About Separation Anxiety Disorder
Separation anxiety disorder is an anxiety disorder that typically occurs in childhood or adolescence, as defined by the American Psychological Association (APA). It is different from the normal separation anxiety experienced by babies and toddlers. This disorder involves excessive and persistent fear of separation from one's home or family, along with ongoing worries about potential negative events that could occur during separation.
Individuals with separation anxiety disorder may refuse to go to school, have difficulty sleeping outside the home or when their main attachment figures are absent, experience nightmares, and may even have physical symptoms like headaches, nausea, or vomiting. While it is most commonly seen in children and adolescents, adults can also experience separation anxiety disorder.
The exact pathophysiologic causes of separation anxiety disorder are still unknown, and further research is needed in this area. However, there are several risk factors associated with the development of separation anxiety disorder:
- Genetic factors: Research suggests that there may be genetic components involved in the development of separation anxiety disorder. People with a family history of anxiety or depression may be at a greater risk.
- Co-existing mental health conditions: Adults with conditions such as obsessive-compulsive disorder (OCD), social phobias, panic disorders, agoraphobia (intense fear of being in places or situations where you feel trapped, embarrassed, or helpless), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), social anxiety disorder, or personality disorders may be at an increased risk of developing separation anxiety disorder.
- Environmental factors: Low levels of parental warmth, being overprotective or too involved, and interfering with a child’s emotions and behaviors can increase the risk of separation anxiety disorder in children.
- Traumatic or stressful life events: The loss or death of a major attachment figure (such as a trusted adult or close caregiver), domestic violence, parental divorce, and frequent moves that disrupt friendships can also increase the risk of separation anxiety disorder in children.
- Childhood adversity: Experiencing childhood traumatic events such as abuse and significant life changes like moving away from family or support structures can also contribute to the development of separation anxiety disorder in adults.
It's important to note that these risk factors do not guarantee the development of separation anxiety disorder but may contribute to an increased likelihood. If you have concerns about separation anxiety disorder, it's best to consult with a healthcare professional for an accurate diagnosis and appropriate management strategies.
The most common early symptoms of separation anxiety disorder in children include:
- Clinging to parents or caregivers
- Extreme and severe crying
- Refusal to do things that require separation
- Physical illness, such as headaches or vomiting
- Violent, emotional temper tantrums
- Refusal to go to school
- Poor school performance
- Failure to interact in a healthy manner with other children
- Refusing to sleep alone
- Nightmares
As the disorder progresses or becomes more severe, additional symptoms may occur, such as:
- Social withdrawal
- Extreme sadness or difficulty concentrating when away from loved ones (in adults)
- Overbearing parenting (in parents)
- Unfounded fears of abduction or injury to loved ones or oneself
- Hesitancy or refusal to leave the proximity of loved ones
- Difficulty sleeping away from a loved one
- Depression or anxiety attacks related to separation anxiety
It's important to note that these symptoms must impair functioning and continue for at least six months for a diagnosis of separation anxiety disorder. If you or someone you know is experiencing these symptoms, it's essential to seek professional help for an accurate diagnosis and appropriate treatment.
If you or someone you know are struggling or in crisis with anxiety, depression or suicidal thoughts, help is available. Call or text 988 or chat 988lifeline.org/chat to connect with trained crisis counselors.
To diagnose separation anxiety disorder in adults, a doctor will typically:
- Conduct a thorough interview: The doctor will ask about the symptoms you are experiencing and how they impact your daily life.
- Use diagnostic criteria: The doctor will refer to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a manual used by mental health professionals, to make a diagnosis.
- Assess impairment: To meet the diagnosis criteria, you must exhibit three or more symptoms that significantly impair your day-to-day functioning for at least 4 weeks.
For children, additional examinations and tests may be used to diagnose and determine the severity of separation anxiety disorder:
- Separation Anxiety Test (F-SAT): This semi-projective task evaluates a child's attachment to their caregiver. It involves presenting the child with pictures showing separation from a familiar caregiver and asking them to describe their feelings and predict their coping strategies.
- Observation of parent-child interaction: A doctor may watch how you interact with your child to assess whether your parenting style affects how your child deals with anxiety.
These examinations, tests, and procedures are commonly used to diagnose and evaluate the stage or severity of separation anxiety disorder. It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan.
The goals of treatment for separation anxiety disorder are to reduce symptoms, improve functioning, and enhance overall well-being. Here are the recommended treatments and how they work to achieve these goals:
- Cognitive Behavioral Therapy (CBT): This therapy helps individuals identify and challenge negative thought patterns and behaviors that contribute to their anxiety. It aims to teach coping strategies and provide tools to manage separation anxiety symptoms. CBT can be effective in reducing anxiety and improving functioning.
- Parent-Child Interaction Therapy (PCIT): This therapy focuses on improving the parent-child relationship and teaching parents healthier ways to interact with their children. By strengthening the bond between parent and child, PCIT can help reduce separation anxiety symptoms.
- Medications: In some cases, doctors may prescribe anti-anxiety medications, such as selective serotonin reuptake inhibitors (SSRIs), to help manage acute symptoms of separation anxiety. These medications can help relieve anxiety symptoms, but they are typically not long-term solutions.
- Support Groups: Joining a support group for individuals with anxiety and separation anxiety can provide valuable support, techniques, and strategies for managing separation-related anxiety.
It's important to note that each individual may respond differently to treatment, so it may be necessary to try different approaches or combinations of treatments to find what works best. Consult with a healthcare professional for personalized recommendations.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.