Separation Anxiety Disorder in Children – What is this about?

Separation anxiety is a mental health condition that makes your child afraid or worried whenever he or she is away from family members. Children or toddlers who have separation anxiety may refuse to go to school, have nightmares about being separated, or have physical symptoms such as stomachaches or headaches.

Even when children with this condition are in a safe and loving place, they may still feel sad or scared.

Some separation anxiety is a normal part of a child’s development, but it can become a concern if your child is overly or unusually anxious about being apart from family. You may notice that other children have outgrown this phase, but your child has not.

What are the causes?

The exact cause of this condition is not known.

What increases the risk?

This condition is more likely to occur in children who:

• Also have ADHD (attention deficit hyperactivity disorder).
• Are girls.
• Have a parent with alcohol use disorder.
• Have a parent with an anxiety disorder.
• Experience life circumstances, such as:
  • Divorce.
  • Having a parent in the military.
  • Foster care.
  • Adoption.
  • Death of a parent.
  • Relocation.

What are the signs or symptoms?

Separation anxiety may start during preschool years, and it is most common in children who are 7–8 years old. Symptoms of this condition include:

• Changes in your child’s sleeping and eating habits. Your child may also not want to do any activity that he or she would normally enjoy.
• Throwing tantrums when you or another family member is not there.
• Nightmares about being separated.
• Worrying about left alone.
• Worrying about the caregiver.
• Bedwetting.
• Physical symptoms of anxiety, including:
  • Sweating.
  • Feeling dizzy or shaky.
  • Trouble breathing.
  • Stomachache.
  • Headache.
  • Nausea or vomiting.

How is this diagnosed?

This condition may be diagnosed based on:

• Your child’s symptoms.
• Your child’s medical history, including your child’s mental health history.
• A physical exam.

Your child may be diagnosed if the symptoms last longer than 4 weeks and are not explained by another condition. Your child may be referred to a mental health professional.

How is this treated?

Your child may need more than one type of treatment. Treatment may include:

• Psychotherapy. This is also called talk therapy or counseling. Your child’s health care provider may recommend psychotherapy for your child, your family, or both.
• Medicines to help with your child’s anxiety.

Your health care provider may recommend that you look into programs that your child’s school may have to help him or her manage anxiety.

If a parent has anxiety or depression, talk with a health care provider about whether treatment is needed for the adult.

Follow these instructions at home:

• Help your child manage anxiety and stress with relaxation methods, like deep breathing or meditation.
• Feed your child healthy and nutritious foods, like grains, legumes, fruits, and vegetables.
• Encourage your child to be more physically active throughout the day.
• Try to make sure your child has a daily routine.
• Make sure your child is getting enough sleep. If you are not sure how much sleep your child should be getting, ask your child’s health care provider.
• Give over-the-counter-and prescription medicines only as told by your child’s health care provider.
• Talk with your child’s school, teachers, and any caregivers about your child’s anxiety and his or her treatment plan.

Contact a health care provider if:

• Your child takes medicine and you notice a change in his or her sleeping or eating habits.
• Your child’s symptoms get worse.
• Your child develops new symptoms.
• Your child has trouble sleeping or doing his or her daily activities.

Get help right away if:

• Your child self-harms.
• Your child has serious thoughts about hurting himself or herself or others.

If you ever feel like your child may hurt himself or herself or others, get help right away. You can go to your nearest emergency department or call your local emergency services (911 in the U.S.).

Summary

• Children or toddlers who have separation anxiety are always afraid or worried when they are away from family members.
• Even when children with this condition are in a safe and loving place, they may still feel sad or scared.
• Help your child to manage anxiety and stress better using relaxation methods, like deep breathing or meditation.