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Mental Health > Anxiety disorders
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Separation anxiety

What is separation anxiety?
Separation anxiety itself is not a disorder. It's a normal developmental stage that children go through around the ages of 8 to 14 months. Up until this age, infants have been mostly unaware of caregiver comings and goings. Awareness grows, but "object permanence" - the knowledge that a thing or person still exists even when we can't see it - is still developing. Young children fret, cry, cling, and throw tantrums to express their unease at being apart from parents or primary caretakers.

While it may be distressing to caregivers to see a child so upset, separation anxiety helps children learn how to master their emotions and their environment. Children often outgrow separation anxiety by the age of 2. Separation anxiety becomes a "disorder" when it lasts beyond - or develops after - this age.

What causes separation anxiety disorder?
Children may not outgrow normal separation anxiety if they feel unsafe in their home, if they are distrustful of people other than their parents or primary caregiver, or if they do not trust that their parents will return when say they will.

Separation anxiety disorder can develop or recur during stressful times, like when a big "new" thing enters their life - a new sibling, a new home, a new daycare situation. Traumatic or upsetting events can bring it on, too, like an illness or prolonged separation from a parent.

Genetic and environmental factors can also contribute to separation anxiety. Children of a parent with an anxiety disorder are more likely to have an anxiety disorder as well. And kids can pick up on and learn anxious behaviour from their parents.

What are the symptoms of separation anxiety disorder?
The behaviour you see will be similar to what you see in children going through developmentally appropriate separation anxiety: fretting, crying, throwing tantrums, and similar responses. Symptoms unique to the disorder include:

  • Emotional symptoms:
    • recurrent, excessive distress when separated from a parent or primary caregiver
    • excessive worry about getting lost or separated in public from parent or primary caregiver
    • excessive worry that something might happen to their parent or primary caregiver (accidents, illnesses, death)
       
  • Sleep symptoms:
    • difficulty falling asleep when the primary caregiver is not nearby
    • asking to sleep in the parents' bed
    • difficulty staying asleep due to nightmares, often involving separation situations
    • waking up and crying so the caregiver will come back
       
  • Behaviour symptoms:
    • fussing, crying, screaming, tantrums, clinging
    • refusing to play outside or otherwise apart from caregiver
    • refusing to attend peers' parties or sleepovers
    • refusing to go to school, especially after long breaks or vacations
    • in some cases, acting withdrawn, sad, demanding, intrusive, attention-seeking

How is separation anxiety disorder diagnosed?
There is no test to diagnose normal separation anxiety. If a child experiences symptoms after the age of 2, a psychiatric evaluation can be done. In order for separation anxiety disorder to be diagnosed, separation anxiety symptoms must have lasted at least 4 weeks and have interfered with daily life and functioning.

How can separation anxiety disorder be treated?
No treatment is required for normal separation anxiety. You can learn ways to help your child deal with separation anxiety. A child who has been diagnosed with separation anxiety disorder may be prescribed anti-anxiety medications or referred to a therapist or psychologist for counselling or individual psychotherapy. Learn more about cognitive behavioural therapy for children.



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