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Separation Anxiety Disorder

Medically reviewed by Last updated on Jul 4, 2022.

What is separation anxiety disorder?

Separation anxiety disorder is a condition that causes your child to feel anxious. Anxiety occurs when he or she is separated from something familiar. Examples of familiar things include parents or regular caregivers, and the child's home. Separation anxiety is normal for children 6 to 30 months of age. Your child may have this disorder if symptoms last past 30 months. Your child may also have this disorder if symptoms do not get better as your child gets older. Separation anxiety disorder may also happen in older children, between 4 and 12 years of age.

What increases my child's risk for separation anxiety disorder?

The cause of separation anxiety disorder may not be known. It may appear after a major stress in your child's life. Examples include the loss or illness of a loved one, divorce of parents, or moving to a new place. The following also increase your child's risk:

  • A close family member with an anxiety, panic, or depressive disorder
  • Being born to a mother who smoked, used drugs, or drank alcohol during pregnancy
  • Low birth weight
  • Being in foster care
  • Parents or caregivers who are overly careful or overly concerned

What are the signs and symptoms of separation anxiety disorder?

Symptoms of separation anxiety disorder last longer than 4 weeks. Signs and symptoms usually appear when the child leaves a familiar person or place, or at bedtime. Separation anxiety disorder prevents your child from doing his or her daily activities. Your child may have poor school performance. Your child may also show any of the following:

  • Your child worries about losing you or other loved ones. He or she may worry that you will be in an accident or get sick. Your child may always want to know where you are. He or she may call you on the phone often when you are apart.
  • Your child does not want to leave home. He or she may refuse to go to school and pretend to be sick. Your child may not want to do events away from home. Your child may refuse to spend time with friends or do other social activities. He or she may want to spend time with you instead. Your child may refuse to sleep away from home. He or she may often worry that he or she will get lost or be kidnapped.
  • Your child is afraid of being alone. Your child may cling to you or follow you around. Your child may refuse to go to sleep alone. Your child may insist that you stay with him or her until he or she falls asleep. During the night, your child may move to your bed or sleep outside your bedroom door. Your child may tell you that he or she sees people or scary creatures. He or she may say that these things go away when you are there.
  • Your child has nightmares about being away from you. He or she may dream of danger, harm, or death affecting you or a loved one.
  • Your child has physical symptoms when separation occurs or is expected. These may include stomachaches, nausea, or vomiting. He or she may also complain of headaches, pounding or fast heartbeat, dizziness, or feeling faint.

How is separation anxiety disorder diagnosed?

Your child's healthcare provider will ask about your child's behavior and fears. He or she may also ask how long your child has had the behaviors. Your child's healthcare provider may also ask how your child is doing in school and with other activities. Tell the provider if any other family members have had anxiety disorders or other mental health problems.

How is separation anxiety disorder treated?

Early treatment can help prevent your child's disorder from getting worse. It can also help prevent other mental health problems such as depression. Your child may need any of the following:

  • Medicines may be used to help your child feel less nervous, anxious, or depressed. Medicines are usually used together with therapy or other treatments.
  • Cognitive behavior therapy can help your child understand his or her anxiety and control negative thoughts. A therapist may also teach your child ways to relax, such as deep breathing and muscle relaxation. You, other family members, caregivers, or your child's teachers may also attend.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

View more treatment options

What can I do to help my child?

  • Try to leave your child with people he or she knows. Use the same babysitter as much as possible. If you have to use a new babysitter, invite him or her to spend time with your child while you are there. If your child will begin daycare, visit the daycare a few times together before you leave your child there.
  • Create a routine with your child. Tell your child that you will be back. Stay calm and try not to show that you are sad or anxious. Leave quickly after you say goodbye. Children become more upset when they are sleepy or hungry. If possible, leave after your child has eaten or taken a nap.
  • Tell caregivers or teachers to distract your child when you leave him or her. Tell caregivers or teachers to start a new activity. They can also give your child his or her favorite toy to play with.
  • Keep promises to your child. Return when you said you would. This will help your child trust you. It will also help decrease your child's anxiety.
  • Help your child practice deep breathing. Deep breathing can help your child relax when he or she is anxious. Your child should learn to take slow, deep breaths several times a day, or before you have to leave him or her. Tell your child to breathe in through the nose and out through the mouth.
  • Offer your child a variety of healthy foods. Healthy foods include fruits, vegetables, low-fat dairy products, lean meats, fish, whole-grain breads, and cooked beans. Healthy foods can help your child feel less anxious and have more energy.
    Healthy Foods
  • Encourage your child to exercise regularly. Exercise can increase your child's energy level. Exercise may also lift your child's mood and help him or her sleep better. Your child's healthcare provider can help you create an exercise plan for your child.
    Hispanic Family Walking for Exercise

Call your local emergency number (911 in the US) for any of the following:

  • Your child has chest pain, tightness, or heaviness that may spread to his or her shoulders, arms, jaw, neck, or back.
  • Your child says he or she feels like hurting himself or herself, or someone else.

When should I call my child's doctor?

  • Your child's symptoms get worse or do not get better with treatment.
  • Your child has new or worsening symptoms.
  • 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 healthcare providers 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.

© Copyright IBM Corporation 2022 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.