Separation Anxiety Disorder is a psychological condition where an individual experiences intense levels of anxiety when separated from a particular person or surrounding. Separation can result in an unreasonable and excessive response, or even panic. In children, the attachment is often formed to a parent, close relative or caretaker. In adults, the anxiety might be triggered by a separation from their spouse or a close friend.

Difference between Separation Anxiety Disorder and Separation Anxiety

Separation Anxiety is a process that occurs as a natural stage of development in normal healthy babies. Infants become anxious and upset when they are separated from their parents or are approached by someone who they are unfamiliar with. As a result the baby will start to cry or cling on to their parent or carer. Separation Anxiety typically starts at around 7 months of age; its effects become more apparent when the infant is between 12 to 18 months of age. Separation Anxiety usually starts to decline when the infant reaches 2 years old, the speed at which the child overcomes this anxiety however, often depends upon how well the adult and child cope with the separation, and how well the parent responds to their child’s separation anxiety.

Separation Anxiety Disorder on the other hand, is a physiological problem where people of any age group, including adults (Adult Separation Anxiety Disorder), become extremely attached to a specific place or person. They become very upset and unable to cope or function properly when separated from the specific object of attachment.

Who gets Separation Anxiety Disorder?

Although mostly recognised as a juvenile anxiety disorder, a survey conducted in 2006 estimated that over 6% of adults will suffer from Separation Anxiety Disorder at some point in their lives. The great majority of adults who suffer from ASAD experience their first onset of the disorder during adulthood. The condition however, is rarely diagnosed amongst adults; as a result, it is not as widely recognised or supported as anxiety disorders such as OCD and social anxiety disorder.

Signs and symptoms of Separation Anxiety Disorder

Common symptoms of Separation Anxiety Disorder (ASAD) include:

• excessive distress when faced with actual or perceived separation from major attachment figures
• constant and excessive worry about something bad happening to the object of attachment
• constant worry about something bad happening or the potential loss of the object of attachment
• feelings of vulnerability
• repeated nightmares of separation
• crying (in babies)

When an individual who is suffering from Separation Anxiety Disorder is separated from their loved one, safe place or object of attachment they may also experience some of the physical symptoms that are commonly induced by anxiety and worry including headaches, restlessness, nausea, vomiting and abdominal disturbances.

Separation Anxiety Disorder Diagnosis

Three or more of the (aforementioned) symptoms must have been prevalent for a duration of at least 4 weeks for a diagnosis of Separation Anxiety Disorder to be made. The disturbances will be severe enough to cause significant distress that interferes with the day to day life of the patient. Diagnosis should be made by a health care professional, or group of health care professionals who hold particular experience in assessing and understanding the condition.

Causes of Separation Anxiety Disorder

As with many anxiety and mental health related disorders, ASAD is likely to be caused by a combination of genetics and environmental factors. Those with close relatives who suffer from anxiety related disorders are at a greater risk of developing the condition.

Treatment for Separation Anxiety Disorder

Counselling, therapy and medications can be applied to treat separation anxiety disorder. Counselling is the favoured method of treatment for milder forms of the condition. A combination of counselling, therapy and medication may be given to those who suffer from more severe symptoms or show no sign of improvement following counselling sessions.

Therapy for Separation Anxiety Disorder
Behavioural modification therapy: applied to addresses the behavioural symptoms associated with separation anxiety disorder. This will involve regular sessions with the patient, caregivers of children may be provided with provision and guidance on how they can help alleviate the child’s dependency and anxiety. Sessions will build upon the child’s sense of confidence and accomplishment, improvements and progress are rewarded and praised to give the child a sense of success.

Cognitive therapy: applied to addresses and manipulate negative thought cycles associated with separation anxiety disorder. Those who undergo cognitive therapy will be taught how to focus on positive thoughts and feelings, and alleviate the negative thought patterns that trigger anxiety. Children may become exposed to different strategies that can be used to take their mind away from negative thoughts by enjoying them selves playing games, colouring and watching television. Relaxation techniques will also be taught to help the patient eradicate and replace intense feelings of distress with a more relaxed meditated state of relaxation.

Medications for Separation Anxiety Disorder
A combination of therapy and medication may be necessary for those who do not respond to therapy alone. Those who suffer from more extreme symptoms may also be prescribed medication to help them cope with intense symptoms of distress and anxiety.

Medications used to treat Separation Anxiety Disorder include:

• Selective serotonin reuptake inhibitors (SSRI’s)
• Tricyclic antidepressants (TCAs)
• Benzodiazepines

Selective serotonin reuptake inhibitors (SSRIs) are found to be the most effective treatment for separation anxiety disorder in both children and adults. TCA’s are known to produce more notable side effects including dizziness, constipation and blurred vision. Benzodiazepines are only prescribed to children if other medications are ineffective. Unfortunately, some patients are at risk of becoming dependant on benzodiazepines.

For more details about medication, therapy and other options available to treat separation anxiety disorder and other anxiety related disorders please visit our treatments pages.

What happens if separation anxiety disorder is left untreated?

Left untreated, the symptoms of separation anxiety disorder can worsen and lead to depression and other forms of anxiety including social anxiety disorder and panic attacks.