Extreme worries about something happening to #parents when you're apart

Rachel Ehmke

What You'll Learn

- What is #separationanxietydisorder?
- How does #separationanxiety affect #kids?
- How is #separationanxiety treated?

- Quick Read
- Full Article
- Worried phone calls and messages
- Missing out on activities
- #Anxiety at even the thought of separation
- Getting effective help
- #Parent training is part of treatment
- #Anxiety interferes with learning

Quick Read

It’s common for young #children to have trouble leaving their #parents. But #children with #separationanxietydisorder have such extreme fears about being apart that they get in the way of daily life. And these fears don’t get better as the #child gets older. For example, a #child with #separationanxiety might have trouble concentrating in class because they are so worried that their #parents will get in a car accident. 

#Kids with #separationanxiety often miss out on activities like sleepovers and sports. They might refuse to go to #school or, if they do go, call home repeatedly to be reassured that #parents are okay. They might also cling to #parents at home or be too worried to sleep in their own beds. Sometimes, #kids will get anxious even before the separation happens, like getting a nervous stomachache days before a #parent goes on a trip.  

If this sounds familiar, getting treatment can help. Treatment for #separationanxietydisorder involves both the #parent and #child attending therapy. #Parents can learn how to set boundaries with their #children and support them exploring the world on their own. Children can learn skills to deal with scary thoughts and feelings and practice separating a little at a time. Most #kids with #separationanxiety get a lot better with treatment, especially if their #anxiety is caught early. More

Toddlers who cling to mom as she’s leaving for work or wail when they’re handed to the babysitter are fairly common. Though their anguish troubles us, we know most of them will grow out of their fear and #anxiety of separating from #parents as they get older and more confident about their own powers.

But for some #children the #anxiety persists into the #school years, and becomes more rather than less pervasive. These #kids have developed #separationanxietydisorder, and their worries about being apart tend to mushroom far beyond the moment of separation. When kids with #separationanxiety are away from caregivers they can develop extreme fears that sound melodramatic to the rest of us, but are very real to them.

For example, a #child with #separationanxiety might have a hard time concentrating in class because she might be afraid her father is going to have a car accident. She might be worried that her family will get hurt, or she will get hurt, or even that she might be abandoned. If a #parent is five minutes late to picking her up from soccer practice, she might assume the family has left town without her.

Worried phone calls and messages

Mobile phone technology, rather than easing #anxiety, can actually exacerbate it, since now there is the expectation that we can always be in touch with each other. Many #parents of #kids with #separationanxiety are used to getting dozens of worried text messages and phone calls throughout the day while they are at work or their #child is at #school, and some #kids will start to panic when mom or dad doesn’t answer or is out of cell phone reception range.

#Separationanxiety itself, when developmentally appropriate, is not necessarily a bad thing. Though it feels uncomfortable, #anxiety can be useful because it spurs us to be more thoughtful and cautious when approaching a new situation.

As Dr. Ron Steingard, a #psychiatrist at the #ChildMindInstitute, explains, “At different stages of development it is normal to have problems around separation, because the world is not safe, and you haven’t learned how to master being away from the people who take care of you. As you develop, and as you begin to master situations and develop skills, it should get easier.”

Missing out on activities

For #kids who have severe, persistent #anxiety at separating, it doesn’t get easier. These #kids will have an unusually hard time saying goodbye—one mom we know has considered quitting her job because of the panic attacks her daughter has whenever she leaves for work—but the #anxiety doesn’t stop there.

The distress these #kids feel about separating prevents them from participating in age appropriate activities and learning opportunities like joining sports teams or even in some cases attending #school. The #anxiety takes a social toll as well—these are the nine-year-olds who still need mom to stand next to them during a birthday party or won’t consider attending a sleepover unless it is being hosted at their own home.

Overattachment also persists at home, where #children will often “shadow” one #parent from room to room. Some #kids with #separationanxiety fear being left alone upstairs or sleeping alone in their beds. #Parents tell us about #kids who insist on sharing mom and dad’s bed at night or describe getting woken up “like an alarm clock” every morning at 5 or 6am when their #child crawls into bed with them.

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#Anxiety at even the thought of separation

While younger #children generally become anxious at the moment of separation, older #children can experience anticipatory #anxiety. Clinical #psychologist Dr. Clark Goldstein says some of the #children he treats for #separationanxiety actually get more nervous anticipating a separation than they actually get during the separation itself. These #kids might also have nightmares about separating. Whether their distress is anticipatory or immediate, many #kids also feel the physical symptoms of #anxiety, which include headaches or stomachaches.

If you think of #anxiety as an alarm system which functions when we perceive a threat, #kids with #separationanxiety have faulty alarm systems, notes Dr. Steingard. “They have either an alarm system that’s on all the time, so they really never feel comfortable taking risks and moving forward, or they have one of these faulty alarm systems that go off every once in a while and just blow them out of the water. Either way they can get locked onto a strategy of having someone there that can protect them—usually #parents. This person can afford me safety, so I’m going to stay with them. Or this place is my safe place; I’m going to stay with it.”

Getting effective help

If these symptoms sound familiar, and you’ve noticed them persisting over time, it’s a good idea to talk to your child’s #pediatrician or consult with a specialist. #Anxiety is harder to treat the longer the #child has lived with it. But the good news is that most #kids respond very well to treatment, particularly if it is caught early.

Treatment for #separationanxietydisorder typically involves #cognitivebehavioraltherapy, a treatment approach that helps #children learn to manage their fears. This might include #exposuretherapy, a form of treatment that carefully exposes #children to separation in small, controlled doses, helping to reduce #anxiety over time. #Doctors might also employ relaxation training and coping statements that encourage rational, positive thinking to help decrease #anxiety. In some more difficult cases medication might be prescribed to help reduce #anxiety and make therapy more effective.

#Parent training is part of treatment

Another important component of treating separation #anxiety is #parent training. Sympathetic #parents who want to spare their #kids worries may inadvertently be strengthening them.

“#Parents are usually very reluctant to separate themselves because they know their #child is worrying,” explains Dr. Jerry Bubrick, a clinical #psychologist at the #ChildMindInstitute who works with #kids who have separation #anxiety. “But by being reluctant, they’re actually reinforcing the fear rather than reinforcing the effort to separate.” #Parents can help by offering positive reinforcement every time a #child successfully completes one of her goals. Some #doctors teach #parents to give a #child points towards a reward for each goal she completes.

Treating separation #anxiety allows #kids to get back to the business of being #kids, which is learning. The longer #kids continue living with their #anxiety, the more they miss out on important learning opportunities. And the longer they make choices based on avoiding painful separation, the greater the chance that they will develop avoidant personalities and other #anxiety or #mooddisorders.

#Anxiety interferes with learning

“Untreated, these #kids can become very inhibited individuals who are risk-avoidant,” notes Dr. Steingard, “which is a bad thing in #childhood, because #childhood is filled with risk-taking and learning. #Kids are at the moment where they’re expanding. By necessity, their universe has to expand. Everything that they’re exposed to is novel, and exposure to novel events is essentially #anxiety-provoking.

Most of us learn how to master that #anxiety, develop skills that allow us to walk into new situations, meet new people. We need to help these kids catch up in development of mastery and accrual of skills until they’re at the point where they’re strong enough to stand on their own.”

Rachel Ehmke is managing editor at the #ChildMindInstitute.
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