Separation Anxiety Disorder

Posted by Frank Gillespie MA

What is separation anxiety disorder?

Separation anxiety disorder (SAD) is a psychological condition in which an individual experiences excessive anxiety regarding separation from home or from people to whom the individual has a strong emotional attachment (e.g. a parent, caregiver, or siblings).

It is most common in infants and small children, typically between the ages of 6–7 months to 3 years, but can affect adult as well if untreated. Separation anxiety itself is a natural part of the developmental process which indicates healthy advancements in a child’s cognitive maturation and should not be considered a developing behavioral problem.

SAD on the other hand is an inappropriate and excessive display of fear and distress when faced with situations of separation. The anxiety that is expressed is categorized as being atypical of the expected developmental level and age.

What are the separation anxiety disorder symptoms?

If separation anxiety is so excessive that it interferes with normal activities like school and friendships, and lasts for months rather than days, it may be a sign of a larger problem: separation anxiety disorder. Telltale signs are if the fear, anxiety, or avoidance is persistent, recurrent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults. SAD may be evidenced by three (or more) of the following symptoms.

Specific symptoms of separation anxiety disorder are:

  • recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated
  • persistent and excessive worry about losing, or about possible harm befalling, major attachment figures
  • persistent and excessive worry that an untoward event will lead to separation from a major attachment figure (e.g., getting lost or being kidnapped)
  • persistent reluctance or refusal to go to school or elsewhere because of fear of separation
  • persistently and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings
  • persistent reluctance or refusal to go to sleep without being near a near a major attachment figure or to sleep away from home
  • repeated nightmares involving the theme of separation
  • repeated complaints of physical symptoms (such as headaches, stomachaches, nausea, or vomiting) when separation from major attachment figures occurs or is anticipated

What are the causes of separation anxiety disorder?

Children with separation anxiety disorder tend to come from families that are close-knit. When separated from home or major attachment figures, they may recurrently exhibit social withdrawal, apathy, sadness, or difficulties of concentration.

Separation anxiety disorder in children occurs when a child feels unsafe in some way. This can be anything that may throw your child’s world off balance, upset your child’s normal routine, or make him or her feel threatened. Take a look and try to pinpoint the causes. This way you’ll be one step closer to helping your child through his or her struggles.

The following are common causes of separation anxiety disorder in children:

      • Change in environment: changes in surroundings —like a new house, school, or day care situation— could trigger and make your child prone to separation anxiety disorder.
      • Stress: stressful situations like switching schools, traumas (such as the loss of a loved one, including a pet) can trigger separation anxiety disorder.
      • Over-protective parent. In some cases, separation anxiety disorder may be the manifestation of the parent’s own anxiety—parents and children can feed one another’s anxieties.

How to deal with separation anxiety in children?

Here are some useful advices for dealing with separation anxiety in children. The following tips can help you create a stable and supportive environment for your child.

        • Talk and listen. Talking about the issue with your child can be very helpful. Explain them calmly where you have to go, why you need to separate and when will you return. Explain them gently that he or she survived the last separation. Also listen to and respect your child’s feelings. The experience of being listened to can have a powerful healing effect.
        • Provide a consistent pattern for the day. Don’t underestimate the importance of predictability for children with separation anxiety problems. If your family’s schedule is going to change, discuss it ahead of time with your child.
        • Schedule separation after napping or feeding: Hunger and tiredness both intensify anxiety.
        • Keep calm during separation. If your child sees that you can stay cool, he or she is more likely to be calm, too.
        • Set limits and offer choices: Let your child know that although you understand his or her feelings, there are rules in your household that need to be followed. Also if your child is given a choice or some element of control in an activity or interaction with an adult, he or she may feel more safe and comfortable.
        • Support the child's participation in activities. Encourage your child to participate in healthy social and physical activities.
        • Praise your child’s efforts. Use the smallest of accomplishments—going to bed without a fuss, a good report from school—as reason to give your child positive reinforcement.
        • Prepare for separation difficulties. Anticipate and be ready for transition points that can cause anxiety for your child, such as going to school or meeting with friends to play. If your child separates from one parent more easily than the other, have that parent handle the drop off.

What about separation anxiety in adults?

Adult separation anxiety (ASA) can be a serious problem, although many adults who are prone to it may not even know about it. Separation anxiety may have developed during childhood, or it may have become a problem due to the experiences you've had as an adult. Many of those with anxiety, and those that have suffered through abuse or neglect find some or all of the symptoms of ASA.

What are the separation anxiety symptoms in adults?

The symptoms in children listed above are also commonly seen in adults with separation anxiety however, there has yet to be a clear diagnostic tool set forth to better understand separation anxiety in adults. Many times adults may label these feelings as mere generalized anxiety rather than being able to pinpoint them as being related to separation anxiety. Some of the symptoms common in adults with separation anxiety include:

        • Extreme fear or anxiety when asked to do things alone or be separated from their attachment figure
        • Avoidance of being alone in any circumstance
        • Fear that the one they are most attached to will leave them or be harmed in some way

Adult separation anxiety can manifest in lighter forms too. Here are some examples of behaviors that could potentially relate to ASA:

        • Extreme Jealousy: Some forms of deep jealousy may be due to separation anxiety although jealousy may be rooted in completely different things too. We can talk about ASA if an individual becomes far less trusting because they're subconsciously worried that someone will leave them. This is especially true if the jealousy is accompanied by anxious thoughts, such as a fear of being alone or irrational concerns about infidelity.
        • Over Strict Parenting: this is sometimes referred to as reverse-separation anxiety. As mentioned above parents and children can feed one another’s anxieties. The parents may be so concerned that their child will leave them someday that they try to control the child's life by all possible means.
        • Stuck in Relationships: another way that separation anxiety may manifest itself is in the way that people treat relationships (not only romantic relationships, but also friendships and familial relationships). Some individuals with adult separation anxiety of some form tend to stuck in relationships that are `bad` for their physical or mental health, yet they are afraid to leave the relationship.
        • Unable to leave `Hotel Mama`: Finally, those that never seem to be able to leave their parent`s home or their friends' house and appear upset over the lack of connection may be experience separation anxiety in some way.

How to treat separation anxiety disorder?

If anxieties intensify or are persistent enough to get in the way of school or other activities, your child may need professional treatment—but there is also a lot that you as a parent can do to help (see above).

Child psychiatrists, child psychologists can diagnose and treat separation anxiety disorder. Keep in mind that children with separation anxiety disorder frequently have physical complaints that may need to be medically evaluated. Specialists can address physical symptoms, identify anxious thoughts, help your child develop coping strategies, and foster problem solving. Professional treatment for separation anxiety disorder may include talk therapy, play therapy, family counseling, school-based counseling and medication in some cases.

Counselling for adult separation anxiety disorder

Non-pharmacological treatments are the first choice when treating individuals diagnosed with separation anxiety disorder. Counseling tends to be the best replacement for drug treatments. The same treatments that help children with separation anxiety may help adults as well. ASA can benefit from cognitive behavioral therapy, as well as systematic desensitization (learning to be alone in a way that is calming and better for mental health). CBT can be an effective treatment helping patients in understanding and being able to recognize their reactions, and help to manage and eventually reduce their overall response to anxiety-inducing situations. CBT therapy has the following components:

        • 1. Recognizing anxious feelings and behaviors
        • 2. Discussing situations that provoke anxious behaviors
        • 3. Developing a coping plan with appropriate reactions to situations
        • 4. Evaluating effectiveness of the coping plan

Any form of treatment you choose you should also make sure that you're treating any other anxiety and stress issues as well, since these tend to exacerbate ASA symptoms.

Frank Gillespie MA

Frank Gillespie has a Master's Degree in Counseling from LaSalle University in Philadelphia. He is a nationally Certified Counselor (NCC). He has provided therapy for over 23 years. During his career, he has helped more than 10,000 people move past their obstacles towards reaching their potential and fulfillment in their lives. He practices Cognitive Behavioral Therapy with a warm and nurturing approach. In addition to being a therapist, Frank has been an adjunct college professor teaching social work, a clinical consultant, a clinical director, and a seminar speaker. Frank has recently retired from his full time practice to focus on a part time online practice. He is married. He enjoys listening to music, watching sports, power walking, swimming, reading and writing.


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