The mother of 9-month-old Elizabeth is concerned—she used to be able to leave baby Elizabeth with the babysitter no problem, but lately when she hands Elizabeth over, the baby just cries and cries. At home, things seem a little odd as well. Lately, when she puts Elizabeth in her high chair and gives her snacks, and then leaves the room to get something, Elizabeth cries and cries until she comes back.
What Elizabeth is experiencing is classic separation anxiety.
According to WebMD, it is very typical for babies 8-14 months old to have some level of separation anxiety or clinginess, and other sources say that for small children 18 months to nearly 3 years old, separation anxiety is quite typical as well. Sometimes, even older children experience some form of separation anxiety for a time, though it’s less typical than with babies. Less common still are children who have crossed from separation anxiety into a disorder.
Classic separation anxiety is when a baby or child cries or has a tantrum when their parent leaves their sight. This is to attempt to get the parent back into their presence again. Sometimes children even have anxiety at the mere thought of leaving their parent, and may cry for a while after they are gone. While this is totally normal, and children usually outgrow it, sometimes they don’t and the feelings intensify.
The mother of 8-year-old James had come to the point where getting him to go to school had become so difficult, she considered homeschooling him. Besides that, he was having trouble sleeping because he was so scared at night. Also, there were plenty of kids in the neighborhood to play with, but James didn’t seem interested in going outside. All he wanted was to stay home.
When she mentioned all this to his pediatrician, he asked more questions and soon they realized James had separation anxiety disorder. The intensity was quite extreme, so with counseling and positive reinforcement, James was able to overcome his fears.
If your child has experienced separation anxiety, or you think he or she might have separation anxiety disorder, here is a guide with everything you need to know.
Why do babies get separation anxiety?
You may be wondering why separation anxiety is even an issue. Really, it’s a product of brain development. Think in terms of what a baby can or cannot understand. A baby knows that his or her mother is there to offer the baby everything he or she needs. The baby almost feel as if he or she is part of the mother, or attached somehow.
But as a baby develops, the brain grasps new concepts. Over time, a baby realizes that his or her mother is a separate being. This may be troubling for a time. So then, the baby really notices when mom leaves the room. Since a baby has no concept of time, he or she becomes scared. The other concept the baby doesn’t grasp yet is permanency. He or she doesn’t have much memory of experiences to go on.
Typically, as the baby’s brain develops and he or she realizes their parents will always return, the baby becomes more confident and less anxious about a parent leaving. Playing peek-a-boo is actually more than just a fun game—it’s a way for babies to start to develop the knowledge that mom and dad are there all the time and even though they can’t be seen for a minute, they are still there. In the meantime, helping to reassure your child through different expressions of separation anxiety should help.
What causes children to develop separation anxiety?
While it makes sense that babies have separation due to brain development, what about children? Some older children who have separation anxiety seem to always have had some degree of separation anxiety, and some go for a period without issues but then develop it again, usually around age 7 or so. Why is that?
Typically this happens because of a new situation. It could be due to starting school, or it could be because they have recently moved and worry that they will get left behind somewhere. There could be other sources of worry, such as a new day care provider, or even a new sibling in the house. All the newness shakes up the child’s whole world, making he or she cling to what helps give them the most comfort. Children thrive on predictability, and when that predictability is threatened, they react by doing what makes them feel most safe.
Still, there could be another reason and older child is more clingy lately. If there is a large degree of family stress or a traumatic event that has caused the child to question their safety, that could cause the child to seek the safety of being with a parent as much as possible. Perhaps they have had a recent hospital stay, gotten lost at the mall, or experienced a death in the family. Children may react by displaying symptoms of separation anxiety.
How much do parent’s actions factor into separation anxiety?
Some parents may not realize that their own demeanor or behavior may be contributing to their child’s separation anxiety. According to WebMD, children of overprotective parents may be more likely to develop separation anxiety. In some cases, it may actually be the parent who has the separation anxiety, their worries are being manifested through the child. Also, if someone in the family has anxiety or another mental disorder, the child is more likely to develop separation anxiety.
As children grow and learn, they tend to take on the emotions of others—especially their parents. If you as a parent are constantly stressed out or anxious, then your child will more likely be the same. So take measures to reduce your stress and anxiety. Get more sleep, remove stress from your life as much as you can, and be calm especially in new situations.
When Dan drops off his son Andy at the babysitter’s house, he stands at the door for at least 15 minutes, talking about his worries about Andy. He constantly says he hopes Andy will do okay while he is gone, and to call him if he cries or has any issues. Then, Dan spends way too much time hugging Andy and saying goodbye. It was no wonder that Andy took on the worries of his father when he was gone.
Finally, the experienced babysitter talked to Dan about how to have a better separation at the door and how it would affect his own emotions and Andy’s emotions. So now, when Dan drops off Andy, he gives the babysitter a piece of paper with pertinent information, and then says a very quick goodbye and leaves. No talk of worries, and no prolonged goodbyes. Dan found that it lessened his worries to talk of them less (if he did have any he simply wrote them down instead), and to make the drop off quicker. No surprise, Andy also did much better after his dad left, too.
Dealing with separation anxiety at night
Little Ben has had a big year. He’s switched to a toddler bed and has even begun potty training. He loves to run and play with trucks. His parents love him, but thanks to Ben, it seems as if no one in the house is getting much sleep.
Many times at night, Ben cries and jumps out of bed and runs to his parents’ room, wanting to get into bed with them. It seems like no matter how many times they march him back to his room, he just cries and cries until his parents are so tired, they give in let Ben sleep in their bed.
The American Academy of Pediatrics said while parents may view this behavior as simply being disobedient, but in fact it’s a normal stay of development in the child. The organization advises parents to keep being firm, but loving. Reassurance is key. Your child needs to know that you aren’t going anywhere. If you are going to be gone for some reason, explain that to your child, and reassure him or her that you will return.
Helping your child cope with you leaving the house
With separation anxiety, it comes down to managing the symptoms as they come. For some children, they may be ok as long as they are home with you, but as soon as you leave the house, they become fearful.
Sydney is just starting Kindergarten, so some anxiety is to be expected. But well into the school year, she is still having trouble. Most mornings, she comes up with excuses as to why she shouldn’t go to school. Every conceivable illness has been mentioned over the past few months, though she hardly ever actually is sick. She also lied a few times, saying that some kids were picking on her; she later confided with the teacher that she just didn’t want to go to school.
Sitting her down one night, Sydney’s parents talked in depth with her about her fears. Sydney explained that she worried a lot that her parents wouldn’t be home when she got off the bus, because something bad would happen to them, or they would forget to be there. They reassured her that they would always be there, and they also discussed what would happen in case of an emergency. Talking about it really helped Sydney.
All children are different, so try different approaches until you find something that works. Considering each situation is important. Overall, preparation is key here. If you are going to the store, for example, explain to your child that you are going to leave around 3 p.m., drive to the store, pick up some groceries, then be back about an hour later, or say the time as “after naptime.”
The Mayo Clinic also gives parents this advice:
- Start by leaving for short periods of time.
- Time departures for when your child is less fussy.
- Give them something fun to do while you are gone.
- Make your actual goodbyes short and sweet.
Remember, when it comes to separation anxiety in children, practice makes things better. As a child practices and is successful, remind them how well they did and that you returned when you said you would. They will come to realize that their fears are unfounded and they develop positive memories of being without you.
Helping your child cope with them leaving you
Heather is an employee at the child care center at a large gym. Many of the kids who come in are pretty excited to play with the toys and the other kids. Some don’t like it quite as much, but tolerate it just fine. After all, they are usually only there for about an hour or so. But there is one child in particular who Heather has noticed has a very hard time every time she comes.
Even before her mom leaves her at the child care center, little Emily is already anxious. She knows what is coming. As she comes through the door she looks down and doesn’t want to take off her shoes and jacket. Heather knows this is her cue to try to get Emily excited to come in.
For many weeks, when Emily comes to the child care center, she cries and is very sad almost the entire hour she is there, no matter how hard Heather tries to distract her with toys or other activities. Over time, things finally start to change. As Emily’s mom keeps coming and reassures her before arriving and says a quick goodbye, Heather quickly takes Emily into the center and tries to help her transition as quickly as possible. She knows what Elizabeth’s favorite toys are and that she loves to color, and she is able to help her focus on playing rather than worrying. It takes a while, but eventually Emily no longer worries, and actually looks forward to her time at the child care center.
As your child ages, he or she will have more and more opportunities to leave the house and not be with you. School, grandparents’ house, scout trips, and more can be a source of anxiety for some children who deep down worry whether they will see their parents again. Talking about it definitely helps. Also, with reassurance, practice, helping them have fun things to look forward to, and a predictable return, your child will develop confidence and hopefully let go of his or her fears over time.
When separation anxiety becomes a disorder
Most children experience some form of separation anxiety at some time in their lives. And, most of time, children will outgrow those feelings. But some children don’t out grow them. In fact, their feelings of anxiety become more and more intense. This can develop into what is called separation anxiety disorder.
According to the Diagnostic and Statistical Manual of Mental Disorders, symptoms of separation anxiety disorder include:
- Excessive anxiety when away from parents.
- Constant worry about losing a parent in some way or something bad happening.
- Not wanting to leave the house or not wanting to be home without a parent.
- Trouble sleeping or nightmares about their fears.
- Complaints about physical symptoms when separation might occur, such as headaches or stomach aches.
Separation Anxiety Disorder is not very commonly diagnosed. According to the Anxiety and Depression Association of America, only 4 percent of children have separation anxiety disorder, and it happens most often in children 7-9 years of age. Interestingly, this is also the time when many children are starting to leave home and be on their own more often. At first they may seem defiant or disobedient, but it’s important to see these symptoms for what they really are in order to help get to the root of their fears so you can help them get past them.
If you think your child may have separation anxiety disorder, which is affecting your day to day lives for at least one month, says Psychology Today, then make an appointment to discuss it with your child’s pediatrician and for a potential diagnosis.
How does the pediatrician diagnose separation anxiety disorder?
There are no lab tests that show whether a child has separation anxiety disorder or not. Your child’s pediatrician will typically ask questions of the child and parent in order to determine if separation anxiety disorder exists in the patient.
Your child’s pediatrician may also look for other possible mental or physical issues that could explain the extreme anxiety, and as such may do blood tests or other evaluations. If no other explanations are present, the pediatrician may refer the patient to a psychologist for a more specific evaluation.
A psychologist will then talk to the patient and parents, asking specific questions. And, combined with their own observations of the patient, the psychologist will offer a diagnosis of separation anxiety disorder, and then discuss treatment options.
Treatment options for separation anxiety disorder
Health care providers may recommend one or more treatment options, depending on the patient’s severity of the disorder and specific behaviors. The U.S. National Library of Medicine reports the following options for separation anxiety disorder:
- Individual counseling or family therapy. This is the most common way of treating children with separation anxiety disorder. A therapist will talk to the child, and possibly the parent either together or separately, and also the family.
Therapists treating this disorder will usually use the technique called cognitive-behavior therapy, which helps to change the child’s thinking so they can react to separation situations in a more emotionally healthy way. For example, the child is taught to recognize their feelings and how they react physically. Then they are taught how to cope with those feelings and physical manifestations. After going through a separation event, they can talk through it and discuss successes and also what to do better. Many therapists offer role play and also relaxation techniques to help children with this disorder.
With a parent or the family, the therapist can help guide others in how to support the child.
- Family education and changes in parenting techniques. Sometimes parents just need a little education in order to know how to better handle their child with separation anxiety disorder.
This type of information may come through therapy sessions or simply from the health care professional overseeing treatment.
- Medication. Though not very commonly used in most cases, anti-anxiety or even antidepressants may be used to help treat children with severe separation anxiety disorder symptoms.
The great news is, most children who undergo treatment with separation anxiety disorder are able to recover and relieve their fears and worries. Sometimes over the coming years, the worries may return, especially if the child encounters a new and stressful situation. But with support and practice, they can learn how to best cope and successful get through being separated from parents.
Separation anxiety is very common in babies and young children. They love their parents and feel safe with them, plus they don’t yet realize that even if they can’t see their parents, they are still there. These anxieties usually fade as the child ages and their brain develops, and also as they successfully see their parents return again and again.
It’s important to know what separation anxiety is so you can better recognize those symptoms in your own child and react accordingly. Offering reassurance, and practice of small periods of separation, are a good way to help your child become more comfortable with leaving your side.
When your child doesn’t outgrow their anxieties and especially when the anxieties intensify, it’s a good idea to take your child to their pediatrician and a psychologist for evaluation. If they are diagnosed with separation anxiety disorder, there are treatment options that are very effective. Most of all, the child will learn how to best cope with their fears and develop a more healthy reaction to separation.