What is separation anxiety disorder?

Separation anxiety is a normal part of childhood development. It commonly occurs in babies between 8 and 12 months old, and usually disappears around age 2. However, it can also occur in adults.

Some children have symptoms of separation anxiety during their grade school and teenage years. This condition is called separation anxiety disorder or SAD. Three to four percent of children have SAD.

SAD tends to indicate general mood and mental health issues. Around one-third of children with SAD will be diagnosed with mental illness as an adult.

Symptoms of SAD occur when a child is separated from parents or caregivers. Fear of separation can also cause anxiety-related behaviors. Some of the most common behaviors include:

  • clinging to parents
  • extreme and severe crying
  • refusal to do things that require separation
  • physical illness, such as headaches or vomiting
  • violent, emotional temper tantrums
  • refusal to go to school
  • poor school performance
  • failure to interact in a healthy manner with other children
  • refusing to sleep alone
  • nightmares

SAD is more likely to occur in children with:

  • a family history of anxiety or depression
  • shy, timid personalities
  • low socioeconomic status
  • overprotective parents
  • a lack of appropriate parental interaction
  • problems dealing with kids their own age

SAD can also occur after a stressful life event such as:

  • moving to a new home
  • switching schools
  • divorce
  • the death of a close family member

Children that experience three or more of the above symptoms may be diagnosed with SAD. Your doctor may order additional tests to confirm the diagnosis.

Your doctor might also watch you interact with your child. This shows whether your parenting style affects how your child deals with anxiety.

Therapy and medication are used to treat SAD. Both treatment methods can help a child deal with anxiety in a positive way.


The most effective therapy is cognitive behavioral therapy (CBT). With CBT, children are taught coping techniques for anxiety. Common techniques are deep breathing and relaxation.

Parent-child interaction therapy is another way to treat SAD. It has three main treatment phases:

  • Child-directed interaction (CDI), which focuses on improving the quality of the parent-child relationship. It involves warmth, attention, and praise. These help strengthen a child’s feeling of safety.
  • Bravery-directed interaction (BDI), which educates parents about why their child feels anxiety. Your child’s therapist will develop a bravery ladder. The ladder shows situations that cause anxious feelings. It establishes rewards for positive reactions.
  • Parent-directed interaction (PDI), which teaches parents to communicate clearly with their child. This helps to manage poor behavior.

The school environment is another key to successful treatment. Your child needs a safe place to go when they feel anxious. There should also be a way for your child to communicate with you if necessary during schools hours or other times when they’re away from home. Finally, your child’s teacher should encourage interaction with other classmates. If you have concerns about your child’s classroom, speak with the teacher, principle, or a guidance counselor.

Online therapy options

Read our review of the best online therapy options to find the right fit for you.

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There are no specific medications for SAD. Antidepressants are sometimes used in older children with this condition if other forms of treatment are ineffective. This is a decision that must be carefully considered by the child’s parent or guardian and the doctor. Children must be monitored closely for side effects.

Emotional and social development are both seriously affected by SAD. The condition can cause a child to avoid experiences crucial to normal development.

SAD can also affect family life. Some of these problems may include:

  • family activities that are limited by negative behavior
  • parents with little to no time for themselves or each other, resulting in frustration
  • siblings that become jealous of the extra attention given to the child with SAD

If your child has SAD, speak with your doctor about treatment options and ways you can help manage its effect on family life.