Every working mother’s or father’s heart breaks a little when they have to leave their toddler at home: the goodbyes are always tearful and tantrum-filled. Separation anxiety is perfectly normal in children, but it can be pretty upsetting for the parent.

What is, after all, separation anxiety?

Separation anxiety is the distress that both children and sometimes adults feel when they think about separating from the people they’ve become attached to. It is the excessive fear or anxiety about being away from home or an attachment figure. It was previously thought to be a childhood issue. However, nowadays it is commonly acknowledged that separation anxiety is an anxiety disorder that can affect people at all stages of life.

Symptoms of separation anxiety

• Anxiety disorder manifests in several ways, as follows:
• Feelings of distress on being separated from attachment figures
• Anxiety about losing major attachment figures
• Worry about experiencing a negative event that leads to being separated from attachment figures
• Refusal to leave home for school or work
• Fear about being alone
• Nightmares involving separation from home or major attachment figures
• Refusal to sleep by oneself
• Bed-wetting
• Temper tantrums especially at night or at the time of leaving an attachment figure
• Physical complaints such as headaches, vomiting and nausea when separation has occurred or is expected

For being clinically diagnosed as suffering from Separation Anxiety Disorder, these symptoms must have been present for at least four weeks in children and adolescents, and six months or more in adults. Moreover, these symptoms must cause impairment of school, social, occupational or personal functioning as a result of the anxiety.

Causes of separation anxiety

Separation anxiety often develops

• after a major traumatic event such as the death of a loved one or a pet, divorce of parents etc.
• after a sudden change in environment ( such as moving to another house or school)
• when parents are over-protective and/or over-anxious
• when there is a family history, including blood relatives who have anxiety disorder

Treatment for separation anxiety

Mild cases of separation anxiety do not need treatment. However, if it interferes with school or other daily functions, treatment is needed.

• Cognitive Behavioral Therapy (CBT):

This is the most common type of psychotherapy recommended for treatment of Separation Anxiety Disorder. Through CBT, children learn to recognize their physical responses to anxious thoughts, and the thoughts that lie behind them. They also learn to identify what triggers those anxious thoughts. Children learn various strategies to manage their anxious thoughts and to cope with the troubling emotions. Typically, CBT is a long process, and covers many sessions, but it is considered very effective to bring about lasting change.

• Family therapy:

Very often the family contributes in some way to the anxiety of the child. In family therapy, parents and siblings learn of new ways of interaction with the child and useful strategies when anxiety symptoms manifest.

• Play therapy:

With very young children who cannot express themselves very well, play therapy can help process emotions and thoughts, as well as how to cope with them.

• Medication

Severe separation anxiety that has progressed to the level of a disorder may have to be treated with medication. Both antidepressants and anxiolytic medications (anxiety reducing medications) are used with success. However, due to the side effects of these medications especially in children, they are used only if absolutely necessary.

Prevention of separation anxiety

Though separation anxiety is natural, parents can adopt certain strategies to prevent it being unmanageable.

• Practice separation over a period of time. If you are a mother who has to leave for work every morning, prepare your child for separation gradually, by leaving the child for short periods of time every day, gradually increasing the time of separation.
• Arrange separations after naps or feedings. Babies are more likely to develop separation anxiety when they’re tired or hungry.
• As far as possible, do not change the primary caregiver. If it is a hired help, it is best to have the same person for at least the first few years.
• Keep your promises. If you say you will return by evening, do return by evening.
• Do not let the child watch scary, violent or sad television shows. The images stay in the young mind for a long time, and will haunt them when alone.
• School-related anxiety can be minimized by going early to school, and letting the child play with other children before the bell rings.
• Follow a consistent routine. Routines provide a sense of security to children, and eliminates the fear of the unknown. Meal times and bed time should be consistent, and any changes should be discussed with the child.