What Is Separation Anxiety Disorder In Children?

Around 4% of children and 1.6% of teens will suffer with separation anxiety disorder (DSM V). It can occur equally between boys and girls. Separation anxiety disorder is an anxiety disorder where the child worries excessively about being apart from close family members or that something bad will occur to a family member or that they will be lost from their family.

Separation anxiety disorder is not the same as separation anxiety that any small children can go through. Small children can be naturally anxious when we, as parents, say goodbye to them. I’m sure you have witnessed or experienced that kind of clinginess or crying on the first day of school. It’s not unusual and is a perfectly normal and healthy reaction to separation at this age. Rest assured though teachers are very adept at distracting children and within minutes of you leaving the child is usually happy and playing. We as parents are likely to be more upset.

The symptoms of separation anxiety disorder are much more severe than separation anxiety. Children may continue throughout school to experience separation anxiety that becomes intense and interferes with their school life and ability to participate in other activities. They experience extreme distress when separated from their parent or main caregiver. In this case it is a much bigger problem and will need professional assessment and support.

What Are The Symptoms Of Separation Anxiety Disorder?

Symptoms can start at any age but usually appear around 8/9 years. As I said symptoms are more severe than normal separation anxiety seen in small children. Separation anxiety disorder can occur after a break from school such as holidays, illness or a traumatic event.

Each child is unique so please trust your gut and seek support sooner rather than later with a child or teen. As some of the symptoms can be similar to other health conditions please speak to your child’s doctor to rule out other causes.

The most common symptoms are:

1. Fear that something terrible will happen to a loved one.
2. Worry that an unpredicted event will lead to permanent separation..
3. Refusal to go to school.
4. Reluctance to go to sleep.
5. Physical sickness like a headache, stomach pain, muscle tension or other physical complaints.
6. Worry about personal safety.
7. Clinging to parent or main caregiver even at home.
8. Nightmares, particularly about separation or loss.
9. Inability to sleep away from home.
10. They can have panic attacks when separated from parent. Or temper tantrums.

The Causes Of Separation Anxiety Disorder.

It is thought that separation anxiety disorder can be caused by both biological and environmental factors. Children may inherit or learn anxiety/fear tendencies from other family members. Any changes in the child’s environment such as a new house, school or care provider may also cause separation anxiety disorder. As well as any stressful or traumatic situation could be a trigger such as moving school, divorce, or the loss of a loved one. Insecure attachment style or an overprotective parent could also be common factors.

Treatment For Separation Anxiety Disorder.

Before treatment can commence a child will require a profession assessment to be carried out. A child psychiatrist or psychologist will perform this assessment after your child’s doctor has ruled out any other medical condition.

Treatment will depend on your child’s age, health and their symptoms. But it usually involves CBT (cognitive behavioural therapy) and Play Therapy to help the child manage their anxiety. Medication may also be given. Family therapy is also common and this will help you to help your child. Plus getting the school involved will enable your child to have supports in school as well.

How Can I Help My Child Live With Separation Anxiety Disorder?

1. Get help and support for you and your child. As I said above your child will need professional support but so will you. Family therapy and individual therapy will enable you to work through what has happened, your child’s diagnosis and give you many tips and support that you need while your child recovers.
2. Make sure to educate yourself about separation anxiety disorder.It is important that you learn as much as you can about your child’s diagnosis. In that way you can help and educate others such as teachers, family members, etc., so they can support your child also. It will also help you be more sympathetic to your child’s struggles as separation anxiety disorder can be very isolating for a child.
3. Don’t cover things up, take the time to talk with your child but more importantly to listen to them and respect your child’s feelings. Remember having separation anxiety can be very isolating for the child. So make sure you take time to listen to what your child is really saying. They need your reassurance, love and support and that in and of itself can be very helpful towards their recovery.
4. Don’t forget to praise any efforts your child makes no matter how small. Every small win is a big win in this case. So if they do something without any fuss then please make sure to praise them.
5. Keep calm and try to anticipate times when separation difficulties might arise. This is where family therapy can help plus your own therapy. Make a list of high stress situations you know will cause your child to have difficulties. You can rate them on a scale of one to ten, with one being the least stressful for your child. Then use the strategies discussed in therapy to help ease their anxiety. I also have some anxiety relieving tips here. Being prepared is key to helping here.
6. Provide a consistent routine for the day. All children need consistent routine but more so if they have separation anxiety disorder. This provides them with a sense of security and calms them. So be as consistent as you can with school collections, bedtime, mealtimes, etc. If you do need to change anything, or if something different is happening such as holidays, weddings, even doctor’s visits, then make sure you prepare the child for these changes in advance. If they know it can or is happening they are less likely to be anxious about it.
7. Support your child in any activities they wish to do but never over schedule them. We all love to see our child participate in things they love. We need to encourage children with separation anxiety disorder to take part in activities they enjoy. This can be very difficult for them and it will take time and patience for them to return to these things. School will be obviously the first thing that we tend to focus on. But you can encourage them to try classes online or work on activities and hobbies they previously enjoyed from the safety of home to get things started again. Again therapy will help you both with getting activities started again. They’re great ways to ease the child’s anxiety and help them develop friendships.
8. You do need to set limits but don’t forget to also offer them choices. House rules should still apply to children with separation anxiety disorder. They need boundaries but you may need to modify these and your child’s therapist will help you to do this. Choices, even small ones, can help the child regain some element of control over their lives again. You can do this without pampering to their every whim. You could give them a choice of taking one toy in their bag to school or encourage them to help with picking meals/recipes. The child’s therapist will have other ideas on how you can help with choice making.
9. You also need to help your child by relieving your own stress. So reaching out for support and taking time to make healthier stress relieving choices also will benefit your child.

Work With Me.

Remember you are allowed to ask for support. No one is an island. If you need extra support then you can also work with me. We all struggle with stress and overwhelm from time to time. If you find this has become a problem for you and you’d like some support then schedule an appointment with me.