When Separation Anxiety Becomes a Disorder, What's Normal - What's Not

What's Normal and What's Not?

Toddler girl crying on mothers shoulder
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Separation anxiety is loosely defined as the fear of being away from the primary caregiver and the most common ways for children to act out their fears is through tantrums and clinging. It's a healthy and normal part of your child's development between the ages of 8 and 14 months. 

Separation anxiety disorder is a diagnosis for children who fall outside the boundaries of this otherwise normal developmental stage.


Symptoms of "Normal" Separation Anxiety

The symptoms of separation anxiety as a developmental stage are considered normal until the age of 2 and always include elements that cause the parent to question leaving, including:

  • Excessive crying
  • Forcefully holding onto the parent's body or clothes
  • Screaming
  • Refusal to engage with caregiver or other children

External triggers can worsen the anxiety and include:

  • New situations that take children out of their routine, including a new caregiver, a recent move, or a new sibling

  • Family difficulties, such as marital  problems or financial issues, that put stress on the adults in the home have a negative effect on children

Separation Anxiety in Older Children

It is normal for some older children, particularly those who are shy, to go through a phase of not wanting parents to leave. However, a caregiver can typically redirect the child to engage in group activities.

Children over the age of 2 who don't respond to redirection or demonstrate severe symptoms may be suffering from separation anxiety disorder.

When separation anxiety becomes a diagnosable disorder

Separation anxiety disorder is a specific psychological disorder that is different from normal separation anxiety, although it can be difficult to tell the difference because symptoms can overlap.

Symptoms more common in separation anxiety disorder include:

  • headaches
  • stomach distress
  • excessive fears or worry that something will happen to either the parent or child while the two are separated
  • flatly refusing to participate in separate activities and inconsolable crying for the duration of the separation
  • age-inappropriate separation anxiety in older children or adults

Coping with normal separation anxiety

Normal separation anxiety is manageable by a joint effort between parents and caregivers, with setting a routine as the most critical component to success. Do not give in to the temptation to sneak away, as this can make children more fearful. The next time your child gets anxious:

  • Explain what will happen in simple, direct terms to explain where you're going, who will be in charge, and when you will return.

  • Give your son time to adjust by visiting a new school or babysitter's house together a few times. Let him get used to the new person before you leave.

  • Remain calm and upbeat, focus on the fun that your child will have, and treat the separation as a normal occurrence.

  • Say goodbye once no matter how much your child screams or cries, give her a big hug and kiss, say goodbye and walk out the door. 

  • Build on small successes by leaving her for only an hour or two the first day and gradually add to the length of time, always returning when you promised.

Seeking treatment for social anxiety disorder

Separation anxiety disorder may require professional intervention with a trained mental health professional.

Gather as much information as possible before your first therapy visit, including details about your child's behavior both when you leave and while you are away. A good therapist will become part of the team that includes you, your child and the caregiver, making suggestions for all of you to follow. 

Over time, you may find that your child is eager to participate in each day's new activities.


National Institutes of Health: Separation Anxiety (2011)

Kids Health: Separation Anxiety (2012)

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