Separation Anxiety Disorder

GENERAL INFORMATION:

What is it? Separation (sep-uh-ra-shun) anxiety (ang-zi-ih-t) is usually a short-term children's problem. Infants from six months old to two and a half-year-old toddlers are most likely to have separation anxiety. It can also occur in older children. Separation anxiety happens when a child gets very upset about leaving their primary caregiver or when leaving home. The primary caregiver may be the child's mother, or whoever takes care of the child most of the time. It is normal for younger children to be afraid when parents leave them. Separation anxiety can make children feel badly about themselves. And it can lead to adult emotional problems.

Causes: Separation anxiety disorder may run in families. Children who are shy or nervous are more likely to have separation anxiety than louder children. Your child may have this disorder after a big change in his life, such as changing schools. It can be caused from moving, a death in the family, being in the hospital, or parents' divorcing.

Signs and Symptoms:

• Your child may cry, scream, or have temper tantrums when left with others. He may want to sleep with you in your room. It may be hard for him to go to sleep. He may be afraid of the dark and of having nightmares. Your child may be afraid of sleeping away from home.
  
  
• It may be very hard for your child to settle down. He may be very shy and have trouble meeting new people. Your child may cling to you at home and follow you from room to room. He may worry about the family's safety.
  
  
• Separation anxiety disorder may get in the way of your child's normal activities. Your child may not want to go to school. He may not want to be involved in activities away from home. He may have headaches, stomachaches, or body aches when he thinks about being away from you. Your child may be sad, quieter than usual, or not able to pay attention.

Care: Caregivers will ask your child and family members questions. These may include questions about your child's behavior and his past. Your answers may help caregivers understand your child better. Your child and family may need to go to counseling meetings. You and your family will learn about separation anxiety disorder at these meetings. You will also learn ways to understand your child and cope with this disorder. Caregivers may help you learn how to help your child do better at home and school. Medicine may be used to help your child feel calmer and less afraid. Your child may also have to attend therapy sessions.

• Medicines:
  
  
  • Anti-Anxiety Medicine: This medicine may be given to help your child feel less nervous. It may be given by IV, as a shot, or by mouth.
    
    
  • Anti-Depressants: This medicine is given to lessen or to prevent the symptoms of depression. It can also be used to treat other behavior problems. It is given by mouth.
  
  
• Care Settings:
  
  
  • Intensive Outpatient Program: This is when your child receives 1 to 3 hours of treatment at the hospital or clinic. This program is usually 2 to 5 times a week for a short period of time.
    
    
  • Outpatient Program: This is when your child meets with his therapist once a week or less. Appointments are one hour long or shorter. He could meet one-to-one with his therapist. Or, he might meet with his therapist in a group. He may have few or many scheduled appointments over time.
  
  
• Caregivers:
  
  
  • Psychiatrist (si-ki-uh-trist): This is a medical doctor who works in the area of mental health. The psychiatrist is in charge of ordering your child's medicine. You may work closely with this doctor and other caregivers.
    
    
  • Therapist: This is a caregiver that works closely with your child during treatment. This person may be a doctor, psychologist (si-kall-o-jist), nurse, mental health counselor, or social worker.
  
  
• Types of Therapeutic Sessions:
  
  
  • Couples Therapy: when you and your significant other meet with a caregiver to talk about how to cope with your child's separation anxiety. Your significant other may be your spouse (husband or wife), or a boyfriend or girlfriend.
    
    
  • Family Meetings: Caregivers meet with you, your child, and your family. Caregivers can help your family understand your child's illness and learn better ways to react to a child with separation anxiety.
    
    
  • Group Therapy: A series of meetings that your child goes to with other children who have separation anxiety. During these meetings, the children and staff talk together about ways to cope with the problem.
    
    
  • Individual Therapy: A time for your child to meet alone with his therapist. They will talk about how to cope with separation anxiety and how your child can feel better about himself.
  
  
• Types of Therapy Approaches:Behavioral Modification (mah-dih-fih-k-shun)
  
  
  • connects specific behaviors (ways of acting) with specific consequences (results). For example, if your child refuses to go to day care, you will take away dessert privileges for a previously agreed upon period of time. If your child goes to day care without fussing, he can have a previously agreed upon reward, such as a dessert.
    
    
  • Cognitive Therapy helps make your child aware of how he sees things. He may have trouble seeing the good in things around him. Then he is more likely to feel depressed, sad or angry. Cognitive therapy teaches him to recognize how he sees things and helps him see them in a more positive way.
    
    
  • Distraction is a way of focusing your child's attention on something other than sad feelings. He may play games, watch TV, or take a walk. He can also visit with friends, paint and write things down. Using planned activities helps to manage the sad feelings. It may also cause him to relax and help him start feeling better about himself and his life.
    
    
  • Insight Oriented Therapy makes your child think about things that have happened in the past. It helps him understand his feelings and behavior now as it relates to past events.

Patient Rights:

• Release of Information Form: This is a legal paper letting caregivers share information with those listed on this form. A parent or legal guardian must sign this form. No information can be released to persons outside the hospital unless this form is signed.
  
  
• Right to Privacy: Information that you and your child share with caregivers is kept private among caregivers. They will not share information with others without your permission.

Coping: Accepting that your child has separation anxiety is hard. Your child's illness may make you feel angry, sad, or frightened. These feelings are normal. Talk to your child's caregiver, family, or friends about your feelings. Caregivers will talk with you about how things are at home. Your caregiver can help your family better understand how to react to a child with separation anxiety.

• Your family may also want to join a support group. This is a group of people who have a child with separation anxiety. Ask your caregiver for the names and numbers of support groups in your town.
  
  
• Ask your health care provider if they know about books that you can read. Reading about your child's illness might help you better understand it. You can also call or write one of the following national organizations for more information.

• American Academy of Child and Adolescent Psychiatry
  3615 Wisconsin Avenue NW
  Washington, DC 20016
  Phone: 1-202-966-7300
  Web Address: http://www.aacap.org
  

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village, IL 60007-1098
  Phone: 1-847-434-4000
  Web Address: http://www.aap.org
  

• Anxiety Disorders Association of America (ADAA)
  8730 Georgia Avenue, Suite 600
  Silver Spring, MD 20910
  Phone: 1-240-485-1001
  Web Address: http://www.adaa.org
  

• National Institute of Mental Health (NIMH), Public Information & Communication Branch
  6001 Executive Boulevard, Room 8184, MSC 9663
  Bethesda, MD 20892-9663
  Phone: 1-301-443-4513
  Phone: 1-866-615-6464
  Web Address: http://www.nimh.nih.gov/
  

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

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