Separation Anxiety Disorder
A young child who is scared of new people and places is normal. However, if a child has continued intense fear that something is going to happen to someone he loves and he stops normal activities, this could be a sign of a larger issue. Separation anxiety disorder affects about 4 percent of children ages six through twelve, and research shows treatment is often successful.
Factors to Consider
Environmental and temperamental factors that seem to characterize children who suffer from separation anxiety disorder are an extremely close-knit family, a fearful or extremely shy temperament as an infant, shyness or passivity in girls aged three to five years old, or an insecure parent who found it difficult to attach in infancy.
The Developmental Process
When your baby was born, you might have noticed she easily adapted to new surroundings and people, which is typical of babies six months old or younger. Actually, with infants, it is usually the parents who have more anxiety than the child when being left with a babysitter or in a new environment! Normal separation anxiety typically occurs between eight months and one year although some children experience it later, between eighteen months and two and a half years old, and some may never experience it at all. During this time, you may find you cannot leave the room for even a moment without your child becoming agitated and upset.
Some degree of separation anxiety in a preschooler is normal, and it is a sign of healthy attachments to loved ones. If the distress continues past three to four minutes, though, this could be a sign of a developing anxiety disorder, and it is time for you to look more closely at other behaviors that may point to anxiety.
Stranger anxiety can also develop during this time. You know it is stranger anxiety when your child clings onto you for dear life; her huge panicky eyes looking like you are going to feed her to a dinosaur if you even try to give her to another person. As time goes by and your child learns to feel safe and secure that you really are going to return, and she really will be given back to you, the anxiety usually fades. It is when she continues to experience excessive fear that seems out of proportion at the start of her elementary school years, that you want to be concerned.
Separation anxiety disorder has a variety of physical and behavioral signs. Your doctor or therapist will look for at least three or more of the following symptoms that must begin before the age of eighteen, be present for at least four weeks, need to cause significant distress in the child, and/or must interfere with social and/or academic functioning. The symptoms also cannot be due to another anxiety or psychiatric disorder:
Excessive distress when separated from you
Worry about losing you, or harm coming to you
Ongoing worry that some awful event such as kidnapping will separate her from you
Recurrent reluctance to go anywhere, even out to play with friends, or to watch TV in a room if you are not present
Ongoing distress about being alone at home or outside the home
Reluctance to go to sleep without you nearby
Difficulty falling asleep without you, or waking from nightmares about separation from you
Repeated physical complaints, such as stomachaches, nausea, and headaches when separated from you or expecting to be separated from you
Separation anxiety can look like or develop into depression because your child might be withdrawn, seem irritable, have difficulty sleeping, or experience difficulty concentrating. Symptoms of separation anxiety may be prompted by a scary experience or something your child heard about, such as child abduction or a fire in the community. For your child to be able to resolve the feelings of separation anxiety it is important he develop a sense of safety in his world, trust people other than parents, and be able to understand that even though his parents have left, they are coming back. When a fracture in the ability to bond or attach in infancy through adoption, illness, or return to work has occurred, it can predispose a child to develop this disorder. Some studies suggest children and teenagers who live in dangerous neighborhoods might be inappropriately diagnosed with separation anxiety disorder, even though it is reasonable for them to have fears about leaving their homes.