Separation Anxiety and Separation Anxiety Disorder
Do your toddler's arms wrap around your thigh like octopus tentacles when you have to part ways? Are uncontrollable crying fits, stomach aches, or diarrhea bouts breaking your heart and your concentration at work? Maybe you're also experiencing these symptoms when separated from your spouse, family, or safe space.
It could be separation anxiety disorder. Explore the various treatment that can help you or your child return to a happier, calmer, more well-adjusted life.
What are separation anxiety and separation disorder?
Separation anxiety is the stage of life when children feel fear or distress when they think about or actually leave places or people that they've become attached to.
There are many ways parents can help their children overcome separation anxiety. Left untreated, it can cause depression, anxiety, and personality disorders in adulthood.
Separation anxiety disorder is a mental health disorder characterized by separation anxiety symptoms that persist past infancy and into adolescence and adulthood. Separation anxiety disorder in adults shares many of the same childhood symptoms, though the anxiety is caused by being away from familiar people and surroundings.
What are the symptoms of separation anxiety and separation anxiety disorder?
Separation anxiety in infants usually begins when they're 7 months old, peaks at 10-18 months, and usually subsides around the age of 3, and includes extremely anxious crying or clinging to parents or caretakers during bedtime or before any separation.
Symptoms of separation anxiety disorder include repeated excessive anxiety or fear over:
- something bad happening to loved ones, including death
- getting lost
- being kidnapped
- going to school
- sleeping without loved ones nearby
Other symptoms of this disorder include the refusal to go anywhere without loved ones or having recurrent nightmares about separation. Behavioral symptoms can include crying fits, tantrums, whining, or begging when separation occurs or is expected. Physical symptoms can include headaches, stomachaches, or diarrhea.
What causes separation anxiety disorder?
Separation anxiety disorder affects 4%-5% of children and adolescents. As with most mental health disorders, it results from a combination of genetics, nutrient deficiencies, and stressful environmental factors like:
- moving to a new house
- switching schools
- an insecure bond between the parent/caregiver and child
- anxiety in parents
- dysfunctional family dynamics
- magnesium deficiency
- omega 3 deficiency
- vitamin B complex deficiency
- lead or mercury exposure
A mother's anxiety while pregnant can increase her child's risk of developing this disorder. About 50%-75% of children with this disorder come from homes of low socioeconomic status.
Adult separation anxiety disorder often develops as a result of the loss of a loved one or due to some other significant life event, like going to college. Adults with separation anxiety may have the following conditions as well:
- generalized anxiety disorder
- post-traumatic stress disorder (PTSD)
- panic disorder
- social anxiety disorder
How is separation anxiety diagnosed?
To qualify for a separation anxiety disorder diagnosis, a minimum of three symptoms must persist for at least a month in children and adolescents and at least six months in adults. The symptoms must also cause significant stress or issues at school or in social relationships. In adults, a separation anxiety disorder is diagnosed when symptoms are so severe that they affect social functioning and responsibilities and cannot be explained by a different disorder.
A child psychologist or mental health professional can assess symptoms and gain a deeper understanding of the child's perspective.
How can you soothe your toddler?
Ways that you can ease your toddler out of separation anxiety include:
- leaving your child with a caregiver for short time periods and then gradually increasing the time of separations
- scheduling separations after naps or feeding
keeping your “goodbye” ritual simple, quick, and consistent
- tell them you are leaving and when you will pick them up
- do not prolong parting ways
- promise that you will pick them up at a specific time and keep that promise
keeping your child's surroundings as similar and familiar as possible
- have a consistent caregiver that comes to your house
- minimizing age-inappropriate television viewing
- listening to and respecting their feelings
- leading by example and staying calm during separation
- encouraging your child to have an active social life
Factors that influence how quickly and successfully children move past their separation anxiety include their temperament, emotional coping skill set, and parental anxiety levels.
If your efforts aren't successful and your own anxiety increases your family may want to consider family therapy or a support group.
Psychotherapy treatments separation anxiety disorder
Various psychotherapy methods have successfully treated separation anxiety disorder. Some common ones include behavioral modification therapy, cognitive therapy, and group play.
Behavioral modification therapy
addresses the behavioral signs of separation anxiety by rewarding children's small victories over symptoms with praises and hugs.
helps children learn how they think, problem solve, and focus on more positive thoughts and feelings to help them be more open to learning strategies to deal with their anxiety.
Group play and art therapy
Group play—especially puppet play— allows children to recognize their illogical thoughts and work through their emotions, as well as learn patience, responsibility, and trust. 1
Art therapy involves allowing kids to make art for their own relaxation and sometimes for therapists to interpret. It provides a safe, engaging space away from negative thoughts.
Treatment for adult separation anxiety disorder is similar to treatments used to treat other anxiety disorders, and include behavioral therapy, group therapy, and family therapy.
Integrative therapies may help resolve separation anxiety?
Along with environment and family dynamics, a child's brain chemistry is greatly affected by nutrition.
Several studies over the last 10 years have linked magnesium deficiencies with anxiety as well as the reduction of anxiety after taking magnesium supplements. Increasing magnesium in your child's diet is relatively easy with foods like rice, wheat, oats, and seeds like pumpkin, sunflower, flax, and sesame.
If dietary changes aren't enough, you can try magnesium supplements. Consult with your healthcare provider, especially if your child has an allergy to magnesium salts, kidney disease, heart disease, intestinal (bowel) disease or neuromuscular disease.
Multiple studies have shown that a deficiency in Omega 3's has been linked to anxiety and ADHD. When choosing an Omega 3 supplement for your child make sure it contains EPA and DHA (vitamin D aids in the absorption of fatty acids).
Vitamin B Complex deficiencies have also been well studied and linked to problems with the nervous system including anxiety. While the research has not focused on children, it is generally safe to increase B vitamins in your child's diet or the addition of a vitamin supplement to help decrease anxiety symptoms.
Other integrative approaches that can release endorphins and increase blood flow to the brain, reducing negative ruminations are:
- mindfulness techniques
- deep pressure therapy
- spending time in nature
- living space modifications
As with all brain chemistry treatments, results with vary from child to child depending on age, attention span, the severity of the condition, genetics, general health, and environmental factors.
What medications can treat symptoms of separation anxiety disorder?
Medication can be useful for severe anxiety. It can provide symptom relief, however, it does not cure anxiety (when the child stops taking the drug, anxiety may return). Pharmaceuticals must be used very carefully – they can cause dependency, as the child forgets how to cope without the drugs.
Selective serotonin reuptake inhibitors (SSRIs) increase the amount of serotonin in the brain, helping to activate cells that have been deactivated by anxiety. Examples of SSRIs include:
- fluoxetine (Prozac)
- fluvoxamine (Luvox)
- sertraline (Zoloft)
- citalopram (Celexa)
Tricyclic antidepressants (TCAs) also affect serotonin levels:
- amitriptyline (Elavil)
- desipramine (Norpramin)
- imipramine (Tofranil)
Benzodiazepines like clonazepam (Klonopin) and alprazolam (Xanax) enhance the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits brain activity. Anxiety may be caused by excessive brain activity. Clonazepam is primarily used for treating panic disorder and preventing certain types of seizures. It can cause the following side effects:
- blurred vision
- dry mouth
- respiratory depression
- enlarged liver
- withdrawal symptoms (if stopped suddenly)
- increased heart rate
- low blood pressure
- blood disorders
Consult with your healthcare provider whether medication is right for your child or you.
Reserve your appointment now
Separation anxiety is a natural state of human development, but symptoms in adolescence or adulthood can be a sign of separation anxiety disorder. There are many treatments available to help you or your child cope.
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