Separation Anxiety Disorder (SAD): Causes, Symptoms, and Treatment

 Introduction

Separation Anxiety Disorder (SAD) is a psychological condition in which fear and distress is

excessive following separation from a person or a place an individual has a strong emotional

bond to. Although it is most often seen in children, people of all ages can have SAD. The

disorder is more than the level of anxiety normal for children who have been separated from their

parents and can interfere with daily life substantially.

It is estimated that 4 to 5% children and 1 to 2% adults have SAD (American Psychiatric

Association, 2020). Mild separation anxiety is expected in early childhood, but persistent and

excessive fear of separation may well be a deeper problem calling for support. Information

related to what causes SAD, symptoms and treatments should be understood to help cope with

SAD and its effect on mental well being.

Understanding Separation Anxiety Disorder

Definition and Classification

Separation Anxiety Disorder is defined in the fifth edition of the Diagnostic and Statistical

Manual of Mental Disorders (DSM-5) as excessive anxiety related to separation that is

developmentally inappropriate. Symptoms present for at least four weeks in children or six

months in adults are included amongst the criteria for diagnosis of the disorder (APA, 2013).

Separation Anxiety in Children vs. Adults

SAD is much more often diagnosed in children; however, it can continue into adulthood if left

untreated. Although SAD presents with symptoms of crying, tantrums, and refusal to attend

school, for adults, separation from loved ones may cause high levels of stress which in turn

contributes to avoidance behaviors, absenteeism from work and relationship problems.

Common Misconceptions about SAD

1. SAD is only a childhood disorder – In reality, adults can also experience severe

separation anxiety.

2. It’s just clinginess – SAD is a serious psychological disorder that affects mental and

emotional well-being.

3. Children will outgrow it naturally – Without proper intervention, SAD can lead to

long-term anxiety disorders.

3. Causes and Risk Factors

The development of SAD involves various factors such as biological, psychological and

environmental components.

Biological Factors

According to research, imbalances in the brain chemicals serotonin and dopamine, which control

the moods and anxiety levels, are present among individuals with SAD (Ehrenreich-May et al.,

2019). SAD is also influenced by genetic predisposition; there is a greater likelihood that

children of parents with anxiety disorders will develop SAD.

Psychological Factors

1. Children with insecure attachment styles are more prone to SAD.

2. Past Trauma: If you have a history of divorce of your parents, losing of a loved then you

are likely to suffer from this condition; i.e. excessive anxiety about separation.

Environmental Factors

1. Parenting involving Overprotective Parenting may unintentionally contribute to the

development of SAD since they do not encourage a sense of independence in the

children.

2. There are major life changes that serve as triggers, such as moving to a new city,

changing schools, or turbulence in the family.

3. Exposure to Anxiety Prone Individuals: Children who grow up in an atmosphere where

caregivers are very nervous have a tendency to develop SAD.

4. Symptoms and Diagnosis

Emotional Symptoms

 Intense distress when anticipating or experiencing separation

 Fear of losing loved ones

 Persistent worry about being alone or abandoned

Behavioral Symptoms

 Clinging to parents or caregivers

 Avoiding social interactions and school refusal

 Difficulty sleeping alone

Physical Symptoms

 Nausea, stomachaches, and headaches

 Rapid heartbeat and dizziness

 Panic attacks

Diagnosis Process

A mental health professional evaluates the individual’s symptoms using clinical interviews and

diagnostic criteria from the DSM-5. Questionnaires such as the Separation Anxiety Inventory

(SAI) and Revised Child Anxiety and Depression Scale (RCADS) may be used for

assessment.

5. Impact on Daily Life

SAD can have profound consequences on various aspects of life, including:

 Academic and Work Performance: Children may struggle with school attendance,

while adults may avoid work-related travel.

 Social and Relationship Difficulties: Fear of separation may lead to dependency issues

and relationship conflicts.

 Risk of Co-Occurring Disorders: SAD increases the likelihood of developing

depression, panic disorder, or generalized anxiety disorder.

6. Treatment Options

Psychotherapy

1. Cognitive Behavioral Therapy (CBT): Helps individuals challenge irrational thoughts

and develop coping mechanisms.

2. Exposure Therapy: Gradual exposure to separation scenarios helps reduce fear over

time.

3. Play Therapy: Used for children, helping them express their anxiety in a controlled

environment.

Medications

1. Selective Serotonin Reuptake Inhibitors (SSRIs): Used in severe cases to manage

anxiety symptoms.

2. Anti-Anxiety Medications: Such as benzodiazepines, though typically recommended for

short-term use.

Parenting and Support Strategies

1. Encouraging Independence: Gradual separation training builds resilience.

2. Using Positive Reinforcement: Rewarding children for managing time apart

successfully.

3. Establishing a Goodbye Routine: A consistent, reassuring departure routine can ease

anxiety.

7. Coping Strategies and Prevention

For Individuals with SAD

 Deep breathing and mindfulness are relaxation techniques to practice

 Further, engaging in structured routines for reducing uncertainty.

 Social support and accessing anxiety management groups

For Parents and Caregivers

 Promoting healthy attachment while not neglecting independence is another great aim.

 Encouraging social activities and new experiences

 Teaching children about anxiety and how to manage them

Prevention Strategies

• Intervention at the earliest time possible through therapy and counseling

• Encouraging resilience and problem-solving skills from an early age

• Involving reduction in the children’s exposure to increased parental anxiety.

Conclusion

Although a very serious illness, Separation Anxiety Disorder is very treatable and afflicts both

children and adults. So while normal separation anxiety is part of development in a child, if the

fear and distress continues for an extended period of time, that arouses our concern and signals

that it’s time that we intervene. This will help individuals and their families to effectively

manage it by understanding its causes, symptoms and treatment.

The early diagnosis and intervention in preventing long term anxiety related disorders. If you or

somebody you understand are combating SAD, you might assist your life quality consider a

psychological wellness expert. Breaking free from separation anxiety becomes possible by

increasing awareness and getting support as well as professional guidance.

References

 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental

Disorders (5th ed.). Washington, DC.

 Ehrenreich-May, J., & Chu, B. C. (2019). Transdiagnostic Treatment of Emotional

Disorders in Children and Adolescents.

 Scharfstein, L. A., & Beidel, D. C. (2017). "Separation Anxiety in Children and

Adolescents: A Review of the Theoretical and Empirical Literature." Journal of Child

Psychology & Psychiatry.