Written by Dr. Inez Van Roy on
December 14, 2021
Reading Time: 7 minutes

Medically Reviewed by our Medical Affairs Team

Written by Dr. Inez Van Roy on:

No one likes to be apart from their loved ones. But when you are, it might not feel comfortable.

A healthy adult or child will adapt to the situation and get curious about the world around them. For those with separation anxiety disorder a moment away from their loved ones feels like a living hell.

Keep reading this article to learn more about this mental condition.

What is separation anxiety disorder?

Separation anxiety disorder is a mental illness. It is classified under anxiety disorders.

Years ago, researchers believed that this mental disorder only existed in young children or at infancy. It seems that adults can actually also suffer from this problem.

Separation anxiety disorder is inappropriate and excessive anxiety or fear about separation. Children usually refuse to leave their parents or have an excessive reaction to it.

Adults usually project the anxiety on their own children or on their partners. They worry excessively when their child spends the day alone or when their partner goes to work.

Separation Anxiety Disorder Symptoms

You might ask yourself “how do I know if I have separation anxiety?”. That is a great question. There are seven common symptoms of separation anxiety.

Adults should suffer for more than six months from these symptoms. Children can be diagnosed after a four-week observation period, taking their developmental stage into account.

You or your child should show at least three of the following symptoms in a recurrent, excessive and persistent way.

  1. The feeling of deep distress separated or possibly separated from their loved one or from their home.
  2. You or your child might be extremely worried that their attachment figure will be hurt or would die. In your or their head, the loved one might fall ill or get deeply injured. Maybe a disaster would strike when stepping in the car that could lead to death for example.
  3. You or the child might worry about experiencing an unfortunate event as well. You could get lost, kidnapped, or fall ill. You might also get in an accident when leaving the house. These events could lead to you losing your family or child.
  4. The person with anxiety might refuse (or be reluctant) to go out of the home. As a result, they might not (want to) go to school, work, or anywhere really.
  5. The child refuses or is very reluctant to undertake activities alone at home or in other settings. The parent or spouse with separation anxiety might be afraid or reluctant to be alone at home or in another setting.
  6. Your child refuses or is highly reluctant to sleep in their own bed alone. Or they might refuse sleepovers with friends or family. An anxious spouse or parent will show a similar pattern of reluctance or refusal towards the attachment figure.
  7. The person with separation anxiety suffers from repeated nightmares in which they are separated from their loved one.

Do these symptoms describe your daily struggle? If so, let’s take a look at some of the causes and how to deal with it.

Separation Anxiety Disorder Causes 

Separation anxiety disorder might have a genetic and environmental link.

Girls are more sensitive to genetic influence. Boys are more at risk due to an anxious or overprotective environment.

Risk Factors for Anxiety Disorders

Genetics (inheritance), environment and this interaction can cause anxiety disorders. Other risk factors that might increase an anxiety disorder are the following.

  • Temperament and personality. Those who favor neuroticism, trait anxiety, behavioral inhibition, and negative affectivity seem sensitive to depression and anxiety.
  • Parenting style and parental modeling might have an influence on anxiety disorders. Parental overprotection and parental rejection showed increased rates in the risk for phobias or depression.
  • Childhood Adversities. Loss of parents, divorce, physical and sexual abuse all are associated with the onset of mental illnesses in adults in the US.
  • Life Events. Life events that are threatening or feel like a loss are bad for our mental health. Losing a parent at a young age, being separated from them, or feeling deep humiliation in an event could negatively influence our mental health.

In short, it can be a mix of many facets.

These risk factors can also play together.

Imagine you and your child went through a traumatic event. You are on vacation taking the bus. You push in your child’s stroller and get locked outside the bus.

The bus leaves with your child in it and you can’t do anything about it. Your child might not remember for the rest of their lives if they are lucky.

You, in contrast, will mostly go through a living hell and panic trying to get your child back. We could all agree that this situation might lead to parental overprotection and anxiety on your part.

Those are all situations a child can observe. They might learn that the world is not safe. Some children will be more sensitive to anxiety messages than others, depending on their genetic material.

Separation Anxiety Disorder Complications 

Untreated separation anxiety disorder can lead to complications later in life. Not only is separation anxiety highly comorbid with other mental disorders!

In an Iranian study, the comorbidity was 65.3% with other psychiatric disorders. Oppositional defiant disorder, known for extreme disobedience, had the highest correlation later in life. It is clear that early detection and prevention is preferred.

The child’s symptoms can also negatively affect their schooling, career, or social development. They might refuse to leave the house, go into extreme distress when going to school, and more.

Separation Anxiety Disorder Prevention

Separation anxiety disorder seems to be an interaction between environment and genetics. As a parent, you can’t change your genes. You can however ask for help as soon as possible.

If you struggle with an anxiety disorder or other mental health issues, you should ask for help. You can help yourself and model your children how you manage the stress and anxiety in daily life. This could have a positive effect on your family life.

We recommend getting your child help to deal with the separation anxiety disorder. Go to the doctor when you suspect this diagnosis.

In the meanwhile, you can already be attentive to the situation which provokes this intense fear. Is it when dropping them off at school, the grandparents, or in other situations.

Does a shopping trip already result in extreme symptoms? Try to write down these triggers, and prepare the child for the separation where possible.

An easy example can be practicing goodbyes every day at school drop-off. Make a visual time frame of when mommy is coming back.

First, they will play some games with the teacher and the other kids. They will have lunch at school. After the nap mommy will be waiting at the door.

Separation Anxiety Disorder Diagnosis

A doctor, psychiatrist or psychologist can diagnose you depending on your region. They will most likely compare the symptoms with the developmental stage first.

They will first exclude physical illness or other mental disorders. A diagnosis includes observation, a structured interview, and psychological testing.

The licensed provider most likely will use the above criteria, stated in the Diagnostic and Statistical Manual (DSM). This manual, made by the American Psychiatric Association, includes all other mental disorders.

Separation Anxiety Disorder in Children

Children should feel anxious. It is a normal part of their development. At one point in time they will be afraid of the dark, of thunder, of dogs, and also of separation.

Usually, separation anxiety ceases after 12 to 18 months old. They have enough trust that their attachment figure is coming back.

A child at that age wants to explore their cognitive abilities and their autonomy while their parent is not holding their hand.

After that age, we could keep a closer eye on what is happening with the anxiety.

Separation Anxiety Disorder in Teenage Years

While some children with separation anxiety disorder grow out to be functioning teens. Others have it more difficult. Your teenager might not want to go to school. This sounds like typical adolescent behavior, still, it is useful to dig deeper.

Separation anxiety disorder could be the cause for teenagers to behave this way. The previous childhood separation anxiety disorder can also grow into agoraphobia or social anxiety. They might find it difficult to meet people or feel extremely overwhelmed to go to new places.

Other signs of anxiety can also be physical symptoms. They might complain about stomach pain, muscle aches and look restless. These might be signs of a teenager with anxiety.

The best course of action would be to get your teen the help they need. They can learn how to work through a panic attack and how to defuse their anxiety-ridden thoughts.

If your teenager shows self-harm behavior or needs crisis (texting) support, they can text HOME to the number 741741. If you, your teen, or your child shows suicidal ideations, you can call Lifeline at 1-800-273-8255.

Adult Separation Anxiety Disorder

Adult separation anxiety disorder is usually projected on another public. They mostly fear losing their own children, their spouses, or romantic partners.

The lifetime prevalence of separation anxiety disorder is about 6.6%. Usually, these adults already show symptoms in childhood.

The symptoms are the same for adults as for children. In contrast to children, adults should suffer for a longer time to be diagnosed (6 months).

It is common that an adult to show panic attacks when thinking of or confronted with the separation of an important family member. That might look like heart palpitations, sweating, muscle tension, and uncontrollable breathing.

Usually adults report that their childhood adversity and/or lifetime trauma might be an underlying precedent. We see this pattern with children and adolescents too.

There might also be a correlation between this disorder and an anxious attachment style. Adults with the disorder seem to score high on the scales “Need for Approval” and “Preoccupation with Relationships”.

Evidence-Based Treatment for Separation Anxiety Disorder

Cognitive-behavioral therapy (CBT) can provide your child with tools to support them in this way. They can also teach your child how to manage their big emotions. There are moderately strong effects that last up to two years.

Youth with a separation anxiety disorder could profit from exposure therapy. This is not easy. Still, they (and you) should stick to the plan. The teenagers get exposed to what they fear while also getting support on how to handle such a scary situation.

Medication can be used for separation anxiety as well. While this could help children with separation anxiety disorder, it is not approved yet. As the brain of a child is still growing, there is more caution to prescribe these for children and adolescents.

Older children and adults might profit from taking complementary medication. Selective serotonin reuptake inhibitors (SSRIs) seem to show the best effect for people suffering from a separation anxiety disorder.

Another study seems to confirm this medication as a candidate against generalized anxiety disorder, social phobias and more for youth.

When to Seek Professional Help

You should seek professional help when you notice that these symptoms are not going away. For younger children that would mean excessive fear outside the appropriate age category.

For adults, we would recommend going to see your doctor when it is impeding your goals and quality of life.

Separation anxiety disorder can lead to physical symptoms as well. You or your child might get panic attacks or it might lead to a panic disorder or other mental disorders.

Concluding Thoughts

The information shared in this blog post is just a glimpse into the world of separation anxiety disorder. Separation anxiety disorder is a mental illness common in children, teenagers, and adults. The cause is not known. Researchers believe it might be a combination of genetics and the environment (e.g., life events).

If you feel like you or your loved one suffers from this disorder, please do not hesitate to reach out for professional help. It could lead to other anxiety disorders when growing older.

We hope that it has helped answer any questions about separation anxiety or how it can be treated. If there are still things you want to know, please visit our corresponding page for more information. You may also join our community here if you have been diagnosed with a mental disorder yourself.

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