Separation Anxiety Disorder
What is separation anxiety disorder?
Separation anxiety disorder (SAD) is defined as excessive worry and fear about being
apart from family members or individuals to whom a child is most attached. Children
with separation anxiety disorder fear being lost from their family or fear something
bad happening to a family member if they are separated from them. Symptoms of anxiety
or fear about being separated from family members must last for a period of at least
4 weeks to be considered SAD. It is different from stranger anxiety, which is normal
and usually experienced by children between 7 and 11 months of age. Symptoms of SAD
are more severe than the normal separation anxiety that nearly every child experiences
to some degree between the ages of 18 months and 3 years of age.
What causes separation anxiety disorder?
Anxiety disorders are believed to have biological, family, and environmental factors
that contribute to the cause. A chemical imbalance involving 2 chemicals in the brain
(norepinephrine and serotonin) most likely contributes to the cause of anxiety disorders.
While a child or adolescent may have inherited a biological tendency to be anxious,
anxiety and fear can also be learned from family members and others who often display
increased anxiety around the child. A traumatic experience may also trigger anxiety.
Who is affected by separation anxiety disorder?
All children and adolescents experience some anxiety. It is a normal part of growing
up. However, when worries and fears are developmentally inappropriate concerning separation
from home or family, separation anxiety disorder may be present. SAD happens equally
in males and females. The first symptoms of SAD usually appear around the third or
fourth grade. Typically, the onset of symptoms happens following a break from school,
such as Christmas holidays or an extended illness. Children of parents with an anxiety
disorder are more likely to have an anxiety disorder.
What are the symptoms of separation anxiety disorder?
The following are the most common signs of SAD. However, each child may experience
symptoms differently. Symptoms may include:
Refusal to sleep alone
Repeated nightmares with a theme of separation
Excessive distress when separation from home or family happens or is anticipated
Excessive worry about the safety of a family member
Excessive worry about getting lost from family
Refusing to go to school
Fearful and reluctant to be alone
Frequent stomachaches, headaches, or other physical complaints
Muscle aches or tension
Excessive worry about safety of self
Excessive worry about or when sleeping away from home
Excessive "clinginess," even when at home
Symptoms of panic and/or temper tantrums at times of separation from parents or caregivers
The symptoms of separation anxiety disorder may resemble other conditions or psychiatric
problems. Always talk with your child's healthcare provider for a diagnosis.
How is separation anxiety disorder diagnosed?
A child psychiatrist or other qualified mental health professional usually diagnoses
anxiety disorders in children or adolescents following a comprehensive psychiatric
evaluation. Parents who note signs of severe anxiety in their child or teen can help
by seeking an evaluation and treatment early. Early treatment can often prevent future
Treatment for separation anxiety disorder
Specific treatment for separation anxiety disorder will be determined by your child's
healthcare provider based on:
How old your child is
His or her overall health and past health
How sick he or she is
How well your child can handle specific medicines, procedure, or therapies
How long the condition is expected to last
Your opinion or preference
Anxiety disorders can be effectively treated. Treatment should always be based on
a comprehensive evaluation of the child and family. Treatment recommendations may
include cognitive behavioral therapy for the child. The focus should be on helping
the child or adolescent learn skills to manage his or her anxiety. The goal is also
to help him or her master the situations that contribute to the anxiety. Some children
may also benefit from treatment with antidepressant or antianxiety medicine to help
them feel calmer. Parents play a vital, supportive role in any treatment process.
Family therapy and consultation with the child's school may also be recommended.
Prevention of separation anxiety disorder
Preventive measures to reduce the incidence of separation anxiety disorders in children
are not known at this time. However, early detection and intervention can reduce the
severity of the disorder, enhance the child's normal growth and development, and improve
the quality of life experienced by children or adolescents with separation anxiety