What is Separation Anxiety Disorder?
When babies are less than 7 months of age they are willing to share their smiles with everyone and are happy to be comforted by almost any caring and loving individual. After 7 months however, infants are more aware of their dependence on their primary caregivers and begin forming very strong relationships with them.
A once care-free child can all of a sudden become very attached and increasingly more upset at the notion of being left at daycare or with the babysitter. This is an important developmental stage where babies suddenly become wary of strangers and both concerned and anxious when familiar people leave the room or house.
Until a child reaches the age 3 or 4 years, Separation Anxiety disorder in children is considered routine and a healthy part of development. It becomes a diagnosable disorder when the anxiety and fear become excessive, or beyond what is expected for the child’s age.
Children with Separation Anxiety often have unrealistic fears of being separated from the important people in their lives and are persistently worried that something terrible will happen to them. They can become clingy, tearful and may refuse to go to school or even leave the house. In some cases they are even afraid of sleeping in their own room separate from their parents.
Diagnosing Separation Anxiety Disorder
Symptoms of Separation Anxiety disorder in children vary, but common symptoms can include:
- Clingy behavior and tearfulness on being left alone, or the idea of being left alone
- Fear that something terrible will happen to their loved ones if they leave
- Fear of being abandoned – that loved ones will not return
- Fear that harm will come to them if they are without their family
- Nightmares and difficulty falling asleep without a familiar person in the room with them
- ‘Shadowing’ parents and following them around the house, from room to room
- Refusal to go to school
- Frequent tantrums when the parent or primary caregiver leaves them in the care of others.
- Unrealistic fears: such as a fear of the dark, monsters, or burglars
- Physical symptoms such as headaches or stomachaches that have no physical cause
The common age of onset for Separation Anxiety disorder in children is between 7 and 11 years, affecting both girls and boys equally. Although less common, it can also develop in the teenage years.
Recent studies have indicated that although the disorder affects as many as 4% of school-going children, the rate of recovery is high (with most children eventually growing out of their Separation Anxiety).
However, if Separation Anxiety is left untreated, children suffering with the disorder are at higher risk of developing other related anxiety disorders such as phobias in their adult years. With appropriate treatment, a child can learn to cope with and resolve these excessive fears.
Should your child present with these symptoms, a medical practitioner will give him or her a physical examination and obtain a complete medical history to rule out any possible medical conditions that may result in similar symptoms such as thyroid problems or side-effects of some conventional drugs or medication. This may involve blood tests and urine analysis, or other medical checks that your health care professional may deem necessary.
If a medical condition is ruled out, you may be referred to a child psychologist or other qualified mental health practitioner who will do further assessments before a diagnosis is made. You will be asked about your child’s developmental history, family history and any other information that is needed.
You will also be asked to describe your child’s behavior and the situations in which the anxiety occurs. Other assessment tools such as questionnaires and observations may also be applied. Once a diagnosis is made, be sure to ask about all possible treatment options and explore which ones would best suit your child!
While many professionals are quick to recommend prescription drugs, these are not always necessary for a successful recovery and it is important to explore all your options before making any decisions!
What Causes Separation Anxiety Disorder?
Genetics – Children whose parents have an anxiety disorder are more likely to develop Separation Anxiety Disorder than others. This suggests that a tendency towards anxiety may be genetic. Other personality traits may also make a child more susceptible to the disorder - for example shyness.
Past Experience and Stress – Certain traumatic past experiences may make a child more vulnerable to the disorder than others. Loss of a loved one as a result of death or divorce, a lengthy hospital stay or other traumatic separation may also ‘teach’ your child that bad things happen and the world is not a safe, constant place. Other stressful life events, especially those involving great change such as moving house or changing school, also seem to increase susceptibility.
Learnt behavior – Overly anxious or over-protective parents may inadvertently instill fears in their children. In other cases parents may be practicing poor parenting techniques relating to separation - thus making departures a difficult time for their child. (For example, some parents think that by sneaking off quietly, they avoid making their child anxious when this tends to do the opposite.)
Help for Separation Anxiety Disorder
Separation anxiety is usually treated with some form of psychotherapy and/or prescription medication - although there is much controversy about putting children on schedule drugs.
Alternative treatments for easing separation anxiety such as relaxation and deep breathing techniques as well as herbal and homeopathic remedies may be very helpful along with psychotherapy – and are less harmful to growing children.
As with other psychological ailments, a holistic approach has proven beneficial in easing separation anxiety, while also incorporating mainstream and complementary treatments along with balanced diet and exercise.
Treatment Options For Separation Anxiety Disorder
Some form of Psychotherapy is generally recommended for easing separation anxiety and there are a number of options to explore depending on the needs of your child and family.
- Cognitive Behavioral Therapy (CBT) – helps your child recognize the thoughts that trigger the anxious emotions. It will address any unrealistic thoughts and provide coping techniques to help them change their behavior.
- Insight therapy – helps your child recognize and deal with the underlying issues surrounding the Separation Anxiety Disorder such as a past loss, or fear of change.
- Play therapy, especially with younger children, can be very effective in helping to build self esteem and confidence and to learn how to ‘banish’ the anxiety
- Family therapy – may be beneficial to help your family deal with the affects of your child’s disorder, as well as any other family problems that may be contributing to your child’s symptoms.
Natural Herbal and Homeopathic Remedies
Herbal and homeopathic remedies provide a safe, non-addictive and side-effect free option for children. Certain remedies may help relieve your child’s anxiety and serve to sooth your child’s panicked state.
In unity with a holistic approach, these herbal and homeopathic remedies, along with psychotherapy, can help bring your child peace of mind in a gentle, natural way.
Some commonly recommended remedies include Hypericum perforatum (St John’s Wort), Passiflora incarnata, Scuttelaria laterifolia (Scullcap), as well as carefully formulated homeopathic remedies.
Be sure to discuss any natural remedies you’re considering with your practitioner if used in conjunction with prescription medication. Also remember that not all natural remedies are suitable for children and those that are need to be formulated to certain therapeutic standards in order to be effective and safe. Source your natural remedies from a reputable company to avoid problems!
Practitioners are often quick to prescribe high schedule medication as the first option to manage your child’s anxiety. It is important to remember that medication only relieves the anxiety without solving any underlying problems, and if this option is taken, it should be done along with some form of psychotherapy for best results. The most commonly prescribed drugs are:
- Anti-anxiety drugs - Benzodiazepines such as alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin) and diazepam (Valium) create a sedative affect to reduce anxiety, although have been criticized for their addictive qualities.
- Anti-depressant drugs – which include fluoxetine (Prozac), paroxetine (Paxil), imipramine (Tofranil), and escitalopram (Lexapro) adjust the neurotransmitter levels in your brain to try and relieve anxiety.
It is strongly advised that you thoroughly research any prescription medication and its side-effects before deciding on what would be the best option for your child.
More Information on Separation Anxiety Disorder
Other Disorders Related to Separation Anxiety Disorder
Yes! Separation Anxiety Disorder is related to other anxiety conditions such as:
- Obsessive-Compulsive Disorder (OCD)
- Social Anxiety Disorder
- Specific Phobias (Particularly school phobia)
- Panic Disorder
Tips for Coping with Age-appropriate Separation Anxiety
While age-appropriate Separation Anxiety is not considered a disorder, it may be a difficult time for both you and your child. There are a number of ways to help your child deal with this phase:
- Prepare your toddler or child in advance if you are planning to leave him or her with someone else or when beginning day-care or school. Help children to familiarize themselves with the new setting or new people before leaving them alone.
- Ease your child into being left alone. When you leave children with a new sitter or at crèche for the first time, make sure it is not for an extended period of time.
- Children quickly notice if you are feeling emotional and nervous about leaving them and may begin to feel anxious themselves. Although this may be an anxious time for you as well, try making light of the situation and keep your tears for after you leave. Make it seem that you have absolute confidence in the people you leave your child with.
- When you leave, reassure your child that you will be back and give an honest time when you can be expected to return. Try not to be late if your child is waiting for you!
- Always say good-bye to your child. Don’t try and avoid the fuss by sneaking out unnoticed or slipping off while children are busy. This will just reinforce the abandonment fear, and increase the anxiety that you may disappear at any moment if you aren’t in sight.
- Make good-byes happy and affectionate. Give children a hug and a kiss and assure them that you’ll be back, but do not prolong the good-byes. Routine and rituals are often beneficial as your child will come to know exactly what to expect. Little habits like a high-five through the window, or blowing a kiss as you leave are often reassuring events that your child will begin to look forward to.
- When you say good-bye, you should leave. Avoid trips backwards and forwards into the house after you have said good-bye as this will give your child false hope and make it more difficult for all involved.
- A nice idea is to give your child something to look forward to. If you have left for an evening appointment and will only return when he or she has gone to sleep, say you will leave a surprise next to the bed – to find when waking up the next morning. (Remember that food is not always the best reward, so instead of sweets, draw a picture, or pick few flowers)