Separation Anxiety Disorder
Early childhood development includes several fairly predictable phases, one of which is separation anxiety. This typically occurs between eight months and two years of age, and the primary feature is that the infant shows signs of anxiety when separated from his or her main caregiver.
At around eight months old, infants begin to gain some idea of what the world is like. They become familiar with their normal home environment, and learn the difference between home and other places. They recognize their main caregivers as being familiar, safe, and comforting.
With the link between home and safety firmly established, infants begin to show signs of anxiety or fright when in unfamiliar places, or when separated from their caregivers.
As the infant grows, he or she begins to understand that separation from home and caregivers is only temporary, and that these familiar people and situations will return. By two years of age, signs of separation anxiety usually begin to cease, providing that the child feels safe in his or her home environment, can trust that caregivers will return when they are gone, and has also been able to form trusting relationships with other people.
Who gets Separation Anxiety Disorder?
Separation anxiety is commonly thought of by most people as something that happens to children, but in fact adolescents and more rarely adults can develop this disorder too. However, it most often occurs in young children of pre-school or early school age.
A child with separation anxiety is likely to display the following types of behavior and symptoms:
- Unrealistic level of anxiety about the safety of caregivers, especially when they are absent.
- Extreme homesickness when away from home.
- Tantrums or other extreme reactions when the child and primary caregiver are separated, or when separation is about to occur.
- Difficulty falling asleep if the primary caregiver is not present. The child might also have nightmares about being separated from home or caregivers.
- Physical symptoms might include dizziness, headaches, nausea, stomach pain, vomiting, muscle pain. These are referred to as psychosomatic symptoms, as they are directly related to and caused by the anxiety.
Separation Anxiety Disorder Causes
Separation anxiety becomes a disorder rather than a normal developmental stage when a child's anxiety becomes extreme and/or persistent even after two years of age.
There are several possible causes for the development of the disorder. One is that the child has not been able to bond with other caregivers such as an adult baby sitter or other non-primary caregivers, resulting in the child's continued reliance on the primary caregiver only. Another is that the child has not received the necessary stability and support to enable him or her to move past the separation anxiety stage. Children are also more likely to develop an anxiety disorder if their parents are overly fearful or anxious themselves.
It should be noted, however, that separation anxiety itself is typically not caused by a parent or primary caregiver. Other factors such as an illness, a death in the family, or sudden changes in routine are more likely to be contributing factors. If the separation anxiety is handled supportively the child will eventually overcome the anxiety.
Genetics-related causes also exist, but these increase the risk of anxiety disorders rather than causing them outright. Where genetics is involved, the child might be prone to anxiety in other areas and might be at risk of developing other anxiety-related disorders later in life. Only a very small number of related genes have been discovered so far, and little is known about how the various genes interact.
National Institute of Health MedlinePlus: Separation Anxiety
Psych Net UK: Separation Anxiety Disorder Information Sheet
Watkins, C., and Brynes, G. Anxiety Disorders in Children and Adults. From Northern County Psychiatric Associates web site.