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Separation Anxiety Disorder

What is separation anxiety disorder?

Separation anxiety disorder is a condition that causes your child to feel anxious when separated from something familiar. Separation anxiety is normal for babies and begins around 6 months of age. It usually lasts until about age 30 months and may become worse over time. Your child may have separation anxiety disorder if it continues after he is 30 months old. It can also appear suddenly, often around 7 to 9 years of age.

What causes separation anxiety disorder in children?

The exact cause is not known. It may appear after a major stress in your child's life. For example, your child loses a loved one or moves to a new neighborhood or school. The following also increase your child's risk:

  • A person raising him shows too much fear and anxiety

  • A close-knit family or a single-parent home

  • A close family member has separation anxiety disorder, or an anxiety or depressive disorder

  • An allergic condition, such as asthma, or skin or nasal allergies

  • A protective, controlling, or critical parent

What are the signs and symptoms of separation anxiety disorder in children?

You may notice any of the following:

  • Your child worries about losing you or other loved ones. He may worry that you will be in an accident or get sick. He may always want to know where you are and be in touch, such as with phone calls. He may often fear that he will get lost or be kidnapped. He may not like traveling alone or from places he knows.

  • Your child does want to go to school. He may refuse to go, or to stay at a friend's home. He may not want to do events away from home. He may have few social activities and would rather spend his time with you.

  • Your child is afraid of being alone. He may not want to be alone, or without a loved one at home or elsewhere. He may cling to you or follow you around. Your child may refuse to go to sleep alone, or when he is away from home. He may insist that you stay with him until he falls asleep. During the night, he may move to your bed or sleep outside your bedroom door. He may report strange things, such as seeing people or scary creatures, that go away when you are present.

  • Your child has nightmares about separation or other fears. He may dream of danger, harm, or death affecting him or a loved one.

  • Your child has physical symptoms when separation occurs or is expected. These may include stomachaches, nausea, or vomiting. He may also complain of headaches, pounding or fast heartbeat, dizziness, or feeling faint.

How is separation anxiety disorder in children diagnosed?

Your child's healthcare provider will ask about your child's health history, behavior, and fears. He will ask if any other family members have had anxiety disorders or other mental health problems. He may want to know how your child is doing in school and with other activities. Tests may be done to check for medical conditions that may be causing your child's symptoms.

How is separation anxiety disorder in children treated?

  • Cognitive behavioral therapy helps your child learn to control negative thoughts by looking at the results of his actions. He may also be taught how to relax. Healthcare providers also help your child face his fears and decrease his anxiety.

  • Psychotherapy is a type of counseling that is usually done in a series of meetings or talks. You, other family members, your child's teachers, or people who are close to him may also attend. These meetings may help everyone to better understand your child's separation anxiety disorder.

  • Medicines may be used to help your child feel less nervous, anxious, or depressed. Medicines may also be used to treat other behavior problems.

What can I do to help my child?

  • Be a positive role model. Learn to control your own anxiety. Your child learns from watching your behavior. Be careful that your actions do not support or strengthen your child's separation anxiety behavior. These actions include checking on your child often and avoiding situations that cause you anxiety.

  • Learn more about separation anxiety disorder. The more you know about your child's anxiety, the better you can help him. Work with your child's teachers to help your child in school.

  • Set rules that do not change. Clear and simple rules can help change how your child thinks and acts. Set limits and routines that are always followed. Praise and reward your child when he is able to control his anxiety.

What are the risks of separation anxiety disorder?

Your child's separation anxiety could get worse if left untreated. He may have problems with school, friendships, and relationships. He is more likely to have another type of anxiety disorder. These can include phobias and panic disorder. He may also develop other serious problems, such as depression. He may have an increased risk for abusing alcohol when he is older.

Call 911 if:

  • Your child feels like hurting himself or others.

When should I seek immediate care?

  • Your child has a seizure.

  • Your child has trouble breathing, chest pains, or a fast heartbeat.

When should I contact my child's healthcare provider?

  • Your child's eating or sleeping habits change.

  • Your child's separation anxiety disorder prevents him from doing his daily activities.

  • You have questions or concerns about your child's condition or care.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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