Separation Anxiety Disorder: Symptoms in Adults & Children and Treatment

Introduction to Separation Anxiety Disorder

Separation Anxiety Disorder can impact anyone, irrespective of age, often leading to debilitating effects on emotional and mental well-being. While it is more commonly associated with children, the condition can persist into adulthood, affecting relationships, work, and everyday functioning.

Separation Anxiety Disorder involves excessive fear or anxiety about separation from individuals with whom the person is emotionally attached - whether it's a parent, partner, or another close figure. If left unaddressed, this condition, can worsen and lead to additional mental health issues such as depression or generalised anxiety.

Separation anxiety is often misunderstood as a normal part of childhood, which it is to some extent. However, when it becomes persistent, overwhelming, and interferes with daily life, it is classified as a mental health disorder. It is not limited to children, and adults can also experience this disorder when their relationships or attachment figures are threatened or disrupted.

This article aims to provide a comprehensive understanding of what is separation anxiety disorder in children and adults, its causes, symptoms, and available treatment options.

What is Separation Anxiety Disorder?

Separation Anxiety Disorder is characterised by an intense, excessive fear of being away from a significant person or place i.e. parent or home. This fear exceeds what would be expected for the individual’s age and development. It lasts for an extended period and interferes with daily functioning.

Is separation anxiety a mental illness?

Yes, the DSM-5 defines Separation Anxiety Disorder as inappropriate and excessive worry concerning separation, leading to distress in various life areas, including school, work, or social interactions.

While mild separation anxiety is normal in early childhood like when a child first starts school, Separation Anxiety Disorder extends beyond what is developmentally appropriate. In adults, it can manifest as a heightened fear of being separated from their partner or other close individuals, often leading to significant impairment in personal relationships.

According to studies, the prevalence of Separation Anxiety Disorder is about 4-5% in children and 1-2% in adults. The disorder can manifest at any age, but its onset is typically before 18 years.

Recognising Separation Anxiety Disorder as a mental health disorder is crucial because early intervention can prevent further emotional and psychological distress.

5 Causes of Separation Anxiety Disorder

What triggers separation anxiety disorder is believed to stem from a combination of genetic, environmental, and psychological factors. Here are some of the key causes of separation anxiety disorder:

1. Genetic Predisposition: Research indicates that anxiety disorders, including Separation Anxiety Disorder, often run in families. Individuals with a family history of anxiety or mood disorders may be more prone to developing Separation Anxiety Disorder.

2. Traumatic Experiences: Events such as parental divorce, the death of a loved one, or moving to a new home can trigger separation anxiety in children and adults. The sudden disruption of an attachment figure can lead to heightened feelings of insecurity and fear of further loss.

3. Environmental Factors: Changes in the immediate environment, such as starting school or moving to a new city, can also provoke anxiety. For adults, experiencing major life transitions like changing jobs or losing a significant relationship may exacerbate these fears.

4. Underlying Mental Health Conditions: Individuals with pre-existing conditions like generalised anxiety disorder, depression, or post-traumatic stress disorder (PTSD) are more likely to experience Separation Anxiety Disorder.

5. Overprotective Parenting: Children raised in overly protective environments might struggle to develop independence and self-soothing mechanisms. This can contribute to the onset of separation anxiety disorder. Similarly, adults in codependent relationships may face similar challenges when separated from their attachment figures.

Understanding the root cause of Separation Anxiety Disorder is vital in tailoring treatment approaches and ensuring long-term recovery.

Separation Anxiety in Children

If you’re wondering when does separation anxiety start?

Separation anxiety typically begins to manifest between the ages of 6 months and 3 years. During this developmental phase, it is normal for children to become upset when a caregiver leaves, as they are still learning that absences are temporary. 

If separation anxiety is normal in children of this age, how do you know if your child has a separation anxiety disorder?

When the anxiety becomes intense and long-lasting, interfering with a child’s ability to attend school or social activities, it may signal the presence of a disorder.

There are three stages of separation anxiety in children:

• Protest: The child wants you to stay
• Despair: The child cries and withdraws
• Detachment: The child holds together until you come back

Common situations where separation anxiety is triggered in children include starting daycare, preschool, or school for the first time. Symptoms may include: 

• Refusing to go to school
• Excessive worry about the safety of their caregiver
• Frequent nightmares about separation
• Headaches or stomach aches when faced with separation
• Difficulty forming relationships outside their immediate family
• Academic difficulty due to frequent absences or inability to focus in class

If unaddressed, separation anxiety disorder in children can impair social, emotional, and cognitive development. 

Separation Anxiety in Adults

Though often associated with childhood, separation anxiety can persist or emerge in adulthood, particularly in the context of close relationships. Experiences of separation anxiety in adults from partners, children, or pets are commonly observed.

What does separation anxiety feel like in adults? Symptoms that may manifest as the following:

• Intense fear of something happening to their loved one 
• Irrational fear that they will never be reunited
• Clinginess
• Constant checking in
• Refusal to spend time apart 
• Codependency, jealousy, and emotional strain
• Find it challenging to hold jobs requiring travel or long hours away from home
• Difficulty sleeping when apart from a loved one
• Excessive worry about their loved one’s well-being
• Nausea or headaches when separated from their loved one

These symptoms can disrupt daily life and strain personal relationships if left untreated.

Symptoms of Separation Anxiety Disorder

Here are separation anxiety disorder symptoms to watch out for:

Emotional Symptoms of Separation Anxiety

Separation anxiety disorder is marked by intense emotional reactions when anticipating or experiencing separation. Emotional symptoms can include:

• Excessive Worry: Individuals may constantly worry about the safety and well-being of their attachment figures.
• Fear of Abandonment: There is an irrational fear that separation will lead to permanent loss.
• Distress during Separation: Children may cry or tantrum, while adults may experience panic or extreme anxiety.
• Low Mood: Prolonged separation anxiety can lead to feelings of Separation Anxiety Disorderness, hopelessness, or depression.

Physical Symptoms of Separation Anxiety

Can separation anxiety cause physical symptoms? Yes, separation anxiety can also manifest physically, particularly in children, but adults may experience these symptoms too:

• Headaches and Stomachaches: These common stress responses often accompany anxiety.
• Sweating and Trembling: Physical signs of panic or distress when faced with separation.
• Nausea: Feelings of queasiness are frequent among individuals with severe anxiety.
• Panic Attacks: In extreme cases, separation can lead to full-blown panic attacks with symptoms such as rapid heartbeat, difficulty breathing, and dizziness.

Behavioural Symptoms of Separation Anxiety

Separation anxiety disorder symptoms include behaviours that often interfere with daily life and relationships, including:

• Refusal to Leave: Children may refuse to go to school or leave home, while adults may avoid work or social gatherings.
• Clinginess: Children may follow their caregivers constantly, while adults may be overly dependent on their partner or attachment figure.
• Social Withdrawal: Individuals may avoid any situation that involves separation, limiting their social interactions.

How Separation Anxiety Affects Relationships

Separation anxiety in adults from partners can have a profound effect on relationships, particularly romantic ones.

Why do I have separation anxiety from my partner?

When one partner experiences extreme anxiety about being away from the other, it can create a cycle of dependency and strain. The anxious partner may constantly seek reassurance, leading to jealousy, controlling behaviour, and a lack of trust.

Over time, this anxiety can lead to codependent relationships where one person becomes overly reliant on the other for emotional stability. This dynamic can be exhausting for both partners, leading to emotional burnout, frustration, and resentment.

In some cases, separation anxiety in relationships can lead to avoidance of activities that require time apart, such as work trips, social outings, or hobbies. Overcoming this anxiety is essential to maintain a healthy balance in the relationship.

How to Cope with Separation Anxiety Without Medication for Children and Adults?

A. Separation Anxiety Coping Strategies for Children

Addressing how to deal with separation anxiety in children involves creating a supportive environment that fosters security and confidence. Here are some effective separation anxiety disorder treatments for helping children manage and overcome separation anxiety:  

1. Gradual Exposure

Gradual exposure is a crucial technique for helping children adjust to separation. This approach involves slowly increasing the child’s time apart from their attachment figure. Start with brief, manageable separations of a few minutes, and gradually extend the duration as the child becomes more comfortable. 

For example, begin by having the child play with a caregiver in a different room, then move to short periods at school or with a babysitter. The key is to ensure that each step is successful before progressing to longer separations, allowing the child to build confidence and reduce anxiety gradually.

2. Establish Daily Routines

Consistent routines provide children with a sense of stability and predictability, which can significantly reduce separation anxiety.

Establishing regular schedules for daily activities, such as meal times, bedtime, and school drop-offs, helps children understand what to expect and feel more secure. 

Routines should be clear and consistent, helping children to know what will happen next and reducing feelings of uncertainty. Additionally, having a consistent goodbye ritual, like a special hug or a short goodbye phrase, can ease the transition during separations.

3. Positive Reinforcement

Positive reinforcement involves acknowledging and rewarding children for their efforts, and successes in managing separations. Praise and rewards for handling short periods of separation can reinforce positive behaviour, and encourage children to face separations more confidently. 

For example, offer verbal praise, stickers, or a small treat when the child successfully manages a brief separation. Positive reinforcement helps children associate separations with positive outcomes, which can reduce anxiety over time.

4. Create Transitional Objects

Transitional objects, such as a favourite stuffed toy, blanket, or personal item, can provide comfort and a sense of security when a child is apart from their primary caregiver. These objects are a tangible reminder of the caregiver’s presence and can help soothe the child during separation. 

Encourage the child to bring their transitional object with them to places where they might experience anxiety, such as school or daycare. Over time, the comfort provided by these objects can help ease the child’s fears and make separations more manageable.

By incorporating these strategies, parents and caregivers can support children in developing resilience and confidence in managing separations. Consistency, patience, and positive reinforcement are essential in helping children navigate their anxiety and build a sense of security. 

If separation anxiety persists or significantly impacts the child’s daily functioning, seeking guidance from a mental health professional can provide additional support and tailored interventions.

B. Separation Anxiety Coping Coping Strategies for Adults

Adults experiencing separation anxiety disorder symptoms can benefit from a variety of coping strategies aimed at reducing symptoms and improving overall well-being. Here’s how to deal with separation anxiety without medication:

1. Mindfulness and Relaxation Techniques

Mindfulness practices can help adults manage separation anxiety by fostering a sense of calm and present-moment awareness.

Techniques such as deep breathing exercises, meditation, and progressive muscle relaxation are particularly beneficial.

Deep breathing helps regulate the body’s stress response, allowing individuals to remain grounded during time apart. Know how anxiety causes shortness of breath?

Meditation practices, including guided imagery or mindfulness meditation, can reduce intrusive thoughts and emotional distress.

Progressive muscle relaxation involves tensing and slowly releasing different muscle groups which can alleviate physical tension.

2. Strengthen Social Support Systems

Building a strong network of supportive relationships is crucial for managing separation anxiety.

Engaging with friends, family, or support groups can provide emotional reassurance and practical assistance, reducing the feeling of being alone during time apart from their loved ones. 

Regular social interactions offer emotional support and contribute to feeling secure and belongingness.

It’s important to nurture these relationships and seek social connections beyond the primary attachment figure to mitigate feelings of dependency.

3. Emotional Independence

Developing emotional independence is key to managing separation anxiety. This can be achieved by pursuing personal interests, hobbies, and goals that provide a sense of fulfilment and self-worth.

Engaging in activities that bring joy and satisfaction can distract from anxious thoughts and promote a healthier sense of self. 

Setting personal goals and working towards them helps build confidence and resilience, reducing the reliance on one individual for emotional support.

By focusing on personal growth and self-care, adults can handle separations better. 

Integrating these coping strategies into daily life can significantly help adults manage separation anxiety.

While these techniques are beneficial, individuals must seek professional help if their symptoms are severe or persistent.

Treatment Options for Separation Anxiety Disorder

1. Therapy

Therapy is often the first line of separation anxiety disorder treatments.

a.Cognitive behavioural therapy (CBT). It is particularly effective as it helps individuals identify and challenge their anxious thoughts, gradually reducing their fears. 

b.Exposure therapy. It is another effective therapy for separation anxiety disorder that encourages individuals to face their fears of separation in controlled, gradual steps, reducing the intensity of their anxiety over time.

c.Family therapy. Since separation anxiety disorder often involves significant relationships, family therapy can be an effective treatment. This form of therapy focuses on improving communication and building healthier, more supportive relationships within the family, helping all members manage their anxiety.

2. Medication

In severe cases, separation anxiety disorder treatments include medication to help manage symptoms. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed as generalized anxiety disorder medication (GAD) and other anxiety concerns as they help balance neurotransmitters in the brain that regulate mood. Individuals need to work closely with a mental healthcare provider to monitor the effects of the medication and make any necessary adjustments.

3. Lifestyle Changes

How to deal with separation anxiety in your daily routine? Lifestyle changes can play a crucial role in managing and complementing separation anxiety disorder treatments. 

a. Structured routine. Building a structured routine can create a sense of stability, reducing anxiety related to uncertainty and separation. 

b. Physical activity. Incorporating physical activity, such as walking or yoga, helps release endorphins which naturally elevate mood and ease anxiety symptoms. 

c. Practising Mindfulness. Mindfulness techniques like meditation and deep breathing can calm the mind during distressful moments. 

d. Social connections. Nurturing social connections beyond a single attachment figure is essential, as it helps build emotional resilience and reduces dependency. 

e. Personal hobbies. Pursuing personal hobbies and interests can foster independence, providing a healthy distraction from anxious thoughts. 

f.Diet and sleep. Finally, adequate sleep, balanced nutrition, and minimising caffeine intake are key factors in supporting overall mental health and well-being, helping manage the symptoms of Separation Anxiety Disorder more effectively.

Frequently Asked Questions

Q1. Can separation anxiety cause panic attacks?

Yes, separation anxiety can lead to panic attacks in some individuals. Both children and adults with Separation Anxiety Disorder may experience overwhelming fear, excessive worry, and physical symptoms such as sweating, rapid heart rate, and shortness of breath when separated from their attachment figure. 

These intense emotional responses can sometimes escalate into a panic attack, especially if the individual feels unable to cope with the separation. The distress caused by Separation Anxiety Disorder can also manifest as avoidance of situations where separation might occur, further increasing the likelihood of panic episodes.

Q2. Is separation anxiety normal in adults?

While separation anxiety is more commonly associated with children, it can persist into adulthood or develop later in life. Adult separation anxiety is often triggered by stressful life changes, such as moving, a breakup, or the loss of a loved one. Though it's less common, it is still considered a mental health disorder when it significantly impacts day-to-day functioning. 

Many adults with separation anxiety experience extreme worry about their partner’s safety or well-being when apart. While some degree of anxiety in relationships can be normal, professional treatment may be necessary when it interferes with daily life.

Q3. What triggers separation anxiety?

Separation anxiety can be triggered by a variety of factors, including significant life changes such as starting school, moving to a new home, or changing family dynamics (i.e. parent’s divorce). Traumatic events, like the death of a loved one, can also trigger separation anxiety. 

In children, developmental stages, such as when they begin daycare or school, are common periods for Separation Anxiety Disorder to manifest. Adults may experience triggers related to major life events or stressors, such as relocation or relationship changes.

Q4. How long does separation anxiety last in adults?

The duration of separation anxiety varies based on the individual's age and the severity of the disorder. In children, it typically begins between 6 months to 3 years old and usually resolves by the time they are 3 years old. However, some children may continue to experience symptoms into adolescence if not appropriately managed. 

In adults, separation anxiety can persist for extended periods, especially if left untreated. Therapy and lifestyle changes can help shorten the duration of symptoms, but the time it takes to recover fully depends on the individual's response to treatment.

Conclusion

Separation Anxiety Disorder can have a profound impact on both children and adults, disrupting daily life, relationships, and mental health. By understanding the symptoms, causes, and treatment options for Separation Anxiety Disorder, individuals and their loved ones can work toward managing this condition effectively. Early intervention is key, as it can prevent long-term emotional and psychological consequences. Whether through therapy, coping strategies, or medication, managing separation anxiety is possible, allowing individuals to lead healthier, more balanced lives.

Citations

1. (N.d.). How to manage your child’s separation anxiety. Retrieved 6 September 2024, from https://www.unicef.org/jordan/stories/how-manage-your-childs-separation-anxiety
2. (N.d.). Separation Anxiety in Relationships: Signs, Causes & How to Cope. Retrieved 6 September 2024, from https://www.choosingtherapy.com/separation-anxiety-in-relationships/
3. Allan, L. (2023, March 2). Everything you need to know about Separation Anxiety in Adults. Retrieved 6 September 2024, from CPD Online College website: https://cpdonline.co.uk/knowledge-base/mental-health/separation-anxiety-in-adults/
4. Feriante, J., Torrico, T. J., & Bernstein, B. (2023). Separation Anxiety Disorder. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK560793/
5. Ivanova, V., & Dhingra, H. (2023, April 27). Separation anxiety disorder: causes, symptoms, and treatments. Retrieved 6 September 2024, from The Diamond Rehab Thailand website: https://diamondrehabthailand.com/what-is-separation-anxiety-disorder/
6. Johnson, S. (2017, November 8). Separation anxiety disorder. Retrieved 6 September 2024, from Healthline website: https://www.healthline.com/health/anxiety/separation-anxiety
7. Khaliq, R. (2023, September 8). Understanding separation anxiety in adults: Symptoms, causes, and coping. Retrieved 6 September 2024, from MEDvidi website: https://medvidi.com/blog/separation-anxiety-in-adults
8. Madhukar, B. R. (n.d.). Understanding separation anxiety in relationships. Retrieved 6 September 2024, from cadabam Hospital website: https://www.cadabamshospitals.com/separation-anxiety-in-relationships/
9. Mateo, A. (2018, November 19). This is what it’s like to be an adult with separation anxiety. Retrieved 6 September 2024, from Health website: https://www.health.com/condition/anxiety/separation-anxiety
10. Nall, R., MSN, & CRNA. (2018, June 8). Separation anxiety in adults: Symptoms, treatment, and management. Retrieved 6 September 2024, from https://www.medicalnewstoday.com/articles/322070
11. Rochaun Meadows-Fernandez, A. (2017, September 29). Separation anxiety in adults: Symptoms, treatment, and more. Retrieved 6 September 2024, from Healthline website: https://www.healthline.com/health/separation-anxiety-in-adults
12. S., A. (2021, December 23). The most common stages of separation anxiety in infants: How to be ready. Retrieved 6 September 2024, from Nested Bean website: https://www.nestedbean.com/blogs/zen-blog/the-most-common-stages-of-separation-anxiety-in-infants-how-to-be-ready
13. Separation anxiety. (n.d.). Retrieved 6 September 2024, from https://kidshealth.org/en/parents/sep-anxiety.html
14. Separation anxiety disorder. (2024, June 12). Retrieved 6 September 2024, from Mayo Clinic website: https://www.mayoclinic.org/diseases-conditions/separation-anxiety-disorder/symptoms-causes/syc-20377455
15. Separation anxiety disorder. (n.d.). Retrieved 6 September 2024, from Cleveland Clinic website: https://my.clevelandclinic.org/health/diseases/separation-anxiety-disorder
16. Separation anxiety disorder. (n.d.). Retrieved 6 September 2024, from https://www.childrenshospital.org/conditions/separation-anxiety-disorder
17. Separation Anxiety Disorder. (n.d.). Retrieved 6 September 2024, from MSD Manual Consumer Version website: https://www.msdmanuals.com/home/quick-facts-children-s-health-issues/mental-health-disorders-in-children-and-adolescents/separation-anxiety-disorder
18. Separation anxiety disorder in children. (n.d.). Retrieved 6 September 2024, from Cedars-Sinai website: https://www.cedars-sinai.org/health-library/diseases-and-conditions---pediatrics/s/separation-anxiety-disorder-in-children.html
19. Separation anxiety disorder in children. (n.d.-b). Retrieved 6 September 2024, from https://www.stanfordchildrens.org/en/topic/default?id=separation-anxiety-disorder-in-children-90-P02582
20. Separation anxiety from your partner? Yes, it’s possible. (2021, June 14). Retrieved 6 September 2024, from Healthline website: https://www.healthline.com/health/anxiety/separation-anxiety-from-boyfriend
21. Separation Anxiety in Adults. (2019, February 19). Retrieved 6 September 2024, from Anxiety Canada website: https://www.anxietycanada.com/disorders/separation-anxiety-in-adults/
22. Separation anxiety in babies and children. (2022, December 31). Retrieved 6 September 2024, from Raising Children Network website: https://raisingchildren.net.au/babies/behaviour/common-concerns/separation-anxiety
23. The Children’s Hospital of Philadelphia. (n.d.). Separation anxiety. Retrieved 6 September 2024, from https://www.chop.edu/conditions-diseases/separation-anxiety
24. The Recovery Village. (2021, April 19). Separation anxiety disorder. Retrieved 6 September 2024, from The Recovery Village Drug and Alcohol Rehab website: https://www.therecoveryvillage.com/mental-health/separation-anxiety/
25. Website, N. H. S. (2023, May 17). Separation anxiety. Retrieved 6 September 2024, from nhs.uk website: https://www.nhs.uk/conditions/baby/babys-development/behaviour/separation-anxiety/
26. Image Designed by Freepik