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Separation Anxiety Disorder

Separation anxiety disorder (SAD) is an excessive worry or fear about being apart from family members or individuals to whom a child is most attached.

Symptoms of anxiety or fear about being separated from family members must last for a period of at least four  weeks to be considered SAD. Symptoms of SAD are more severe than the normal separation anxiety that nearly every child experiences to some degree between the ages of 18 months and 3 years of age.

Separation anxiety causes

All children and adolescents experience some anxiety. It's a normal part of growing up. When worries or fears are developmentally inappropriate, separation anxiety disorder may be a cause.

Anxiety disorders are believed to be caused by a combination of biological, family and environmental factors, including:

  • A chemical imbalance of two chemicals in the brain, norepinephrine and serotonin
  • An inherited biological tendency toward anxiety
  • Anxiety learned from family members and others
  • A traumatic experience

Separation anxiety disorder occurs equally in males and females, with symptoms often appearing around third or fourth grade. The onset of symptoms typically occurs after a break from school, such as over the holidays or summer.

Separation anxiety disorder symptoms

Although every adolescent experiences separation anxiety disorder differently, some common signs of a problem include:

  • Refusal to sleep alone

  • Repeated nightmares with a theme of separation

  • Excessive distress when separation from home or family occurs or is anticipated

  • Excessive worry about the safety of a family member

  • Excessive worry about getting lost from family

  • Refusing to go to school

  • Fearful and reluctant to be alone

  • Frequent stomachaches, headaches or other physical complaints

  • Muscle aches or tension

  • Excessive worry about safety of self

  • Excessive worry about or when sleeping away from home

  • Excessively clingy behavior, especially at home

  • Symptoms of panic and/or temper tantrums at times of separation from parents or caregivers

The symptoms of separation anxiety disorder may resemble other conditions or psychiatric problems. Always consult your child's doctor for a diagnosis.

Diagnosis and treatment

A child psychiatrist or other qualified mental health professional usually diagnoses anxiety disorders in children or adolescents following a comprehensive psychiatric evaluation. Parents who note signs of severe anxiety in their child or teen can help by seeking an evaluation and treatment early, which can often prevent future problems.

It is possible to effectively treat anxiety disorders with a combination of:

  • Medications, such as antidepressants
  • Cognitive behavioral therapy
  • Family therapy
  • Consultation with the child's school

Prevention of separation anxiety disorder

Preventive measures to reduce the incidence of separation anxiety disorders in children are not known at this time. However, early detection and intervention can reduce the severity of the disorder, enhance the child's normal growth and development and improve the quality of life experienced by children or adolescents with separation anxiety disorder.

Make an Appointment


Outpatient Psychiatry Clinic


Behavioral Health Day Treatment Programs: PHP/IOP

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