms – Help Guide
- When reactive attachment disorder in childhood grows up – RAD Advocates
Reactive Attachment Disorder in Adults Infographics
