Separation Anxiety - is it a disorder?

Jul 29
Separation Anxiety Disorder (SA) is a type of anxiety disorder in which children have an excessive fear of separation from their parents or caregivers. Children with SA may experience extreme distress when they are separated from their loved ones or even when they anticipate separation.

It's not just infants that experience separation anxiety. Its not uncommon to occur again at school-age. But how do you know if its developmentally normal, or becoming a disorder?

As parents, witnessing our children experiencing separation anxiety can be heart-wrenching. It's natural for children to feel some level of discomfort when apart from their parents or caregivers, but how do we know when it's a typical developmental phase or something more concerning like Separation Anxiety Disorder? We'll explore the difference between developmentally normal separation anxiety and Separation Anxiety Disorder in school-aged children, helping parents better understand their child's emotions and needs.

What is Developmentally Normal Separation Anxiety?
Developmentally normal separation anxiety is a common phase that most children experience as they grow and explore the world around them. Typically, this phase begins around the age of 6 to 7 months and may peak between 1 to 2 years of age. Again, around age 5 years, in time with starting school, separation anxiety can be seen again.  During this time, children may become clingy, cry, or protest when separated from their primary caregivers. This behavior is a sign of healthy attachment and should gradually diminish as the child gains confidence and trust in their environment.

Developmental milestone separation anxiety at around the age of 5 years old is a common and normal experience for many children. At this age, children are entering a new phase of development where they are becoming more independent, curious, and socially engaged. However, they may still experience bouts of separation anxiety, particularly in new or unfamiliar situations. 

Key characteristics of developmental milestone separation anxiety at age 5 +:
1. School-related anxiety: Starting school or transitioning to a new school year can trigger separation anxiety in children. They may feel apprehensive about leaving the comfort of their home or being away from their parents during school hours.

2. Social situations: In group settings or social events, a child may cling to their parent or caregiver initially, especially if they are meeting new people or interacting with larger groups.

3. Fear of unknown environments: Visiting new places or being in unfamiliar surroundings can make a 5-year-old feel anxious and seek reassurance from their parents.

4. Sleep-related anxiety: Some children may experience separation anxiety at bedtime. They may request extra attention, have difficulty falling asleep, or wake up during the night seeking comfort from their parents.

5. Parental departures: Even if a child has been apart from their parents for extended periods before, certain situations or changes in routine may trigger anxiety when their parents leave.

Supporting a child through developmental milestone separation anxiety:
  • Empathize with their feelings: Acknowledge your child's emotions and reassure them that it's okay to feel anxious or worried in new situations.
  • Prepare in advance: Talk to your child about upcoming events, like starting school or visiting new places. Discuss what they can expect and emphasize the positive aspects.
  • Create a predictable routine: Maintaining a consistent daily schedule can provide a sense of security and help reduce anxiety.
  • Encourage independence: Gradually allow your child to explore new environments and social interactions, providing support and encouragement as needed.
  • Offer a transitional object: A comfort item, like a favorite toy or blanket, can provide reassurance when separation anxiety arises.
  • Practice short separations: Start with brief periods of separation and gradually increase the time apart. This can help your child build confidence in coping with separation.
  • Be patient and supportive: Respond calmly and reassuringly to your child's anxiety, showing them that you are available to support and comfort them.

Remember that every child is unique, and the intensity and duration of separation anxiety may vary. Developmental milestone separation anxiety is a natural part of a child's emotional growth, and with time, patience, and understanding, most children will navigate through these challenges and develop increasing independence and resilience. However, if the anxiety becomes severe, persistent, or significantly interferes with the child's daily life, it's essential to seek guidance from a pediatrician or mental health professional for further evaluation and support.

Understanding Separation Anxiety Disorder (SA):
On the other hand, Separation Anxiety Disorder is a more persistent and intense condition that goes beyond the normal developmental phase. Children with SA experience excessive fear and worry about being separated from their primary caregivers, leading to significant distress and impairment in daily functioning.  Children older than 5 years can suffer from SA, at our clinic we often see children around 7 years old on average with a form of SA.  It may be triggered by a traumatic event, bullying, or change in family circumstances.

Symptoms of SA in children may include:

1. Refusal to go to school or leave the house: Children with SA may refuse to go to school or leave the house to avoid separation from their parents or caregivers.

2. Extreme fear or worry about separation: Children with SA may become extremely anxious or distressed when they anticipate separation from their parents or caregivers.

3. Physical symptoms: Children with SA may experience physical symptoms such as headaches, stomachaches, or nausea when faced with separation.

4. Nightmares or sleep disturbances: Children with SA may have difficulty sleeping or experience nightmares about separation.

5. Excessive clinginess: Children with SA may be excessively clingy to their parents or caregivers, even when they are not facing separation.

6. Fear of harm or danger: Children with SA may have an irrational fear that harm or danger will come to themselves or their loved ones while they are separated.

If you suspect that your child may have SA, you can try self help strategies first and it's also important to speak with a mental health professional for an accurate diagnosis and treatment plan.  Erinnah's Treehouse is a uniquely developed online program for kids to do themselves as a self guided therapy program.  Treatment for SA may include cognitive-behavioral therapy (CBT) or play therapy. CBT can help children learn coping skills and strategies to manage their anxiety. 
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