For some children and parents, the drop-off at daycare or school is the worst part of the day. Every. Single. Day.
There are even children that struggle with their parents or caregivers leaving the room or being out of eyesight.
This level of separation anxiety can be mentally and emotionally for both parties.
If this is you, take a deep breath. I’m here to tell you that there are ways to help your child gain a sense of security and be more comfortable. Let’s walk through the signs, causes, and treatments of separation anxiety disorder together. You can do this!
What Is Separation Anxiety Disorder?
Separation anxiety disorder (SAD) most often presents itself as an intense fear of being physically separated from family or loved ones.(1)
Other symptoms of separation anxiety disorder include:
● Temper tantrums or panic attacks at times of separation(1)
● Refusal to go to school or daycare
● Refusal to sleep alone
● Intense nightmare about separation
● Excessive worry about losing family members
● Frequent headaches, stomachaches, and muscle aches
● Being very clingy when with caregiver
● Refusal to leave home
SAD is diagnosable when a child is experiencing the above symptoms for 4 weeks or longer and the symptoms significantly impact their daily life.(4) Approximately 4 to 5% of children have clinical SAD.(5) Around 65% of children with SAD also suffer from another psychological disorder.(6)
To listen to my Genius Little Minds podcast episode about separation anxiety disorder and other anxiety disorders that children can experience, click here.
What Causes Childhood Separation Anxiety?
You may find yourself asking, ”Does that mean that some separation anxiety is normal?”
Yes! Separation anxiety is often developmentally typical for infants, toddlers, and young children. Infants typically go through a phase between seven and ten months in which separation from the primary caregiver is difficult. During this time, and even into toddlerhood, simply focusing on forming a secure attachment in your child is all the treatment separation anxiety needs. Even up to the age of three, separation anxiety is normal.(2)
Clinical separation anxiety disorder is likely caused by both environmental factors and an imbalance of norepinephrine and serotonin in the brain. The most common time for a child to start exhibiting symptoms of SAD is between the age of seven and ten years old.(1) It can start, though, at any time, even through the teenage years and into adulthood.(2)
It often shows up after a long break from school due to holidays, vacations, or an illness. Significant life events, such as death of a loved one, parents getting divorced, or moving, can also cause SAD.
Separation anxiety disorder has not been found to affect one gender more than the other.(5) A parent having an anxiety disorder does make the child more likely to experience SAD.(1)
How Do You Help a Child With Separation Anxiety?
There are many ways that you can help your child cope with typical childhood separation anxiety.
1. Read Books About Separation Anxiety
Many books have been written on childhood separation anxiety. There is, however, a great need for a therapeutic book that helps the child overcome separation anxiety disorder. Coming out soon is Charlie Cub Is Afraid To Leave His Mother, which uses cognitive behavioral therapy techniques to address this exact issue.
Cognitive Behavioral Therapy (CBT) helps children recognize their thought patterns and identify where and when those patterns help and where they hurt. In other words, how we think and act affects how we feel. My book uses Graded Exposure, which is a stepladder approach, as part of CBT. The child slowly and systematically faces his fears and reduces the symptoms of his anxiety.
In Charlie Cub Is Afraid To Leave His Mother, Charlie Cub wants to go to sleepovers, but he’s afraid to leave his mother. To overcome his fear, he uses a stepladder process to gradually expose himself to being away from his mother. With patience and courage, Charlie manages his anxiety and reaches his goal of going to a pajama party.
Through storytelling, my I’M AFRAID Anxiety Disorder Series teaches children to manage their anxiety symptoms. This book focuses on Separation Anxiety and includes an About Anxiety page along with a Coping Strategies page and a Stepladder page. Parents and mental health professionals will appreciate this series aimed at relieving children’s anxiety symptoms.
Charlie Cub Is Afraid To Leave His Mother can be pre-ordered by clicking here.
Other good book options for more age-appropriate, non-clinical separation anxiety are:
● The Kissing Hand by Audrey Penn
● Llama Llama Misses Mama by Anna Dewdney
● I Love You All Day Long by Francesca Rusackas
● The Invisible String by Patrice Karst
Social stories
Social stories are stories that show a child exactly what is about to happen. To treat separation anxiety, the social story would show the child getting ready, heading to daycare (or wherever your child goes), getting dropped off, processing their feelings, and then being okay playing. The story could be tweaked and modified to show exactly what your child will be experiencing.
These stories help your child know what’s going to happen, what they may be feeling, and how to handle those emotions.
Many parents and teachers simply draw pictures and bind them together in a book to make a social story catered to one specific child. I know what you’re thinking…I’m no artist! Trust me; your child will love seeing your art as much you love seeing theirs. And the personal, handmade aspect will pique their interest in what the book has to say.
2. Set Expectations, Prepare Them for What Will Happen
Even if you choose not to use social stories or your child is too old for them, just talking about what to expect can serve the same purpose. Try to anticipate what new situations may be stressful to them and have a conversation with them beforehand. Discuss what they may feel in the situation and how they can handle those feelings.
For older children, it can be very helpful to talk about past events. Talk about how every time that you have left them, you have come back to them safe and sound. This often will not work the first time and definitely will not calm a child that is very upset. But reminding them of this often may eventually decrease their anxiety.
3. Get Them Help from a Professional
It can be difficult to determine when your child is just wanting to spend more time with you and when they are truly struggling with separation anxiety. To read more about how to tell when your child is just going through a phase and when they need mental health help, check out my article here.
Knowing that seeking outside help is the next step you need to take can be scary. But your pediatrician can help guide you. Oftentimes your child will be evaluated to rule out any physical problems.
Then your child’s doctor may suggest different treatment options, such as cognitive-behavioral therapy, medication, family therapy, or interventions at school. It is important to get your child the proper treatment as untreated SAD can lead to panic disorder or another anxiety disorders in adulthood.(3)
Separation anxiety can feel like an insurmountable issue when your child is experiencing it. But rest assured! There are paths to getting your child happy and healthy again.
Pre-order Charlie Cub Is Afraid To Leave His Mother HERE. To check out other books in the I’M AFRAID anxiety disorder series, visit: www.DrMadeleineVieira.com/books/imafraid
To stay up-to-date on all my articles on childhood mental health, be sure to subscribe to my newsletter!
References
https://childmind.org/guide/quick-guide-to-separation-anxiety-disorder/
Masi, G., Mucci, M. & Millepiedi, S. Separation Anxiety Disorder in Children and Adolescents. Mol Diag Ther 15, 93–104 (2001). https://doi.org/10.2165/00023210-200115020-00002
Francis, G., Last, C.G. & Strauss, C.C. Expression of separation anxiety disorder: The roles of age and gender. Child Psych Hum Dev 18, 82–89 (1987). https://doi.org/10.1007/BF00709952
Mohammadi MR, Badrfam R, Khaleghi A, Hooshyari Z, Ahmadi N, Zandifar A. Prevalence, Comorbidity and Predictor of Separation Anxiety Disorder in Children and Adolescents. Psychiatr Q. 2020 Dec;91(4):1415-1429. doi: 10.1007/s11126-020-09778-7. PMID: 32418141.