最後更新日期 八月 30, 2021.
Separation anxiety is a common stage of development for young children. Children often experience a period of separation anxiety, though most can outgrow feeling anxious upon separation from a caregiver. However, fear of separation is a sign of developing separation anxiety disorder in some children, starting as early as in preschool.
Learn more about the symptoms, causes and treatments of separation anxiety disorder and understand how to manage the condition in this article.
What is Separation Anxiety Disorder?
Separation anxiety disorder is a condition when someone experiences excessive and persistent distress and fear with the anticipation of separation from home or attachment figures, usually the loved ones, by expressing reluctance. Separation anxiety disorder is usually more prominent in children than teenagers and adults, although it can manifest in all of them. If the individual’s separation anxiety is excessive and prolonged, it may interfere with school or other daily activities or experience panic symptoms.
Separation anxiety generally occurs from babies of 6 months to toddlers of 3. However, some children exhibit symptoms of separation anxiety during their teenage years while adults may also experience separation anxiety.
Signs & Symptoms of Separation Anxiety Disorder
There are some common signs and symptoms of separation anxiety disorder:
- An excessive and persistent worry that something terrible will happen to the loved ones if the individual leaves
- An exorbitant and persistent worry that something bad will happen to the individual if they leave the loved ones
- Refusal to go out, away from home, to school, to work or elsewhere because of fear of separation.
- Refusal to go to sleep or sleep away from home without the loved ones
- An excessive and persistent fear of being alone or without major attachment figures.
- Recurring nightmares centred around separation
- Recurrent complaints of physical symptoms, including but not limited to headaches and stomachaches, when the separation occurred or anticipated
- Recurrent excessive distress when anticipating or experiencing separation from home or form major attachment figures.
Separation anxiety disorder may be associated with panic attacks, which are repeated episodes of a rush of intense mental and physical symptoms related to anxiety that can come very quickly.
Risk factors of Separation Anxiety Disorder
Both environmental and genetic factors can play a role in the development of separation anxiety disorder.
- A significant stressful event or trauma related to separation in the individual’s life: moving to a new home, divorce and the death of a close family member/pet, illness of the individual or a relative, change of schools, parental divorce, etc.
- Children who have overprotective parents may be prone to separation anxiety. It may also be a sign of parental separation anxiety, in which the anxiety of the parent and the children is in a vicious cycle.
- Insecure attachment to the loved ones, such as parents or caregivers
- A family history of anxiety or depression will be prone to separation anxiety disorder, indicating inherited traits.
- Individuals with obsessive compulsive disorder (OCD) will be more likely to develop separation anxiety disorder.
Diagnosis of Separation Anxiety Disorder
Diagnosis of separation anxiety disorder primarily involves the assessment of the individual’s stage of development. To help diagnose separation anxiety disorder, the clinician will provide a psychological evaluation, which includes thoughts and feelings accompanied by separation and related behavior.
Children that experience 3 or more of the above symptoms may be diagnosed with separation anxiety disorder. The disorder may cause significant distress in the daily functioning of the individuals. The fear, anxiety or avoidance will be persistent, lasting at least 4 weeks in children and adolescents and 6 months or more for adults.
Treatments of Separation Anxiety Disorder
Both therapies and medications can be used to treat separation anxiety disorder.
Cognitive behavioral therapy (CBT) is the primary treatment for separation anxiety disorder. During therapy, individuals can acquire skills to confront the fears about separation and uncertainty. Through reshaping individuals’ thought patterns, they can change their dysfunctional thinking and maladaptive behavior. Parents of the children may also learn how to provide emotional support and assist them in managing feelings and thoughts.
Parent-child interaction therapy can also be used to treat separation anxiety disorder. There are usually 2 treatment phases. The first phase of treatment aims to establish warmth in the parent-child relationship through learning and applying skills to secure their connections and good about themselves. In the second phase, the parent will seek to manage the most challenging behavior of the child while remaining confident, calm and consistent in practice. Parents will learn strategies to help children comply with appropriate rules and demonstrate proper behavior in public. To be specially designed to treat separation anxiety disorder, the therapist will insert the bravery-directed interaction phase between the 2 main stages. This phase educates parents about their child’s source of anxiety. Then, the therapist and the individual will collaboratively build a bravery ladder to show situations that manifest the anxiety. Rewards will be given for positive reactions.
School intervention is also paramount in successful treatment. The child needs a safe place when they feel anxious. Provide a way for the child to communicate with parents if necessary when they are away from home. Also, a teacher can encourage interaction with other peers.
There are no specific medications for separation anxiety disorder. Sometimes, antidepressants such as selective serotonin reuptake inhibitors (SSRIs) are prescribed in children with the condition if other treatments are ineffective, or they will be used together with the therapy. These drugs cannot provide long-term solutions to the disorder, though.
Before receiving medications, patients should consult a clinician or healthcare provider to understand the drugs’ possible risks and side effects. Please also note that some of the listed medicines are not available over-the-counter and require a prescription by a qualified professional.