Attachment-Related Distress in Common DSM-5 Diagnoses

Why Attachment Trauma Shouldn't Be Overlooked in Adult Mental Health

While attachment theory has long been associated with childhood development, its relevance doesn't end there.  Attachment insecurity often persists into adulthood, shaping how individuals experience and navigate mental health challenges. Yet in the current DSM-5 diagnostic framework, attachment trauma remains largely underrecognized, despite its significant role in some of the most commonly diagnosed psychiatric conditions.

Let's explore how attachment wounds are linked to two key diagnoses: Major Depressive Disorder (MDD) and Borderline Personality Disorder (BPD).

1. Major Depressive Disorder (MDD) and Attachment Trauma

How Insecure Attachment Fuels Depression

Individuals with insecure attachment styles—especially anxious or avoidant patterns—are more vulnerable to developing depressive symptoms. Here's why:

• They often carry deep-rooted beliefs of unworthiness and hopelessness.

• Difficulty forming and maintaining secure, emotionally supportive relationships limits access to co-regulation and comfort.

• Childhood attachment disruptions often result in a lack of early emotional attunement, leaving individuals without the internal tools to self-soothe or process distress.

Attachment Trauma and Suicide Risk

• An estimated 60% of individuals who die by suicide have a mood disorder, most commonly depression.

• Attachment trauma compounds suicidality, reinforcing persistent feelings of isolation, rejection, and despair.

The Takeaway: Depression isn't just a chemical imbalance—it is often the expression of unresolved attachment wounds. Recognizing this connection can open doors to more profound, trauma-informed healing.