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Separation Anxiety in Children

Separation anxiety is normal in very young children (those between 8 and 14 months old). Kids often go through a phase when they are "clingy" and afraid of unfamiliar people and places. When this fear occurs in a child over age 6 years, is excessive, and lasts longer than four weeks, the child may have separation anxiety disorder.

Separation anxiety disorder is a condition in which a child becomes fearful and nervous when away from home or separated from a loved one -- usually a parent or other caregiver -- to whom the child is attached. Some children also develop physical symptoms, such as headaches or stomachaches, at the thought of being separated. The fear of separation causes great distress to the child and may interfere with the child's normal activities, such as going to school or playing with other children.

What Are the Symptoms of Separation Anxiety Disorder?

Following are some of the most common symptoms of separation anxiety disorder:

  • An unrealistic and lasting worry that something bad will happen to the parent or caregiver if the child leaves
  • An unrealistic and lasting worry that something bad will happen to the child if he or she leaves the caregiver
  • Refusal to go to school in order to stay with the caregiver
  • Refusal to go to sleep without the caregiver being nearby or to sleep away from home
  • Fear of being alone
  • Nightmares about being separated
  • Bed wetting
  • Complaints of physical symptoms, such as headaches and stomachaches, on school days
  • Repeated temper tantrums or pleading

 

What Causes Separation Anxiety Disorder?

Separation anxiety often develops after a significant stressful or traumatic event in the child's life, such as a stay in the hospital, the death of a loved one or pet, or a change in environment (such as moving to another house or a change of schools). Children whose parents are over-protective may be more prone to separation anxiety. In fact, it may not necessarily be a disease of the child but a manifestation of parental separation anxiety as well -- parent and child can feed the other's anxiety. In addition, the fact that children with separation anxiety often have family members with anxiety or other mental disorders suggests that a vulnerability to the disorder may be inherited.

How Common Is Separation Anxiety Disorder?

Separation anxiety affects approximately 4%-5% of children in the U. S. ages 7 to 11 years. It is less common in teenagers, affecting about 1.3% of American teens. It affects boys and girls equally.

How Is Separation Anxiety Disorder Diagnosed?

As with adults, mental illness in children is diagnosed based on signs and symptoms. If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no laboratory tests to specifically diagnose separation anxiety disorder, the doctor may use various tests -- such as blood tests and other laboratory measures -- to rule out physical illness or medication side effects as the cause of the symptoms.

If no physical illness is found, the child may be referred to a child and adolescent psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illness in children and teens. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a child for a mental illness. The doctor bases his or her diagnosis on reports of the child's symptoms and his or her observation of the child's attitude and behavior.

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