Separation Anxiety Disorder

By Medically reviewed by hellodoktor


What is separation anxiety disorder?

Separation anxiety is the fear or distress that can happen to both children and adults when they think about separating from home or from the people they’ve become attached to. Separation anxiety refers to excessive fear or anxiety about separation from home or an attachment figure.

How common is separation anxiety disorder?

Separation anxiety is a normal part of childhood development. It commonly occurs in babies between 8 and 12 months old, and usually disappears around age 2. However, it can also occur in adults. Please discuss with your doctor for further information.


What are the symptoms of separation anxiety disorder?

The common symptoms of separation anxiety disorder are:

  • Recurrent and excessive distress about anticipating or being away from home or loved ones
  • Constant, excessive worry about losing a parent or other loved one to an illness or a disaster
  • Constant worry that something bad will happen, such as being lost or kidnapped, causing separation from parents or other loved ones
  • Refusing to be away from home because of fear of separation
  • Not wanting to be home alone and without a parent or other loved one in the house
  • Reluctance or refusing to sleep away from home without a parent or other loved one nearby
  • Repeated nightmares about separation
  • Frequent complaints of headaches, stomachaches or other symptoms when separation from a parent or other loved one is anticipated

Separation anxiety disorder may be associated with panic disorder and panic attacks ― repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you or your children have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes separation anxiety disorder?

Separation anxiety is a normal stage in an infant’s development. It helped keep our ancestors alive and helps children learn how to master their environment. It usually ends at around age 2, when toddlers begin to understand that a parent may be out of sight right now but will return later. Sometimes, separation anxiety disorder can be triggered by life stress that results in separation from a loved one. Genetics may also play a role in developing the disorder.

Risk factors

What increases my risk for separation anxiety disorder?

There are many risk factors for separation anxiety disorder, such as:

  • A family history of anxiety or depression
  • Shy, timid personalities
  • Low socioeconomic status
  • Overprotective parents
  • A lack of appropriate parental interaction
  • Problems dealing with kids their own age
  • A major life event such as a divorce or the death of a loved one

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is separation anxiety disorder diagnosed?

Diagnosis of separation anxiety disorder involves determining whether your child is going through a normal stage of development or the issue is actually a disorder. After ruling out any medical conditions, your child’s pediatrician may refer you to a child psychologist or child psychiatrist with expertise in anxiety disorders.

To help diagnose separation anxiety disorder, your mental health professional will likely give your child a psychological evaluation, including a structured interview that involves discussing thoughts and feelings, as well as observing behavior. Separation anxiety disorder may occur along with other mental health problems.

How is separation anxiety disorder treated?

Separation anxiety disorder is usually treated with psychotherapy, sometimes along with medication. Psychotherapy, sometimes called talk therapy or psychological counseling, involves working with a therapist to reduce separation anxiety symptoms.

Cognitive behavioral therapy (CBT) is an effective form of psychotherapy for separation anxiety disorder. During therapy your child can learn how to face and manage fears about separation and uncertainty. In addition, parents can learn how to effectively provide emotional support and encourage age appropriate independence.

Sometimes, combining medication with CBT may be helpful if symptoms are severe. Antidepressants called selective serotonin reuptake inhibitors (SSRIs) may be an option for older children and adults.

Parent-child interaction therapy is another way to treat SAD. It has three main treatment phases:

  • Child-directed interaction (CDI), which focuses on improving the quality of the parent-child relationship. It involves warmth, attention, and praise. These help strengthen a child’s feeling of safety.
  • Bravery-directed interaction (BDI), which educates parents about why their child feels anxiety. Your child’s therapist will develop a bravery ladder. The ladder shows situations that cause anxious feelings. It establishes rewards for positive reactions.
  • Parent-directed interaction (PDI), which teaches parents to communicate clearly with their child. This helps to manage poor behavior.

There are no specific medications for SAD. Antidepressants are sometimes used in older children with this condition if other forms of treatment are ineffective. This is a decision that must be carefully considered by the child’s parent or guardian and the doctor. Children must be monitored closely for side effects.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage separation anxiety disorder?

The following lifestyles and home remedies might help you cope with separation anxiety disorder:

  • Learn about your child’s separation anxiety disorder. Talk to your child’s mental health professional to learn about the disorder and help your child understand it.
  • Stick to the treatment plan. Make sure to keep the therapy appointments for your child. Consistency makes a big difference.
  • Take action. Learn what triggers your child’s anxiety. Practice the strategies developed with the mental health professional so you’re ready to deal with your child’s anxious feelings during separations.
  • Demonstrate calm support. Encourage your child or loved one to try new experiences, experience separation and develop independence with your support.
  • Practice goodbyes. Leave your child with a trusted caregiver for short periods of time to help your child learn that he or she can count on you to return.

There’s no sure way to prevent separation anxiety disorder in your child, but these recommendations may help.

  • Seek professional advice as soon as possible if you’re concerned that your child’s anxiety is much worse than a normal developmental stage. Early diagnosis and treatment can help reduce symptoms and prevent the disorder from getting worse.
  • Stick with the treatment plan to help prevent relapses or worsening of symptoms.
  • Seek professional treatment if you have anxiety, depression or other mental health concerns, so that you can model healthy coping skills for your child.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: February 27, 2019 | Last Modified: September 13, 2019

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