Does My Child Have Separation Anxiety Disorder? Four Questions to Ask

Separation anxiety is a normal developmental phase that first occurs in babies once they grasp the concept of object permanence, i.e. the idea that even though they may not see something before their eyes, they know it still exists. Separation anxiety disorder, on the other hand, is different.

Most babies, by about eight or nine months old (some younger, others older, given that all children develop according to their own timeline) will burst into tears or shriek when their parents leave the room, and if a favorite toy gets hidden, they will search for it.

Understandably, a child does not want to be separated from their parent given that they represent everything secure and solid about the world around them. But when separation is necessary, for example, if a parent needs to go to work and leave the child with a caregiver, or if a toddler or young child has started at a play school, separation anxiety in children can cause stress, particularly for the parent who feels guilt at leaving their crying child.

Be encouraged by the fact that this type of separation anxiety is entirely normal, and the phase, which peaks between 8 and 14 months old, tends to pass gradually, although some kids are still “clingy” and afraid of new people and places well into their pre-school years. To survive the phase, be consistent with drop-off times and pick-up, practice short, loving goodbye rituals, and practice being apart by allowing friends and family to babysit

When is separation anxiety abnormal?

When this type of separation anxiety in children extends past about six years old and is a heavy fear that persists for longer than about a month and interferes with the enjoyment of regular activities, the child may be suffering from what is known as Separation Anxiety Disorder (SAD). A child suffering from SAD becomes unusually afraid and anxious when away from home or separated from a loved one.

The fear of separation becomes so overwhelming that they are unable to attend school or play with other children. Some will develop physical symptoms such as stomach aches or headaches, manifesting their internal stress. It affects between 4-5% of children in the United States who are between 7 and 11 years old, while it is less common in teenagers, affecting 1.3% of American teens. SAD has been evidenced to affect both girls and boys equally.

If you are concerned that your child may have an unnatural fear of separation, you will no doubt have noticed symptoms such as refusing to go to school, along with a constant and unrealistic fear that something bad will happen to their caregiver, or themselves, when they are separated.

A child suffering from SAD may refuse to go to sleep if the person they are attached to is not present and may have nightmares or wet the bed when they are asleep. They may have intense tantrums every time a separation is imminent, as they are so deeply afraid of being alone.

In addition to fear, they may experience feelings of guilt, as they are not in control of their emotional response to separation.

What causes separation anxiety in children?

SAD may be triggered by a stressful event in the life of a child, although genetics can also play a role in the development of the disorder. A stressful event could include the illness or loss of a parent or the break-up of a home due to divorce. Moving to a new city or country or the loss of a beloved pet can also be a cause of separation anxiety in children that goes beyond what would be considered an appropriate amount of stress.

Experiencing some type of disaster that involves separation can also give rise to the disorder. Some temperaments and personalities may be more susceptible to it, as would those with a family history of anxiety. Studies show that anxiety disorder traits can be inherited, so blood relatives who suffer might pass on their affliction in this way.

While those exhibiting risk factors usually develop the disorder in childhood, it can also emerge in adolescence and adulthood and may be associated with panic attacks (an episode in which an individual experiences overwhelming feelings of dread and fear that reach a peak in minutes) as well as other anxiety disorders like Generalized Anxiety Disorder (GAD), social anxiety disorder, obsessive-compulsive disorder, and depression.

How can SAD be diagnosed?

Stanford Children’s Health reports that the first symptoms of SAD arise around third or fourth grade. As above, the child exhibits a crushing fear of being separated from a loved one, which prevents normal childhood activities such as going to friends’ houses or attending school, to the point of not wanting to sleep alone at night and possibly experiencing nightmares.

Their mental stress may be accompanied by physical symptoms which can vary from stomach aches to muscle tension and other health complaints. As SAD may look like an array of other issues, it must be diagnosed by a child psychiatrist or other mental health professional.

As separation anxiety in children may produce bodily ailments, a medical screening will eliminate any physical causes. Early diagnosis is key with any mental health issue, and this is no different with SAD. Be sure to ask the child psychiatrist any questions you have about the diagnosis, as well as any instructions they give about next steps.

What treatment is available for separation anxiety disorder?

The treatment will depend on symptoms and age, but separation anxiety in children is usually treated with a mix of cognitive-behavioral therapy, family therapy, and medicine. In cognitive-behavioral therapy, child therapy techniques will be used to help the child understand what they are grappling with and how they can start to get control of their anxiety.

As parents play a vital role in treatment, they will likely be involved in sessions somehow and will need to walk the journey with them toward managing and eliminating the disorder from their lives. This might include recognizing situations that might put your child under stress, and preparing them appropriately in advance so that they’re better able to handle it.

Your child’s school will also need to be made aware of their diagnosis and treatment plan and may even be actively involved in putting it together. If a child is unable to participate in their therapy sessions (or regular life) due to the disorder, an anti-depressant may be prescribed to help them feel calmer. Be sure to ask questions about why the particular drug has been prescribed, and if there are any known side effects that you need to look out for in your child.

As it can be stressful to parent a child dealing with this issue, caregivers would do well to reach out to other parents who have been through the same thing, so that they can offer each other support and share tips on things they found that helped their child navigate their way through the disorder.

It can be extremely frustrating and heartbreaking to witness separation anxiety in children. While experts don’t know how SAD can be prevented in children and teens, the important thing is to recognize that the child is not acting out on purpose, but that they are going through a real and serious mental health disturbance.

By listening to them and being a non-judgmental sounding board, there is a greater chance that, together with professional input, the symptoms can be lessened. The problem may take a while to work through, but seeking evaluation early on will go a long way toward enhancing your child’s normal development and improving their quality of life.

If you would like to meet with one of the faith-based counselors at our site to determine whether your child needs further evaluation for separation anxiety disorder, please contact our offices today.