Overview

Separation anxiety is a normal stage of development for infants and toddlers. Young children often experience a period of separation anxiety, but most children outgrow separation anxiety by about 3 years of age.

In some children, separation anxiety is a sign of a more serious condition known as separation anxiety disorder, starting as early as preschool age.

If your child's separation anxiety seems intense or prolonged — especially if it interferes with school or other daily activities or includes panic attacks or other problems — he or she may have separation anxiety disorder. Most frequently this relates to the child's anxiety about his or her parents, but it could relate to another close caregiver.

Less often, separation anxiety disorder can also occur in teenagers and adults, causing significant problems leaving home or going to work. But treatment can help.

Symptoms

Separation anxiety disorder is diagnosed when symptoms are excessive for the developmental age and cause significant distress in daily functioning. Symptoms may include:

  • Recurrent and excessive distress about anticipating or being away from home or loved ones
  • Constant, excessive worry about losing a parent or other loved one to an illness or a disaster
  • Constant worry that something bad will happen, such as being lost or kidnapped, causing separation from parents or other loved ones
  • Refusing to be away from home because of fear of separation
  • Not wanting to be home alone and without a parent or other loved one in the house
  • Reluctance or refusing to sleep away from home without a parent or other loved one nearby
  • Repeated nightmares about separation
  • Frequent complaints of headaches, stomachaches or other symptoms when separation from a parent or other loved one is anticipated

Separation anxiety disorder may be associated with panic disorder and panic attacks ― repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes.

When to see a doctor

Separation anxiety disorder usually won't go away without treatment and can lead to panic disorder and other anxiety disorders into adulthood.

If you have concerns about your child's separation anxiety, talk to your child's pediatrician or other health care provider.

Causes

Sometimes, separation anxiety disorder can be triggered by life stress that results in separation from a loved one. Genetics may also play a role in developing the disorder.

Risk factors

Separation anxiety disorder most often begins in childhood, but may continue into the teenage years and sometimes into adulthood.

Risk factors may include:

  • Life stresses or loss that result in separation, such as the illness or death of a loved one, loss of a beloved pet, divorce of parents, or moving or going away to school
  • Certain temperaments, which are more prone to anxiety disorders than others are
  • Family history, including blood relatives who have problems with anxiety or an anxiety disorder, indicating that those traits could be inherited
  • Environmental issues, such as experiencing some type of disaster that involves separation

Complications

Separation anxiety disorder causes major distress and problems functioning in social situations or at work or school.

Disorders that can accompany separation anxiety disorder include:

  • Other anxiety disorders, such as generalized anxiety disorder, panic attacks, phobias, social anxiety disorder or agoraphobia
  • Obsessive-compulsive disorder
  • Depression

Prevention

There's no sure way to prevent separation anxiety disorder in your child, but these recommendations may help.

  • Seek professional advice as soon as possible if you're concerned that your child's anxiety is much worse than a normal developmental stage. Early diagnosis and treatment can help reduce symptoms and prevent the disorder from getting worse.
  • Stick with the treatment plan to help prevent relapses or worsening of symptoms.
  • Seek professional treatment if you have anxiety, depression or other mental health concerns, so that you can model healthy coping skills for your child.
May 08, 2018
References
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  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.
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  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.
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Separation anxiety disorder