What is separation anxiety?
Separation anxiety refers to the anxiety (usually expressed as fear, worry, excessive clinginess, or even anger) displayed by a baby when separated from home or from individuals with whom he or she has formed an attachment (parents or primary caregivers).
Babies can show signs of separation anxiety as early as 4 to 5 months but this commonly starts at 9 months. By age 3, most children have outgrown separation anxiety and they start to socialize with strangers more easily (particularly children their age).
Some infants do not experience separation anxiety at all. For others certain life stresses can trigger feelings of anxiety about being separated from a parent or caregiver. These children might not have had any separation anxiety prior to the trigger. These triggers include a new childcare situation or caregiver, a new sibling, moving to a new house, or tension in the home.
Separation anxiety disorder
Separation anxiety is normal in the development of infants and toddlers. However, for some children separation anxiety is a sign of a more serious condition known as Separation Anxiety Disorder (SAD). This is a condition in which a child becomes fearful and nervous when he or she is away from home or separated from a loved one.
What makes this different from normal separation anxiety is that the fear of separation causes great distress and may interfere with the child's normal activities like going to school or playing with other children. The child might also develop physical symptoms such as headaches or stomach aches at the thought of being separated. Separation anxiety disorder is a mental health condition that will usually not go away without treatment and can lead to panic disorder and other anxiety disorders in adulthood.
What causes separation anxiety?
Separation anxiety occurs when babies begin to learn object permanence. Object permanence is the understanding that people and objects continue to exist, even when the baby cannot see them. Babies begin to understand this when they are 6–12 months old. However, because they do not yet have the ability to understand time, they are not able to know when their caregiver will come back which causes them to become afraid and agitated.
Signs of separation anxiety in babies
Potential signs of separation anxiety in a baby or toddler:
crying when a caregiver leaves the room
clinging to the caregiver, especially in new or unfamiliar situations
a fear of strangers
a strong preference for one caregiver over another
requiring a caregiver to remain nearby so that they can fall asleep
waking at night and crying for their caregiver
How to ease “normal” separation anxiety
Here are some steps that you can take to make the process of seperation easier (for childen with normal separation anxiety).
create quick good-bye rituals
Be consistent!
Try to do the same drop-off with the same ritual at the same time each day. A routine can diminish the heartache and will allow your child to simultaneously build trust in her independence and in you.
Attention
When separating, give your child your full attention, be loving, and provide affection. Say goodbye quickly despite their antics or cries for you to stay.
Keep your promise
You will build trust and independence as your child becomes more confident in his or her ability to be without you if you stick to your promise of return.
Practice being apart
Take your child to other homes, schedule playdates, allow friends and family to provide childcare for you (even for an hour) on the weekend.
Before starting childcare or preschool, practice going to school and your good-bye ritual before you even have to part ways. Give your child a chance to prepare, experience, and thrive in your absence!
Try not to give in.
Reassure your child that he or she will be just fine. Setting consistent limits will help your child to adjust to separation.
When to seek help
Normal childhood separation anxiety may look very similar serious separation anxiety disorders. Therefore, it is important for you to recognize the signs of separation anxiety disorder early and seek medical attention to begin treatment. Common signs include;
refusing to sleep alone
repeated nightmares with a theme of separation
too much worry about the safety of a family member and self
too much worry about getting lost from family
refusing to go to school
fearful and reluctant to be alone
frequent stomach aches, headaches, or other physical complaints
being very clingy (even when at home)
panic or temper tantrums at times of separation from parents or caregivers
Take home message
Separation anxiety is part of normal childhood development.
It will improve after your child reaches the age of 3.
It is important to differentiate between normal separation anxiety and more serious mental health condition that requires medical attention.
This article is written by Dr Itumeleng Buti (MBChB)
References:
1. Healthychildren. Org. How to Ease Your Child’s Separation Anxiety. [Internet] American Academy of Pediatrics Council on Communications and Media; Wendy Sue Swanson; [Updated 2021, July 29; Cited 2022 February 27] Available from: https://www.healthychildren.org/English/ages-stages/toddler/Pages/Soothing-Your-Childs-Separation-Anxiety.aspx
2. Standford Children’s Health. Separation Anxiety Disorder in Children. [Internet] Standford Children’s Health. [Cited 2022 February 28] Available from: https://www.stanfordchildrens.org/en/topic/default?id=separation-anxiety-disorder
3. HelpGuide. Separation Anxiety and Separation Anxiety Disorder.[ Internet] Help Guide.org; Lawrence Robinson, Jeanne Segal, and Melinda Smith; [Updated 2021, October; Cited 2022 February 28] Available from: https://www.helpguide.org/articles/anxiety/separation-anxiety-and-separation-anxiety-disorder.htm
4. Dabkowska M, Araszkiewicz A, Dabkowska A, Wilkosc M. Separation anxiety in children and adolescents. IntechOpen; 2011 Sep 12.
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