Separation Anxiety Disorder in Children

Children are a blessing from God, and most parents will do whatever it takes to protect them and help them to flourish and have a happy life. Children sometimes feel anxious when they say goodbye to their parents or caregivers to attend school or go for a playdate.

Even when they are a bit older, it’s normal for them to have a little bit of worry over being separated from mom and dad. Your child having a tantrum, crying or getting a bit clingy at the prospect of being separated from you is a normal and healthy reaction.

You may, however, begin to get concerned that there is a problem, particularly if the tantrums and clinginess are intense and carry on after your child is a certain age. It is helpful in such cases for parents to understand not only separation anxiety, which is a normal stage of development for your child, but to also know about separation anxiety disorder.

Separation Anxiety vs. Separation Anxiety Disorder

There is a difference between the typical separation anxiety that is part of the development process for a child and separation anxiety disorder. Separation anxiety is a normal stage of development for infants and toddlers.

At this stage of their lives, children do not yet understand that when a parent or caregiver goes away, they are still nearby and will be coming back. Although young children often experience a period of separation anxiety, most children will have outgrown this normal separation anxiety by the time they are around the age of three.

When this fear of separation occurs in a child over six years of age, is excessive, and lasts longer than four weeks, the child may have Separation Anxiety Disorder. In other words, if your child’s separation anxiety seems to be intense or extended over a long period, especially if it begins interfering with school or other daily activities like playing with friends, he or she may have Separation Anxiety Disorder.

This condition affects between 4-5% of children (boys and girls equally) in the United States aged 7-11. It is a condition wherein a child becomes fearful and nervous when away from home or separated from a loved one to whom the child is attached (usually their caregiver or parent).

Causes of Separation Anxiety Disorder

Some children whose parents are over-protective may be more susceptible to separation anxiety disorder. The child’s separation anxiety may be triggered and result from their parent’s separation anxiety.

In such cases, the parent and child’s anxiety can feed off and amplify each other. Children with separation anxiety disorder often have family members with anxiety or other mental disorders; this may suggest a genetic link that brings a vulnerability to the condition.

Sometimes, Separation Anxiety Disorder can develop after a significant stressful or traumatic life event for the child which results in separation from a loved one, such as an overnight stay in the hospital, divorce of parents, a change in environment (such as changing schools or moving to another house) or the death of a loved one or the family pet. Additionally, experiencing an event such as some type of disaster that involves separation from loved ones may trigger the onset of separation anxiety disorder.

Symptoms of Separation Anxiety Disorder

When should you go to a mental health professional to seek help for your child?

There are a few symptoms you can look out for, behavior that goes beyond typical separation anxiety. If the separation anxiety disorder seems to have occurred suddenly or overnight, the cause may be linked to a traumatic experience instead of separation anxiety.

Remember that similar symptoms for separation anxiety disorder would also be present if your child suffered trauma, so you must remain aware of that possibility. As trauma and separation anxiety disorder are treated differently, getting the correct diagnosis is very important.

The red flags to look out for if you suspect your child has separation anxiety disorder include:

• Excessive and prolonged fear of leaving the house
• Refusing to fall asleep away from home or without their parent being nearby

• Refusal to go to school for extended periods of time
• Withdrawing from family and friends
• Physical symptoms such as headaches, stomachaches or diarrhea when separation from a loved one has occurred or is anticipated
• Worrying and fearing that something bad will happen if they get separated from their parent or caregiver
• Bedwetting
• Repeated nightmares with the theme of separation
• Tantrums and clinginess that is age-inappropriate

Diagnosing Separation Anxiety Disorder

Separation anxiety disorder is diagnosed when symptoms of separation anxiety are prolonged and are excessive for the developmental age, causing significant distress in daily functioning such as going to school or playing with friends.

Your doctor or mental health professional will perform an evaluation based on your child’s complete medical history as well as a physical exam. Mental health professionals such as psychologists or psychiatrists will use interview and assessment tools specially designed to evaluate whether a child has a mental health problem.

Treatment Options

While there is no sure or known way to prevent the onset of separation anxiety disorder, acting quickly in the early stages when symptoms begin to appear can limit or minimize distress for your child as well as reduce the impact on their day to day functioning by the condition.

Separation anxiety disorder usually doesn’t go away without treatment. Left untreated, it can develop into Panic Disorder and other generalized anxiety disorders in adulthood.

There are several goals for the treatment, including:

• Reducing anxiety in the child
• Educating the child and caregivers/family of the necessity of natural separation
• Assisting the child in developing a sense of security
• Helping the child develop coping and problem-solving strategies

There are several treatment options available, including:

• Cognitive Behavioral Therapy (CBT) helps a child to reshape their thinking to develop helpful and appropriate ways to think of themselves and their situation
• Talk therapy is one of the main treatment approaches for separation anxiety disorder. It provides a safe space for your child to express their feelings and be listened to with empathy.
• Play therapy is the therapeutic use of play to get kids to talk about their feelings and experiences.
• Family therapy may also help educate the family about the disorder so that they can be better informed about how to support the child during periods of anxiety.
• Medication. In most mild cases of separation anxiety disorder, there is no need to use medicine. That being said, medication such as antidepressants or other anti-anxiety medications may be used to treat severe cases of separation anxiety disorder. However, medication should only be used in conjunction with other forms of therapy.

Getting the Help You Need

Our children are a precious gift given to us by God. No parent or caregiver wants to see their child in distress. We want to do what we can to protect them and see them flourish, so it can seem like a good option to try and help your child by steering clear of the situations or things they’re afraid of.

In the long-term, however, that may only serve to reinforce your child’s anxiety. God, who is the giver of all good gifts, has said that the Spirit He gave us is not one of fear, but of power, of love and of self-discipline (2 Timothy 1:7).

Instead of trying to avoid separation wherever possible from fear that it will trigger tantrums or other negative reactions, cultivating a sympathetic home environment can make your child feel more loved and understood. Though your efforts may not completely resolve the situation, it’s worth remembering that being empathetic may serve to ease your child’s and family’s distress.

If you suspect that your child may be suffering from Separation Anxiety Disorder, do not hesitate to take them to a mental health professional who can evaluate them and help you in charting a course of treatment for them.