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Separation Anxiety Disorder
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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.


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.


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.


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.
Separation Anxiety Disorder
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