Separation anxiety is a common issue for many kids. The fear of being separated from a parent or caregiver can cause kids to experience anxiety and distress. Separation anxiety commonly happens for toddlers and young children but can persist and worsen throughout a child’s development.
What Is Separation Anxiety in Children?
Separation anxiety is the anxiety or fear that occurs when a parent or caregiver separates or is separated from the child. The child feels scared or worried about the caregiver’s absence and struggles to calm themselves. Separation anxiety is normal for infants and toddlers, and as children grow, tends to gradually decrease. Children who still experience symptoms past preschool age may be suffering from an anxiety disorder.
Signs of Separation Anxiety in Children
Every child expresses separation anxiety differently, though this does not necessarily indicate the presence of an anxiety disorder. Common signs may include:
- Crying when separating from caregivers
- Fear that the caregiver will leave even when at home
- Behavioral outbursts (tantrums)
- Worrying the caregiver will be hurt or will not return
Many children will have mild symptoms when entering a new situation or after challenging family events such as divorce. However, when the symptoms of separation anxiety seem to become more intense, do not subside in familiar settings, and interfere with the child’s functioning, and last longer than one month, the issue may be a separation anxiety disorder. Symptoms of separation anxiety disorder as characterized by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) include:
- Recurrent distress when leaving home or caregiver or thinking of leaving home or caregiver
- Excessive worry about losing the caregiver to injury, illness, or death
- Excessive worry about unlikely events which would cause separation from a caregiver (for example: being kidnapped)
- Refusal or reluctance to leave home or go to school or daycare or refusing to allow the caregiver out of the child’s line of sight while home
- Reluctance to sleep without the caregiver
- Repeated nightmares about separation
- Complaints of physical symptoms such as headache, stomachache, or nausea
A mental health professional can help determine if the child’s symptoms reflect a diagnosable condition.
What Causes Separation Anxiety?
Separation anxiety occurs for an important reason. As infants and toddlers develop and learn the importance of their caregivers’ role in keeping them safe and healthy, they notice the risks involved when the caregiver is not with them. Even children with secure attachments to their caregivers will likely experience times of separation anxiety.
Separation anxiety disorder can be the result of trauma, genetics, or major life changes such as divorce. They may also be linked to other mental health issues of the child. Traumatic events can cause the child to fear for their overall safety, which increases the need for security from the caregiver. For example, if a child was in a minor car accident, the child may begin to worry that they will be in a car accident again or that the caregiver will be in an accident. This worry may increase the ‘clinging’ to the caregiver or parent.
Life changes in the family, such as divorce or the loss of a family member, can cause a child to worry about the loss of other family members. The child may not be able to verbalize the fear, and the signs of separation anxiety may be their way of expressing that fear.
Family patterns and attachment styles may also play a role in the occurrence of a separation anxiety predisposition. Studies have indicated that higher maternal anxiety levels increase the likelihood of separation anxiety in children. Family patterns and styles of attachment may cause difficulty for the child to feel safe and secure when not with the caregiver and have a hard time settling when the caregiver returns.
How to Deal With a Child’s Separation Anxiety
Dropping off a crying child at daycare, school, or grandma’s house is hard. It is heartbreaking to see and hear the child feeling so upset. There are some ways to manage and reduce the anxiety.
Remind Them of the Plan
Before the day on which they will be separated, spend time talking about what will happen. Even a young child will benefit from hearing the plan. Tell them where they will go, what they will do, and who will be keeping them safe while the caregiver is gone. The most important part is to emphasize that the caregiver will always come back. It’s important to focus on the coming back part, rather than the leaving them part.
Make the Drop-off Quickly
Make the drop-off process as quick as possible. Don’t linger around and allow the child to cry. Have a quick routine of hugs, reminding them of the caregiver’s return and leave.
Bring a Transition Object
Some children find it helpful to have a small object they can hold. This can act as a sensory distraction or a special trinket that reminds them of the caregiver. Either way, the object can be helpful during the transition.
Treatment of Separation Anxiety Disorder
When the separation anxiety becomes more intense or seems to impact the child over a period of four or more weeks, it may be time to seek treatment. There are a variety of treatment options to help the child work through the separation anxiety.
Play Therapy
A parent may choose to seek out therapy for their child. For young children, the therapy modality most often used is play therapy. This type of therapy helps the child work through the fear, past trauma, or changes in the family to improve the child’s ability to cope with separation.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy is typically used for older children to help process the fears of separation. CBT helps the child to notice the negative thoughts (such as “mom will never come back”) and change the thoughts to more rational thoughts (such as “mom is going to work and will pick me up after work”). CBT has been shown effective in clinical studies with many types of anxiety in children, including separation anxiety.
Exposure Therapy
Exposure therapy is a type of therapy used to expose the child to small doses of fear, in this case, separation from the caregiver. This might look like the caregiver stepping out of the office for a few minutes and returning. Then, the caregiver steps out for a more extended period. This type of therapy shows the child they are safe even when their fear (the separation) is present, and the caregiver will return.
Medication
Another option for separation anxiety disorder may be prescribed medication. This would be a conversation to have with a medical doctor and may be used to manage other anxiety mental health disorders or extreme separation anxiety cases.
Keeping Perspective
Separation anxiety in children, especially in severe cases, can be very disruptive to a family’s daily functioning. While children usually outgrow it, parents that are concerned that their child’s separation anxiety is not appropriate for their age, or maybe a sign of a larger problem, should consult with their doctor. The good news is that the treatment options are diverse and can be effective.
Sources
- Lewinsohn, P. M., Holm-Denoma, J. M., Small, J. W., Seeley, J. R., & Joiner, T. E., Jr (2008). Separation anxiety disorder in childhood as a risk factor for future mental illness. Journal of the American Academy of Child and Adolescent Psychiatry, 47(5), 548–555. https://doi.org/10.1097/CHI.0b013e31816765e7
- Seligman, L. D., & Ollendick, T. H. (2011). Cognitive-behavioral therapy for anxiety disorders in youth. Child and adolescent psychiatric clinics of North America, 20(2), 217–238. https://doi.org/10.1016/j.chc.2011.01.003
- Brückl, T. M., Wittchen, H. U., Höfler, M., Pfister, H., Schneider, S., & Lieb, R. (2007). Childhood separation anxiety and the risk of subsequent psychopathology: Results from a community study. Psychotherapy and psychosomatics, 76(1), 47–56. https://doi.org/10.1159/000096364
- Verduin, T. L., & Kendall, P. C. (2003). Differential occurrence of comorbidity within childhood anxiety disorders. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 32(2), 290–295. https://doi.org/10.1207/S15374424JCCP3202_15
Katie is a licensed professional clinical counselor (LPCC). She has a passion for healing trauma using body-based somatic therapy. Katie believes that healing trauma and restoring physical and emotional health comes from healing the body and nervous system.