How Does The Anxious-Preoccupied Attachment Style Affect Mental Health?

Medically reviewed by Majesty Purvis, LCMHC
Updated October 31st, 2025 by Regain Editorial Team

Key takeaways

  • The anxious-preoccupied attachment style is characterized by a strong desire for closeness paired with a deep fear of abandonment.
  • In addition to impacting relationships, the anxious-preoccupied attachment style can impact a person’s overall anxiety symptoms, self-worth, and self-esteem.
  • To manage the effects of an anxious-preoccupied attachment style, you can practice mindfulness, use positive self-talk, and seek therapy.

Attachment style can impact more than just relationship dynamics. A key feature of the anxious-preoccupied attachment style is a negative self-view—in other words, not viewing yourself as capable and worthy of love. This attachment style can have profound effects on an individual’s anxiety levels, self-esteem, and overall mental health. However, these challenges are not insurmountable. There are ways to manage the effects of an anxious-preoccupied attachment style and support both mental and relationship health. 

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What is the anxious-preoccupied attachment style?

The anxious-preoccupied attachment style is an adult attachment style typically characterized by a strong desire for closeness and a deep fear of abandonment, which can result in a need for frequent reassurance. Some of the key features of the anxious-preoccupied attachment style may include the following:

  • A high need for care from a partner
  • A persistent desire for closeness and protection
  • An intense worry about abandonment 

 Insecure attachment styles 

According to attachment theory, attachment styles can fall into two overarching categories: secure and insecure. Anxious-preoccupied attachment style, sometimes called preoccupied attachment or anxious attachment style, is considered a type of insecure attachment style that can lead to challenges in intimate adult relationships. 

Other forms of insecure attachment styles in adults include avoidant (also called dismissive) and disorganized (also called fearful-avoidant). In children, there can also be various types of insecure attachment styles, including avoidant attachment style, ambivalent or anxious-ambivalent attachment style, and disorganized attachment style. 

Secure attachment style

In contrast to the anxious-preoccupied style, a secure attachment style is characterized by the following: 

  • Comfort with emotional intimacy
  • Respect for a partner’s boundaries
  • A healthy balance between closeness and independence 
  • The ability to trust one’s partner and confidently express one’s own needs

These dynamics generally pave the way for positive, stable relationships. 

How does the anxious-preoccupied attachment style impact fear and anxiety?

People with preoccupied or anxious attachment tend to have a deep fear of being abandoned by their partner, which can influence their needs and behaviors in the relationship. However, beyond influencing relationships, the anxious attachment style has been shown to have an impact on overall anxiety symptoms and the development of anxiety disorders. 

Research on anxious-preoccupied attachment style and anxiety

Recent research on the connection between anxiety and attachment styles shows that:

  • Specific attachment styles have been associated with anxiety disorders.
  • Secure attachment is negatively associated with anxiety symptoms and anxiety disorders.
  • Insecure attachment is positively associated with anxiety symptoms and anxiety disorders.
  • Of the insecure attachment styles, anxious attachment has the highest correlation with anxiety.

How does anxious-preoccupied attachment impact self-worth?

In addition to impacting anxiety, the anxious-preoccupied attachment can also impact a person’s self-worth and self-esteem in significant ways.

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How does this attachment style affect a person’s need for emotional support?

Another common component of the anxious-preoccupied attachment style is a high need for reassurance, attention, and emotional support. Individuals with this style may become very worried at even the smallest perceived slight from their partner, such as their partner having to change plans at the last minute or not replying to their texts immediately. To ease their persistent fear of abandonment, an individual with this style may need frequent reassurance from their partner that they are loved, supported, and cared for. 

Emotional dependency vs. healthy emotional support 

It may be important to distinguish between healthy levels of emotional support and emotional dependency in a relationship. In romantic relationships, being able to lean on your partner for support and provide support to them in turn can be a crucial aspect of a strong and fulfilling relationship. However, this is different from one person becoming fully dependent on their partner for their overall emotional well-being. 

How can you develop a more secure attachment style and improve mental health?

There are a variety of strategies and resources available to help individuals manage the effects of an anxious attachment style, including the following:

  • Practicing mindfulness and meditation to manage anxiety symptoms
  • Using positive affirmations and self-talk to improve self-esteem 
  • Seeking therapy to gain professional support for these and other mental health concerns

Managing fear and anxiety in therapy

In therapy, you can work with a qualified mental health professional to dig into the roots of your attachment anxiety, learn new ways to manage anxiety symptoms, and take steps to cultivate greater self-esteem. In addition, you can receive support for your close relationships and learn how to develop stronger, more fulfilling bonds.

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Seeking mental health support from home

You can find relationship support in person or online, but if you are experiencing high levels of anxiety and low self-esteem, traveling to a therapist’s office and participating in face-to-face sessions may seem difficult or uncomfortable. In these cases, being able to meet with a qualified therapist from the comfort of home may be easier. 

Plus, research has shown that online therapy can be effective for a range of relationship and mental health concerns, including anxiety and self-esteem. A growing number of studies support the use of online therapy as a valid alternative to in-person care.

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Takeaway

Characterized by a deep fear of abandonment, the anxious-preoccupied attachment style has been associated with higher levels of anxiety and lower levels of self-esteem, among other mental health impacts. To manage these effects and cultivate stronger relationships, there are several strategies that may help, including practicing meditation, incorporating positive self-talk, and seeking support from an in-person or online therapist. 

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