Separation Anxiety Disorder

Separation Anxiety Disorder is a condition in which children four years of age or older experience distress when being
separated from their parents or other individuals, to whom they are closely attached. In addition to experiencing anxiety
and distress at school or in other situations that separate them from their parents, children with this disorder cling to
their parents when they are at home, following them around the house, trying to sleep in their bedroom, and resisting
being left with baby sitters.

Being separated from a parent may be a traumatic time for a child, especially if he or she is not old enough to
understand the circumstances of the separation. It is usually overcome when the child's attention is diverted or he or
she adapt to the surroundings. For some children, the anxiety of being away from a parent or loved one is too
overwhelming to comprehend, and causes severe emotional stress.

These children have difficulty falling asleep by themselves at night. When separated, they may fear that their parent will
be involved in an accident or taken ill, or in some other way be gone to the child forever. Their need to stay close to
their parent or home may make it difficult for them to attend school or camp, stay at friends’ houses, or be in a room
by themselves. Separation anxiety disorder almost always occurs in children.

Symptoms

Fear of separation in separation anxiety disorder can lead to symptoms of dizziness, nausea or palpitations and is also
associated with the symptoms of depression, sadness, withdrawal, apathy and concentration challenges. Some children
also develop physical symptoms, such as headaches or stomachaches, at the thought of being separated. Young
children even suffer from fear and experience nightmares with separation anxiety disorder. Separation anxiety disorder
may run in families and is likely to affect shy, nervous children.

Causes

The cause of separation anxiety disorder is not clearly known although some risk factors have been identified.
Separation anxiety disorder is triggered by major changes in the child’s life such as death, hospitalization, divorce, a
move to a new school, significant family stress, or trauma especially physical or sexual assault can trigger separation
anxiety disorder. The symptoms of separation anxiety disorder are displayed in a number of ways as diverse as temper
tantrums, nightmares, fear of the dark, physical symptoms, and lack of concentration.

Separation anxiety disorders in children are equally distributed between the sexes, although separation anxiety disorder
according to surveys is higher in girls. The remission rate is high with separation anxiety disorder. Children affected
with separation anxiety disorder tend to emerge from close-knit families and although separation anxiety disorder tends
to run in families, the exact role of environmental and genetic factors is yet to be established.

Separation anxiety disorder in children or adolescents should not be confused with the normal separation anxiety
experienced in infants and toddlers. To reach the diagnostic threshold for this disorder, the anxiety or fear must cause
distress or affect social and academic functioning. If an older child continues to react to potential separations with
unreasonable fear, separation anxiety disorder may be diagnosed. Without professional help this disorder can damage a
child’s self image and ultimately lead to adult emotional problems.

Treatments

Most mild cases of separation anxiety disorder do not need medical treatment. In more severe cases or when the child
refuses to go to school, treatment may be needed. The goals of treatment include reducing anxiety in the child,
developing a sense of security in the child and the caregivers, and educating the child and family/caregivers about the
need for natural separations.

Psychotherapy (a type of counseling) is the main treatment approach for separation anxiety disorder. The focus of
therapy is to help the child tolerate being separated from the caregivers without the separation causing distress or
interfering with function. A type of therapy called cognitive-behavioral therapy works to reshape the child's thinking
(cognition) so that the child's behavior becomes more appropriate. In cognitive-behavioral therapy, a related therapy,
patients learn to react differently to the triggers of anxiety attacks. They also learn to understand how their thinking
patterns contribute to their symptoms and how to change their thoughts to reduce or prevent the symptoms. Family
therapy also may help teach the family about the disorder and help in teaching better support for the child during
periods of anxiety.

There is no known way to prevent separation anxiety disorder, but recognizing and acting on symptoms when they
appear can minimize distress and prevent problems associated with not going to school. In addition, reinforcing a
child's independence and self-esteem through support and approval may help prevent future episodes of anxiety. Most
children with separation anxiety disorder get better, although their symptoms may recur for many years, particularly
when stressful events or situations occur. When treatment is started early and involves the family as well as the child,
the child's chance of recovery improves. Most patients respond well to treatment, and the success rates among those
who receive treatment are usually very high, allowing patients to return to productive, fulfilling lives