Separation Anxiety

Separation anxiety can create an overwhelming feeling of fear and anxious thoughts. Understanding how separation anxiety affects children and adults and what causes it can pave the way to getting needed treatment.

What is separation anxiety?

Separation anxiety is a type of anxiety disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, separation anxiety occurs when a person is overwhelmed by the possibility of separation or actually being separated, from a person, place, animal (such as a pet), or object. Symptoms of separation anxiety can be both psychological and physical.

Separation anxiety in adults vs. in children

Separation anxiety is different for children and adults. In children, separation anxiety is a natural phase of growing up. It’s common for children ages 2 and under to become anxious when apart from parents or caregivers. Eventually, they grow out of this phase as they progress in their cognitive development. Experiences like going to summer camp can help children to develop independence and build relationships with others.

For adults, separation anxiety can occur after a traumatic event, such as losing a loved one, experiencing a major life transition, or having strict parents or authority figures. Children diagnosed with an anxiety condition early in life can potentially develop separation anxiety as an adult.

What is separation anxiety disorder?

Separation anxiety disorder can occur when a person experiences distress and anxiety at the absence of a certain person, place, animal, or object. This can disrupt their daily lives and affect their work, relationships, and routines.

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Signs and symptoms of separation anxiety

Separation anxiety and separation anxiety disorder share similar signs and symptoms. However, symptom intensity may be more acute with the disorder and result in a greater disruption to everyday life. Symptoms of separation anxiety and separation anxiety disorder can include:

  • Extreme distress over the absence of a particular person, place, animal, or object
  • Extreme fear, worry, or concern about this absence
  • Excessive fear, worry, or concern that something will happen that will result in the separation
  • Reluctance to separate
  • Difficulty sleeping or having nightmares
  • Physical symptoms that can include nausea, headaches, upset stomach, tightness of breath, and chest pains
  • Panic attacks or other anxiety-related episodes

What causes separation anxiety?

Separation anxiety can have different causes. For children, early relationships with authority figures like parents or caregivers may contribute to the development of separation anxiety. This may happen if the parenting or care style is overprotective, critical, negative, or neglectful (Weinfield et al. 1997, Başbuğ et al. 2016). For adults, genetics and a family history of separation anxiety may also contribute to developing separation anxiety (Yaklaşımlar, 2022). Traumatic events, such as losing a parent, can also cause separation anxiety (Alkın, 2010).

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How is separation anxiety diagnosed?

To diagnose separation anxiety, a doctor or clinician will meet with the individual and/or parent to discuss symptoms. A diagnosis requires the presence of at least three symptoms that disrupt daily life for at least four weeks.

Treatments

Separation anxiety is highly treatable. Treatment options include therapy and medication, which can help alleviate symptoms.

When to seek treatment

Seek treatment if symptoms are persistent and disrupt work, school, or personal relationships. Parents and caregivers may want to explore treatment options for children as soon as possible. Early treatment can help alleviate symptoms sooner and may prevent the development of anxiety-related conditions in adulthood.

Therapy

Therapy is a common treatment for people experiencing separation anxiety. Cognitive behavioral therapy (CBT) is a popular type of therapy used for treating anxiety. CBT can help a patient focus on the situations, behaviors, and thoughts that worsen anxiety and teach them to more effectively manage these situations.

Medication

A mental health clinician may prescribe anti-anxiety medication, often in conjunction with therapy.

What happens if separation anxiety disorder goes untreated?

Left untreated, separation anxiety disorder can significantly affect a person’s relationships and interactions. Untreated separation anxiety disorder in children can lead to panic disorders as an adult, as well as other anxiety-related disorders. For adults, untreated separation anxiety disorder can result in difficulties forming attachments and maintaining relationships with others. They may also have more severe depression and anxiety (Milrod et al, 2014).

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References

  • APA (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed., (DSM-5). Washington, DC, American Psychiatric Association.
  • Weinfield NS, Ogawa JR, Sroufe LA (1997) Early attachment as a pathway to adolescent peer competence. J Res Adolesc, 7:241–265.
  • Başbuğ S, Cesur G, Durak-Batıgün A (2016) Algılanan ebeveynlik biçimi ve yetişkin ayrılma anksiyetesi: kişilerarası bilişsel çarpıtmaların aracı rolü. Türk Psikiyatri Derg, 27:1–13.
  • Alkın T (2010) Yetişkin ayrılma anksiyetesi bozukluğu. Türkiye Klinikleri J Psychiatry- Special topics, 3:53-63.
  • Namli, Z., Özbay, A., Tamam, L. Yetişkin Ayrılma anksiyetesi,bozukluğu: Bir Gözden Geçirme. Psikiyatride Guncel Yaklasimlar – Current Approaches in Psychiatry, 14(1), 46–56. https://doi.org/10.18863/pgy.940071
  • Milrod, B., Markowitz, J. C., Gerber, A. J., Cyranowski, J., Altemus, M., Shapiro, T., Hofer, M., & Glatt, C. (2014). Childhood separation anxiety and the pathogenesis and treatment of adult anxiety. American Journal of Psychiatry, 171(1), 34–43. https://doi.org/10.1176/appi.ajp.2013.13060781