Separation Anxiety in Children: Symptoms, Causes, Diagnosis and More

It’s normal for young children to feel anxious when they're separated from a loved one. However, when this fear occurs in a child above six years of age, is intense, and persists for more than four weeks, the child may have separation anxiety disorder.

What is Separation Anxiety Disorder?

Separation Anxiety Disorder (SAD) is a condition in which a child becomes fearful when separated from a loved one or away from home. The loved one is usually a parent or other caregiver to whom the child is emotionally attached the most. The fear and thought of separation causes great distress to the child and may interfere with his or her normal life and activities, such as going to school or talking to other children. There are some physical symptoms too associated with the thought of being separated, such as headaches or stomachaches.

Symptoms of Separation Anxiety Disorder

Some of the most common symptoms of SAD include:

• Cling to parents or caregiver
• Extreme crying
• Worry that an unexpected event will lead to permanent separation
• Refusal to go to school
• Poor school performance
• Physical illness, such as headaches, stomachaches or vomiting
• Violent, emotional tantrums
• Failure to interact with other children
• Reluctance to sleep alone
• Nightmares about separation

Causes of Separation Anxiety Disorder

SAD occurs when a child feels insecure in some way. The following are some of the common causes of SAD in children:

• A family history of anxiety or depression
• Low socioeconomic status
• Overprotective parents
• A lack of sufficient parental interaction

SAD can also occur after a stressful situation such as:

• Loss of a loved one, including a pet
• Change in environments such as new school or house
• Divorce of parents

How Is Separation Anxiety Disorder Diagnosed?

SAD is diagnosed in the children on the basis of signs and symptoms. If three or more of the above symptoms are present in the child, the doctor will begin the evaluation by performing a complete physical exam. Additional medical tests may be required. Your doctor might also observe you interact with your child to determine if your parenting style is the cause of the disorder.

Once the disorder is confirmed, the child may be referred to a child psychiatrist or psychologist, who is specially trained to treat mental illness in children and teens.

Treatment of Separation Anxiety Disorder

The mental healthcare provider may suggest a combination of following treatments to relieve your child’s SAD symptoms:

1. Cognitive behavior therapy (CBT): In this therapy, children learn techniques such as deep breathing and relaxation to cope with anxiety.
2. Parent-child interaction therapy: This therapy can be broken into three main treatment phases:
3. Child-Directed Interaction (CDI): It involves warmth, attention, and praise to improve the quality of the parent/child relationship and help a child feel secure.
4.  Bravery-Directed Interaction (BDI): It educates parents about why their child feels anxious. To achieve this, the therapist develops a bravery ladder showing situations that cause anxious feelings. 
5.  Parent-Directed Interaction (PDI): This phase teaches parents to communicate with their child clearly. This helps to manage poor behavior.
6.  Medication: While there are no specific medications for treating SAD, Antidepressant or other anti-anxiety medications may be used in older children to treat severe cases. 

In addition to above, the school environment also plays a major role in treating your child’s anxiousness. The school environment must be safe and sound for your child. The child’s teacher should also extend support by encouraging interaction with other classmates.