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A Parent’s Guide to Separation Anxiety

Posted on: August 15th, 2019

Does your child cling, cry, or melt down when you attempt to leave the room, leave the house, or when he or she goes to school?  Does your child attempt to spend the night, only to call, crying, saying they need to be picked up?

You’re not alone.  I’ve been there.  When my son was five, he started kindergarten and began riding the bus for the first time.  The school was close by and could be seen from our house.  For about six months, the mornings began with tears, prolonged hugs, and questions like, “Will I ever see you again?”  It’s heartbreaking to see your child stressed, but more specifically when you know it’s the idea of being apart from you that drives it.  

What is separation anxiety?

Separation anxiety is a form of anxiety in which the fear of separation is so great, it’s all the person can think about.  Some individuals may have nightmares and physical complaints, are reluctant to go to school, or other places.  Symptoms can last for six months or more and interfere with daily life. 

The DSM-V classifies separation anxiety in the following ways:

  • Unusual distress about being separated from a person or pet
  • Excessive worry that another person will be harmed if they leave them alone
  • Heightened fear/worry surrounding being alone
  • Physical symptoms when they know they will be separated from another person soon
  • Needing to know where a loved one is at all times

Who can have separation anxiety?

Separation anxiety is common, with more than 200,000 cases per year, affecting children 13 and under.  While it’s rarer among teens, adults can also be affected by it.  

What causes separation anxiety?

In children, separation anxiety is a normal part of childhood development, with the timing of it varying. Some children might go through it between 18months and 2 and1/2 years of age, while others may never experience it.

Kids with separation anxiety disorder fear being lost from their family members and are often convinced something bad will happen to them.  Physical symptoms may include:

  • Panic symptoms (nausea, vomiting, shortness of breath), or panic attacks before a parent leaves
  • Nightmares about separating
  • Fear of sleeping alone
  • Excessive worry about being lost, kidnapped, or going places without a parent

Life stressors can also be a factor, such as a new sibling, moving to a new place, loss of a caregiver, or a parent’s divorce.  

In adults, it can stem from a parent, partner, or child moving away (leaving home, going to college), or a significant life change, such as divorce.  It may also be related to another underlying mental health condition.  Controlling or overprotective tendencies are often ways an adult may express fears of separating.

Other risk factors for separation anxiety are having OCD (obsessive compulsive disorder), being female, childhood adversity (such as the death of a family member), or a history of childhood traumatic events (abuse).  

How is it treated?

Separation anxiety is largely treated with cognitive-behavioral therapy (CBT), and in some cases, in combination with medication.  CBT aims to identify and change the person’s thoughts and behaviors that are making the anxiety worse.  

Parenting strategies, group therapy, family therapy, as well as support groups are also avenues where folks can gain help in learning techniques to reduce anxiety.  In children, this may involve play techniques, therapeutic stories, and coping tools incorporating breathing games and expressive arts activities.

Making Transitions Easier

For Parents:

  • Timing matters.  Be wary of starting daycare or childcare with an unfamiliar person if your child is between 8-12 months.  Also, do not try to leave when your child is hungry, tired, or restless.  Schedule your leaving for after naps and meals.
  • Practice being apart.  Introduce new people and places slowly.  Visit daycare or school a few times before staring a full program.  Practice leaving your child with a caregiver for short periods so your child can get used to being away from you.
  • Stay calm.  Have an exit ritual.  Keep it pleasant, loving, and firm.  Show confidence in your child.  Let your child know you’ll be back.  Give your full attention to your child during goodbyes.  Leave when you say you’re leaving.  (Coming back in again makes things worse).
  • Be consistent.  Follow through on promises and return when you say you will.  

How Parents may feel:

  • Guilty.  It’s okay to take time out for yourself, leave your child with a caregiver, or go to work.  Your child’s unwillingness to leave you is a good sign of a healthy attachment.  Over time your child will learn that you consistently return after being away.  
  • Overwhelmed.  Your child my need a lot of attention and time from you.  By practicing being apart, your child gets a chance to develop coping skills and become a little more independent.

For the Caregiver:

  • Distract the child.  Have an activity, toy, song, game that will shift the child’s attention.  Keep trying until you find something that works.
  • Use clear language.  Answer the child’s questions in a simple, straightforward way.  If you need to mention Mom and Dad, do so like this, “Mommy and Daddy will be back as soon as they get home from work.  Let’s play with some toys.”

For both:

  • Trust your instincts.  Is your child refusing to go to a certain sitter, day care, or displaying other signs of stress?  Is your child having trouble sleeping or eating?  There could be a problem with the child care situation.

When should I see a mental health professional?

For most kids, the natural phase of separation anxiety passes without a need for further attention.  But, if you are unsure whether you or your child’s fears are related to separation, contacting a counselor is a great start.

If intense separation anxiety lasts into pre-school, elementary school, or beyond and is interfering with you or your child’s daily life, it’s time to see a mental health professional or talk to your doctor.

Need support with your child’s separation anxiety?  Contact me at Sound Health Counseling Solutions.