Separation anxiety in infants and young toddlers is a natural part of development that stems from the child’s increasing ability to distinguish parents and other loves ones from unfamiliar strangers. Feelings of anxiety may be expressed through crying and pouting when the child must be separated from a parent or caregiver.
In children between the age of eight months and two years, these symptoms are normal. Parents can help alleviate symptoms of separation anxiety in young children by making them aware of upcoming periods of separation in advance and introducing temporary caregivers while the parent is present and providing comfort.
Normal separation anxiety becomes a disorder when it persists beyond the toddler years and begins to interfere with the child’s healthy development. A doctor may diagnosis separation anxiety disorder in a child older than five who displays strong symptoms of separation anxiety for longer than four weeks. If left untreated, the disorder could lead to the development of panic attacks and panic disorder.
Symptoms of Separation Anxiety Disorder
Children and adolescents with separation anxiety disorder may display the following behavioral and emotional symptoms:
- Desire to return to the parent or caregiver during times of separation
- Intense feelings of fear for their personal safety or the safety of a parent during separation and anticipation of a separation
- Repeated nightmares involving abandonment
- Strong reluctance to go to school (called school refusal)
- Unwillingness to go to bed and difficulty falling asleep.
During periods of separation or anticipation of separation, physical symptoms of anxiety may be present, including heart palpitations, nausea, feeling lightheaded and dizziness. These physical symptoms are typical of many anxiety disorders.
Treatment for Separation Anxiety Disorder
The most effective treatment for separation anxiety in children and adolescents is cognitive behavioral psychotherapy. This treatment involves a therapist teaching the child how to recognize when she is feeling anxious so that she can change her thought patterns that elevate the anxiety. Patients are also taught how to cope with the physical symptoms of fear.
Including the parents in the therapy can be greatly beneficial. Parents can learn the best way to handle their child’s separation anxiety and how to prepare the child for times of separation. In family therapy sessions, the therapist may incorporate exercises that separate the child from the parents in a controlled and safe environment. This way, the child can practice identifying and coping with anxiety. For very young children, family therapy may include the use of toys, puppets and art activities to help the child express his fears and teach him to cope.