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Separation Anxiety

Separation anxiety disorder is an intense fear of being separated from a loved one or caregiver. It can affect children and adults. Separation anxiety is a normal emotion in babies and toddlers. When anxiety interferes with age-appropriate behavior, it becomes a disorder that needs to be treated. Treatment can include therapy and medication.

Overview

What is separation anxiety?

Separation anxiety is when you feel nervous (anxious) when you’re separated from a loved one, such as a primary caregiver. While separation anxiety in babies and toddlers is a normal stage of development, separation anxiety disorder can affect children and adults.

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What is the difference between separation anxiety in children and adults?

Separation anxiety in babies usually starts at about 8 months. At this age, babies often become scared when they see new people. They feel safe with their parents and unsafe when their parents leave. By age 2, toddlers begin to understand that their parents will return.

In some children, separation anxiety continues beyond age 2. Separation anxiety disorder is most commonly found in younger children. It can affect older children and adults too.

One of the main differences between separation anxiety disorder in children and adults is the type of loved one involved. Children are usually anxious when separated from their parents or other trusted caregivers.

Adults experience anxiety when separated from their children. They also can feel separation anxiety in relationships, such as with a spouse or significant other.

What is the difference between separation anxiety and separation anxiety disorder?

Separation anxiety is a regular part of a child’s development. Separation anxiety disorder is an extreme fear of being separated from a loved one or primary caregiver (attachment figure). It's much more intense and not developmentally appropriate. Separation anxiety becomes a disorder when the anxiety interferes with age-appropriate behavior.

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Symptoms and Causes

What causes separation anxiety in children?

Separation anxiety disorder can be genetic. It runs in families. Environmental factors also can cause separation anxiety disorder. These factors include:

  • Death in the family.
  • Separation or divorce of parents.
  • Parental absence.
  • Geographic move or relocation.
  • Change of school.
  • Anxiety diagnosis in a parent.
  • Parental alcoholism.
  • Foster care/adoption.

What are the risk factors for getting separation anxiety disorder as an adult?

Adults may experience separation anxiety due to stressful life events or past experiences. Risk factors include:

  • Loss of a loved one.
  • Big life changes, such as a move.
  • Strict parental upbringing.
  • Diagnosis of an anxiety disorder as a child.
  • Diagnosis of other anxiety or mental health disorders as an adult.

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What are the symptoms of separation anxiety in children?

Separation anxiety disorder in children often starts in preschool, daycare or playdate settings. Your child may refuse to go or have a temper tantrum when you leave. Other signs of separation anxiety disorder can include:

  • Fear that something bad will happen to a family member during separation.
  • Fear of being abducted or getting lost.
  • Following caregiver around the house.
  • Fear of being left alone.
  • Nightmares.
  • Bedwetting (nocturnal enuresis).

What are the symptoms of separation anxiety in adults?

Some symptoms of separation anxiety in adults are the same as separation anxiety in children. These symptoms include:

  • Fear that something bad will happen to a family member during separation.
  • Fear of being abducted.
  • Following loved ones around the house.
  • Fear of being left alone.

Other symptoms in adults include:

  • Panic attacks when you can’t reach loved ones.
  • Fear that you or a loved one will get injured during separation.
  • Social withdrawal.
  • Difficulty concentrating.

Physical symptoms of separation anxiety disorder in children and adults can include:

What complications can arise from separation anxiety?

Separation anxiety disorder is a serious condition that can affect your quality of life. It can have a stressful effect on your work, school and social interactions. Separation anxiety disorder can lead to mental and physical issues. These include:

Diagnosis and Tests

How is separation anxiety diagnosed in children?

Your child’s healthcare provider may do a number of tests to diagnose a separation anxiety disorder. They may observe your child in a scene of separation.

Your child’s healthcare provider will ask you about your child’s history. They will ask you about your child’s symptoms too. They will ask you how long your child has had his or her symptoms.

Generally, symptoms must be present for at least four weeks before a diagnosis will be made in children. Also, they must cause major impairment to normal functioning.

How is separation anxiety diagnosed in adults?

Your healthcare provider will ask you questions about your history and symptoms. With your permission, they also may ask your friends and loved ones about your symptoms. In this way, they can see how your symptoms affect your life. You also may speak with a therapist.

Your healthcare provider will use a book called the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) to diagnose a separation anxiety disorder. The DSM-V says that symptoms of separation anxiety disorder must meet three criteria:

  • Symptoms must be present for at least six months in adults.
  • Symptoms must cause major impairment to normal functioning.
  • Symptoms cannot be explained by a different diagnosis.

Management and Treatment

How can I ease my child’s separation anxiety at home?

Parents can help babies and toddlers deal with typical separation anxiety in the following ways:

  • Keep transitions short and sweet.
  • Have a good-bye routine and be consistent.
  • Build trust by returning when you say you will.
  • Practice being apart by letting a trusted caregiver babysit.

How is separation anxiety order in children treated?

Separation anxiety disorder can be treated with cognitive behavioral therapy (CBT). Cognitive behavioral therapy teaches children how to understand and manage their fears. CBT is used during separations to help children learn coping skills. These skills can be used when a child is feeling anxious.

If separation anxiety disorder in your child is severe, medication may be prescribed. Antidepressants called selective serotonin reuptake inhibitors (SSRIs) can help manage symptoms of separation anxiety disorder.

How is separation anxiety order in adults treated?

Separation anxiety disorder in adults also can be treated with cognitive behavioral therapy (CBT). Your healthcare provider may recommend CBT or another type of therapy. Other therapy options include:

  • Dialectical behavioral therapy (DBT), a type of therapy that helps you deal with difficult emotions.
  • Family therapy.
  • Group therapy.

Medications also may be prescribed. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and anti-anxiety medication (benzodiazepines) can help manage symptoms.

What are the complications of treatment?

Therapy has no risks during treatment. Side effects of SSRIs and benzodiazepines are mostly mild. Side effects should be discussed with your healthcare provider. Side effects can include:

Prevention

How can I prevent separation anxiety?

There is no known way to prevent separation anxiety disorder. If you have feelings of anxiety or depression, call your healthcare provider as soon as possible. They can help diagnose and treat your separation anxiety disorder.

Outlook / Prognosis

What is the outlook for separation anxiety disorder?

Separation anxiety can affect your quality of life in many ways. If you think you may have symptoms of separation anxiety disorder, call your healthcare provider. Separation anxiety can be controlled with therapy and medication. You can go on to lead a normal, healthy life.

Living With

When should I get help for separation anxiety?

Separation anxiety is a normal part of development in babies and children. If symptoms of separation anxiety persist beyond age 2, call your healthcare provider.

What can I do at home to manage my separation anxiety?

For people with mild separation anxiety disorder, education and coping techniques may be enough to help you manage your symptoms. Some things you can do to help manage your separation anxiety include:

  • Learn about separation anxiety disorder.
  • Determine what triggers your separation anxiety.
  • Practice self-care.
  • Manage your stress.

A note from Cleveland Clinic

Whether you or your child are experiencing symptoms of separation anxiety disorder, it can affect your quality of life. While a diagnosis of separation anxiety disorder is scary, it’s important to remember that it’s treatable. If you think you or your child may have a separation anxiety disorder, call your healthcare provider right away. They can help you determine a treatment plan that’s right for you.

Medically Reviewed

Last reviewed on 06/01/2022.

Learn more about our editorial process.

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