It is common to miss the people we love the most when they aren’t around, but those feelings can cause a serious problem if they intensify into separation anxiety. During early life, separation anxiety is a normal part of development. However, it can develop into a debilitating disorder when the fear of being separated from certain people or places continues into childhood and beyond.

Symptoms of Separation Anxiety

The symptoms of separation anxiety disorder include

• High levels of distress when away from home or attachment figures
• Persistent worry about attachment figures getting hurt or lost
• Reluctance to leave home or another place due to fear of separation
• Refusal to sleep without attachment figure close by
• Nightmares about being separated from loved ones

Separation Anxiety in Children

People of any age can experience a separation anxiety disorder, but it occurs most frequently in children. School avoidance is a common sign. Saying goodbye leads to crying and begging the attachment figure not to leave, and the child will focus almost entirely on the return of the attachment figure during their absence. Tellingly, the child will seem completely unconcerned once they are with the attachment figure again.

Separation Anxiety in Adults

The symptoms of separation anxiety in adults are similar to those in children, but the attachment figures can be different. An adult might have excessive anxiety about being separated from a spouse or child. People who had the disorder as children are more likely to have it as adults. It is sometimes triggered by the death of a loved one or other traumatic experience.

Causes

While some separation anxiety is normal and is experienced by most children, it typically goes away as the young child develops and understands that the person will return. A precise cause of separation anxiety is not yet known; however, major stress, like a relative or pet dying or a change in schools, can trigger separation anxiety disorder in children. Also, some people might be more genetically prone to anxiety. The cause is likely a blend of genetic and environmental factors.

Diagnosing Separation Anxiety Disorder

A doctor diagnoses separation anxiety disorder after discussing the type of symptoms the patient experiences and how long they persist. Doctors typically diagnosis adults with separation anxiety disorder when they have symptoms for six months or longer. Children and adolescents must have persistent symptoms for at least four weeks. Fear, anxiety, or avoidance must cause impairment in daily functioning to be considered indicative of separation anxiety.

Separation Anxiety vs. Other Types of Anxiety

Separation anxiety disorder shares symptoms with other anxiety disorders. For example, not wanting to leave home can be a sign of agoraphobia. However, agoraphobia mostly centers around the fear of being in a place where that person does not feel safe. Some parents might mistake a refusal to go to school with social phobia when it is actually separation anxiety. Generalized anxiety can cause excessive worry about the health and well-being of loved ones. It’s important to get an evaluation from a mental health professional for an accurate diagnosis.

Separation Anxiety Treatment

Treatment for separation anxiety varies based on the age of the person. Very young children need to develop a sense of safety and learn to trust that their parents will return and that they can trust other people. Family education about how to nurture this sense of safety in children can be helpful. Treatment for older children and adults can include psychotherapy, family or group therapy, and anti-anxiety medications.

Preventing Separation Anxiety

There is no guaranteed way to prevent separation anxiety. However, experts know that children who are diagnosed with this disorder tend to be vulnerable to setbacks in symptoms after holidays and summer breaks. It is recommended that parents practice short separations from the child during those periods so that the child stays accustomed to spending time apart.

Outlook

Separation anxiety disorder is highly manageable in both adults and children. Cognitive-behavioral therapy is one evidence-based treatment that teaches people to manage unhelpful ways of thinking that lead to anxiety. Adults can benefit from support groups with others who understand what they’re going through, especially if their anxiety is a result of trauma.

Next Steps

Anyone who suspects that they or their loved one is experiencing separation anxiety should talk with a health care professional about it. Sometimes the severity can be missed in children because they act normally when they are home with their families. It helps to open up to loved ones so that they can understand what is going on and provide support.