Separation anxiety

Almost any parent of a toddler can tell some sort of story of taking their child to pre-school for the first time, as mom tried to leave she got tears, screams or the child physically attaching himself to her legs as she attempted to walk out the door. It's a cute story that usually ends in the child quickly coming to terms with the separation and having fun with the other kids.

However, some children experience separation anxiety to a larger degree. This is a well known and relatively common experience and we can probably all think of a child who just doesn't get over the parents leaving, who is afraid of sleepovers or in other situations where he or she is away from home or parent.

Separation anxiety may result in excessive worry about losing a parent or about a parent coming to harm. Children experiencing this worry may refuse to go to school; be reluctant to be alone or to go to sleep without their parent; or have repeated nightmares involving separation. Sometimes, physical complaints such as stomach aches or headaches may occur when separation is anticipated.

True separation anxiety occurs in four percent of children at some time and is sometimes referred to as separation disorder. Children with this condition are also likely to have other anxiety disorders, two thirds meet diagnostic criteria for another anxiety disorder with social anxiety being the most common.

These children are also much more likely to develop other conditions as they grow up. Studies have found that almost 90 percent will have at least one other psychiatric condition in their lifetime. Half will have a mood disorder later in life, half will develop an impulse control disorder and almost a third develop substance use problems.

Unfortunately, less than a quarter of children with separation anxiety receive any treatment.

Parents with children displaying this kind of separation anxiety can respond in several ways. If they respond protectively by keeping their child at home, sleeping in the same bed or expressing too much concern over physical symptoms, those symptoms are likely to escalate, continue into adulthood and cause significant impairment.

A better approach is to encourage independence by gradually facing the situations the child fears. It is best to be supportive of the child, but not to indulge in avoidance behaviour.

In some cases, overly protective parents may themselves have an anxiety disorder that should be treated for their own benefit and for the benefit of the child.

Although less well known in adults, a recent study found that approximately six percent of adults also experience separation anxiety at some point during adulthood. In about one third of adult cases, the anxiety continues from childhood, but in the rest it begins for the first time in adulthood.

This diagnosis is not made very often in adults as it is not widely recognized and if adults receive treatment it is usually for a co-existing condition rather than the separation anxiety itself. Untreated, adults have the same rates of also developing other anxiety disorders, mood disorders and substance use conditions as those found in children with this condition.

If you think your child is exhibiting symptoms of separation anxiety, don't be afraid to seek the advice of your doctor or a mental health practitioner. Often, simple strategies to teach the child to cope with feared situations will be extremely helpful.

If you are an adult with this condition, speak to your doctor about your options. Cognitive behaviour therapy can be quite effective as can some medications.

Okanagan Clinical Trials currently has a number of studies examining investigational treatments for adults with anxiety disorders. Contact our office for more information.


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