Separation Anxiety

Separation anxiety disorder is an anxiety disorder that causes intense fear and anxiety due to being separated from an attachment figure. The attachment figure can be anyone the person has a strong relationship with. The anxiety caused is generally inconsistent with the individual's developmental level and is also prolonged and severe.

Separation anxiety disorder is considered normal for infants and toddlers, who are expected to outgrow it when they reach three years of age. Separation anxiety disorder is an anxiety disorder in which being separated from an attachment figure produces significant worry and distress. Anyone with whom the person has a close bond can serve as an attachment figure. The anxiety is unusual for the individual's developmental level and lasts for a long period of time.  

This disorder causes individuals to struggle in several aspects of their lives, and it is reflected differently in children and adults. For example, children may struggle to attend school and be separated from their caregivers. They also tend to cling to their parents and follow them around the house and can even refuse to sleep in separate beds. They struggle to fall asleep when their parents are away, and they are constantly worried about their parents being harmed when they are separated. When separated from their attachment figure, children with separation anxiety disorder can appear distant, depressed, and unable to focus. They may be afraid of flying, vehicle accidents, or other situations that could cause the loss of their attachment figure. When children experience separation from their parents, they may become aggressive. Children may also experience physical symptoms and go to great lengths to avoid being separated from their parents.  

Adults can also suffer from separation anxiety disorder, making it difficult for them to move out of their parent's homes and become independent. They are also likely to fear being alone and constantly check where their parents/children are at all times. Adults with separation anxiety disorder may also appear overprotective, possessive, and/or dependent. They may oppose their partner's or child's efforts to do things independently. It can lead to work insecurity, financial difficulties, and interpersonal conflict. Separation anxiety disorder can also develop as a result of a divorce, a breakup, or the loss of a loved one.  

Symptoms

  • Significant and unusual distress caused by the anticipation of or actual separation from an attachment figure.  
  • Constant and excessive fear of attachment figures being harmed, such as suffering from an illness or injury.  
  • Persistent worry of an unexpected separation from an attachment figure due to an unforeseen event, such as getting lost or kidnapped.  
  • Refusing to separate from or leave an attachment figure, causing them to avoid going out or attending school/work.  
  • Frequent nightmares about separation.  
  • Physical symptoms (e.g., headaches, stomach aches, nausea, vomiting) when separated from their attachment figures.  

Prevalence

Studies show that the lifetime prevalence rate of separation anxiety disorder is around 3.1% when comparing the statistics for several countries.

Prognosis

If left untreated, separation anxiety disorder in childhood may continue into adulthood. However, with proper treatment, the prognosis of separation anxiety disorder is generally good, and children can outgrow their symptoms. Conversely, the treatment process may become more difficult for adults if other severe emotional disorders accompany them.

When to seek help

Separation anxiety disorder is unlikely to fade away and would need proper treatment in order to prevent it from affecting one's daily activities and responsibilities. If you or someone you know is experiencing separation anxiety disorder symptoms, seek help from a mental health professional as soon as possible.

Treatment

The severity and frequency of symptoms encountered may influence the treatment method for separation anxiety disorder. The initial step is to seek psychotherapy, although clients may sometimes be required to take medication with the help of a medical professional.  

  • Psychotherapy:    

One of the most commonly used therapy methods for separation anxiety disorder is cognitive behavioral therapy (CBT). It helps individuals overcome their anxiety by teaching them new ways of thinking, acting, and reacting when separated from their attachment figures. CBT also teaches them how to use practical social skills and coping mechanisms in anxiety-provoking situations. Exposure therapy is frequently used with relaxation techniques to assist clients in dealing with their fears. This type of CBT is based on the fact that intense anxiety will decrease with gradual exposure to the stressful situation. Clients are urged to gradually expose themselves and confront the attachment-figure separation. Parent training could also be useful when treating separation anxiety disorder in children, where they are taught how to reward courageous separation behaviors while ignoring anxiety-driven behavior.  

  • Medications:  

If a client's separation anxiety disorder symptoms appear severe, their doctors may recommend medication in addition to psychotherapy.  

  • Benzodiazepines  
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Tricyclic antidepressants