Separation Anxiety Disorder In Children: Symptoms And Causes

Children may seem anxious and worried but can cope well with different therapies.

Medically reviewed by Dr. Neha Bhave Salankar, MD Dr. Neha Bhave Salankar Dr. Neha Bhave SalankarMD facebook_icon Specialty: PsychiatryExperience: 11 years
Written by Manjari Srivastava
Last Updated on

Separation anxiety disorder in children is a mental health disorder that triggers symptoms of distress and extreme fear in children at the prospect of being separated from an attachment figure, be it a parent or caregiver. The separation may not be real in some cases but may still trigger the same reaction.

Around 1–4% of children develop childhood separation anxiety disorder or SAD. While most children under three years exhibit clingy behavior and short-term separation anxiety, some children may experience it later in life when under stress. Furthermore, some children may experience more severe symptoms that last longer (1).

Read this article to learn about the symptoms, causes, complications, treatment, and coping strategies for SAD in children.

Symptoms Of Separation Anxiety In Children

The symptoms of separation anxiety may commonly be seen in children after a break from school, such as after a long-term sickness or extended holiday. Although the symptoms may vary in each child, the following are some common ones (2).

  1. Nightmares about separation
  2. Refusal to sleep alone or stay alone
  3. Constant worry about the safety of family members
  4. Constant worry about getting lost from family or losing someone close
  5. Reluctance and refusal to go to school
  6. Excessive concern about one’s safety
  7. Excessive clinginess at home
  8. Constant worry when sleeping away from home
  9. Tantrums and panic at the time of separation from parents, caregivers, or family members
  10. Frequent complains about physical issues, such as headaches and stomach aches
  11. Difficulty saying goodbye to parents

These symptoms can also be seen in other health issues. Thus, consult a pediatrician for an exact diagnosis and treatment.

Causes And Risk Factors For Separation Anxiety In Children

Separation anxiety disorder is often linked to the following risk factors (3).

  • Biological factors: Imbalance in the brain chemicals called neurotransmitters can control how someone feels. Neurotransmitters such as serotonin and dopamine are known to trigger anxiety feelings (2).
  • Family factors: Anxiety issues can be inherited or learned from anyone anxious around the child. Sometimes, parental responses such as allowing a child to miss school if they are eager to go to school can cause more issues on the following day.
  • Environmental factors: Sometimes, traumatic or stressful events such as an illness, death of a family member especially one of the parents, or parents’ divorce can trigger separation anxiety disorder in children.

According to the Child Mind Institute, children who experience trauma, stress, changes in the environment such as moving to a new school or home, and unpleasant events in the family are more vulnerable to separation anxiety disorder than others. In addition, genetic factors may also increase the risk for SAD in some cases (4).

Complications Of Separation Anxiety Disorder In Children

Separation anxiety disorder may increase the risk for anxiety and mood disorders such as panic disorder, obsessive-compulsive disorder (OCD), and agoraphobia (fear of places and situations) in later life. It may also increase the likelihood of substance use disorders and depression (1).

Children may also face problems maintaining interpersonal relationships and face issues at school or other surroundings due to the symptoms. Further, poor academic performance, school refusals, apathy, and social withdrawal can also occur in some cases.

Prevention Of Separation Anxiety In Children

There are no sure-shot ways to prevent separation anxiety disorder in children. However, seeking early psychiatric advice may help reduce the symptoms or prevent the symptoms from worsening (3).

Diagnosis Of Separation Anxiety Disorder

Pediatric psychologists may diagnose separation anxiety disorder by evaluating the child’s symptoms. The child must have had persistent symptoms impairing normal functioning for more than four weeks to meet the diagnostic criteria (4).

Doctors may also see if the level of distress in the child while separated from the parents or caregivers is excessive for their age.

Treatment For Separation Anxiety In Children

The following treatments are recommended for children with SAD (5).

  • Cognitive-behavioral therapy (CBT): It helps teach a child to cope with anxiety. In the initial phase, it can train the child to face the fear of separation and then manage it.
  • Family therapy and parental training sessions: These are also provided to teach strategies and skills to the parents and caregivers to manage a child’s anxiety.
  • Medications: Medicines such as serotonin reuptake inhibitors (SSRIs) are often prescribed to change the level of neurotransmitters in the brain.

In addition to these treatments, psychotherapists also teach a child to develop good sleep habits and ways to manage their academics with the condition.

How To Help A Child Cope With Separation Anxiety?

The following tips may help your child cope with separation anxiety disorder (6).

  • Keep the therapy sessions and follow-ups up to date.
  • Reassure and support your child.
  • Encourage age-appropriate independence in children.
  • Identify the stressful situations that trigger your child’s anxiety and plan to help them cope with them.
  • Inform teachers and peers about the condition and remind them that your child needs additional reassurance at times.
  • Seek support from local and other organizations.

Frequently Asked Questions

1. At what age do most children develop separation anxiety?

Separation anxiety may develop in children as young as four to five months old. Most children develop separation anxiety from 18 to 36 months of age. After three years of age, most children come out of this phase, but it may persist in some children (7).

2. What happens if separation anxiety is left untreated in children?

If your child has separation anxiety even after the age of three years, treatment is usually necessary. Potential complications of untreated separation anxiety include poor mental and physical health, poor academic performance, depression, social seclusion, and other anxiety disorders (1).

Several genetic and environmental factors can contribute to separation anxiety disorder in children. This condition may increase the risk of various mood disorders, including depression in the later stages. However, timely diagnosis and treatment that includes different therapies and medication can help alleviate the symptoms and prevent worsening conditions. Also, fostering a healthy parent-child bond and keeping the home environment stress-free can help your child cope with the problem. If you have difficulty in identifying symptoms, consult your child’s pediatrician.

Key Pointers

  • About 1-4% children may suffer from separation anxiety disorder due to a traumatic experience, neurological issue, or family responses.
  • It typically persists with symptoms such as extreme clinginess, anxiety about losing someone, or complaining about health issues.
  • The psychologist may carry out talk therapies, family sessions, or prescribe medications depending on the symptoms.
  • Be mindful of your child’s behavior since anxiety issues may also lead to complications such as OCD and panic disorder.


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Dr. Neha Bhave Salankar is a consultant psychiatrist at Bhave Institute of Mental Health based in Nagpur and has around 11 years of experience in the field. Having been a meritorious student throughout, she bagged the prestigious gold medal for medicine in MBBS and MD psychiatry.

Read full bio of Dr. Neha Bhave Salankar
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