Children who are very young are likely to experience separation anxiety as a normal part of growing up
There is a high prevalence of separation anxiety and clinginess to some degree among children aged 18 months to 3 years
Around 4-5% of children between ages 7 and 11 in the US suffer from separation anxiety
Separation anxiety is less prevalent in teenagers, with about 1.3% suffering from it
What is SAD?
Separation anxiety disorder (SAD) is one of the most prevalent childhood anxiety disorders
It is characterised by excessive worries, concerns, and even dread in response to the actual or anticipated separation from an individual
SAD is influenced by both genetic and environmental factors, including an imbalance of 2 chemicals in the brain (norepinephrine and serotonin), a family history of mental health issues, parenting disruptions, parental loss, and birth complications.
Symptoms typically come to light in preschool and early elementary school (they may come to light later in some rare cases)
Whenever the child is not with their family, they may feel anxious and worry that something bad may happen to a family member
The fear of separation causes great distress to the child and may interfere with their daily activities, like sleeping alone, going to school or playing with other children
Some children also develop physical symptoms, such as headaches, muscle aches and stomach aches
There is evidence that separation anxiety disorder may be associated with panic disorders and panic attacks (sudden episodes of intense anxiety and fear or terror)
Teenagers and adults may also suffer from SAD, causing significant difficulty leaving home or reaching work
Before a child can be diagnosed with SAD, they must exhibit symptoms for at least four weeks, and experience symptoms that are more severe than those associated with separation anxiety in general
The diagnosis is based on DSM-5 criteria (3 out of 8 symptoms) and can be assessed using the SAAI tool for both children and adults - this is a self and parent-report measure
There is a wide range of differential diagnoses to be considered, including other anxiety disorders, mood disorders, behavioural pathologies, personality disorders, and medical causes of somatic complaints
In the absence of treatment, individuals diagnosed with SAD are at an increased risk of developing other anxiety disorders, such as generalised anxiety disorder, panic attacks, phobias, social anxiety disorder or agoraphobia
SAD can also be associated with depressive disorders, poor academic performance, social isolation, and poor physical and mental health outcomes
A combination of therapy and medication is used to treat SAD.
Both of these treatments are effective in reducing anxiety and in developing a sense of security in the child, but they are affected by symptoms, age, general health, and the severity of the condition.
Cognitive behavioural therapy (CBT)
CBT is the primary treatment method for separation anxiety disorder, also known as talking therapy
The primary objective is to assist children in identifying the thoughts and behaviours that contribute to their separation anxiety as well as how to handle being separated from their caregiver without causing distress or interfering with their functioning
Relaxation and deep breathing are commonly used techniques
It is also possible for parents to learn additional parenting techniques that can help them reduce their separation anxiety
Currently, there are no specific medications available for the treatment of SAD
Antidepressants may be prescribed by a doctor to help a person through the more acute symptoms of separation anxiety
A selective serotonin reuptake inhibitor (SSRI) will typically be included in these treatments
Medication is not a long-term solution to the underlying disorder, and this is a decision that must be carefully considered by a child's parent or guardian as well as their doctors
There should be close monitoring of side effects in children.
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