Diagnosis

Diagnosis of separation anxiety disorder involves determining whether your child is going through a normal stage of development or the issue is actually a disorder. After ruling out any medical conditions, your child's pediatrician may refer you to a child psychologist or child psychiatrist with expertise in anxiety disorders.

To help diagnose separation anxiety disorder, your mental health professional will likely give your child a psychological evaluation, including a structured interview that involves discussing thoughts and feelings, as well as observing behavior. Separation anxiety disorder may occur along with other mental health problems.

Treatment

Separation anxiety disorder is usually treated with psychotherapy, sometimes along with medication. Psychotherapy, sometimes called talk therapy or psychological counseling, involves working with a therapist to reduce separation anxiety symptoms.

Cognitive behavioral therapy (CBT) is an effective form of psychotherapy for separation anxiety disorder. During therapy your child can learn how to face and manage fears about separation and uncertainty. In addition, parents can learn how to effectively provide emotional support and encourage age appropriate independence.

Sometimes, combining medication with CBT may be helpful if symptoms are severe. Antidepressants called selective serotonin reuptake inhibitors (SSRIs) may be an option for older children and adults.

Lifestyle and home remedies

While separation anxiety disorder benefits from professional treatment, you can also take these steps to help ease your child's separation anxiety:

  • Learn about your child's separation anxiety disorder. Talk to your child's mental health professional to learn about the disorder and help your child understand it.
  • Stick to the treatment plan. Make sure to keep the therapy appointments for your child. Consistency makes a big difference.
  • Take action. Learn what triggers your child's anxiety. Practice the strategies developed with the mental health professional so you're ready to deal with your child's anxious feelings during separations.

Coping and support

Coping with a child who has separation anxiety disorder can be frustrating and cause conflict with family members or cause a great deal of worry and anxiety for parents.

Ask your child's therapist for advice on coping and support. For example, the therapist may advise you to:

  • Demonstrate calm support. Encourage your child or loved one to try new experiences, experience separation and develop independence with your support.
  • Practice goodbyes. Leave your child with a trusted caregiver for short periods of time to help your child learn that he or she can count on you to return.

It's also important to develop and maintain supportive relationships for yourself, so you can better help your child.

Preparing for your appointment

You may start by seeing your child's pediatrician. He or she may refer you to a mental health professional with expertise in anxiety disorders.

What you can do

Before your appointment, make a list of:

  • Your child's symptoms of anxiety. Note when they occur, whether anything seems to make them better or worse, and how much they affect day-to-day activities and interactions.
  • What causes your child to be stressed. Include any major life changes or stressful events your child dealt with recently, as well as any past traumatic experiences.
  • Any family history of mental health problems. Note if you, your spouse, your parents, grandparents, siblings or other children have struggled with any mental health problems.
  • Any other health problems your child has. Include both physical conditions and mental health issues.
  • All medications that your child takes. Include any medications, vitamins, herbs or other supplements, and the dosages.
  • Questions to ask to make the most of your appointment.

Questions to ask may include:

  • Are there other possible situations, psychological issues or physical health problems that could be causing or worsening the anxiety?
  • Does my child need any tests?
  • What type of therapy might help?
  • Would medication help? If so, is there a generic alternative?
  • In addition to treatment, are there any steps I can take at home that might help my child?
  • Do you have any educational materials that I can have? What websites do you recommend?

Don't hesitate to ask other questions during the appointment.

What to expect from your doctor

The mental health professional is likely to ask you a number of questions. For example:

  • What are your child's symptoms, and how severe are they? How do they impact your child's ability to function?
  • When did you first begin noticing your child's separation anxiety?
  • What, if anything, seems to reduce your child's anxiety?
  • Has your child had any traumatic experiences recently or in the past?
  • What, if any, physical or mental health conditions does your child have?
  • Does your child take any medications?
  • Do you or any of your blood relatives have persistent anxiety or other mental health conditions, such as depression?

Preparing and anticipating questions will help you make the most of your time with the mental health professional.

April 05, 2021
  1. Separation anxiety disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed Feb. 28, 2018.
  2. Separation anxiety disorder. Merck Manual Professional Version. http://www.merckmanuals.com/professional/pediatrics/mental-disorders-in-children-and-adolescents/separation-anxiety-disorder. Accessed Feb. 28, 2018.
  3. Separation anxiety disorder. American Academy of Child and Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-Who-Won%27t-Go-To-School-%28Separation-Anxiety%29-007.aspx. Accessed Feb. 28, 2018.
  4. Milrod B, et al. Childhood separation anxiety and the pathogenesis and treatment of adult anxiety. American Journal of Psychiatry. 2014;171:34.
  5. 5Bennett S, et al, Anxiety disorders in children and adolescents: Epidemiology, pathogenesis, clinical manifestations, and course. https://www.uptodate.com/contents/search. Accessed Feb. 28, 2018.
  6. Bennett S, et al. Anxiety disorders in children and adolescents: Assessment and diagnosis. https://www.uptodate.com/contents/search. Accessed Feb. 28, 2018.
  7. Alvarez E, et al. Psychotherapy for anxiety disorders in children and adolescents. https://www.uptodate.com/contents/search. Accessed Feb. 28, 2018.
  8. Glazier Leonte K, et al. Pharmacotherapy for anxiety disorders in children and adolescents. https://www.uptodate.com/contents/search. Accessed Feb. 28, 2018.
  9. Vaughan J, et al. Separation anxiety disorder in school-age children: What health care providers should know. Journal of Pediatric Health Care. 2017;31:433.
  10. Rochester J, et al. Adult separation anxiety disorder: Accepted but little understood. Human Psychopharmacology: Clinical and Experimental. 2015;30:1.
  11. Whiteside SP (expert opinion). Mayo Clinic, Rochester, Minn. April 13, 2018.

Separation anxiety disorder