Separation Anxiety Disorder
What
is separation anxiety disorder?
Separation anxiety disorder (SAD) is defined as excessive worry and
fear about being apart from family members or individuals to whom a
child is most attached. Children with separation anxiety disorder fear
being lost from their family or fear something bad happening to a family
member if they separated from them. Symptoms of anxiety or fear about
being separated from family members must last for a period of at least
four weeks to be considered SAD. It is different than stranger anxiety,
which is normal and usually experienced by children between 7 and 11
months of age. Symptoms of SAD are more severe than the normal separation
anxiety that nearly every child experiences to some degree between the
ages of 18 months and 3 years of age.
What
causes separation anxiety disorder?
Anxiety disorders are believed to have biological, family, and environmental
factors that contribute to the cause. A chemical imbalance involving
two chemicals in the brain (norepinephrine and serotonin) most likely
contributes to the cause of anxiety disorders. While a child or adolescent
may have inherited a biological tendency to be anxious, anxiety and
fear can also be learned from family members and others who frequently
display increased anxiety around the child. A traumatic experience may
also trigger anxiety. The manner in which a person copes with anxiety
may make it worse or better over time.
Who
is affected by separation anxiety disorder?
All children and adolescents experience some anxiety. It is a normal
part of growing up. However, when worries and fears are developmentally
inappropriate concerning separation from home or family, separation
anxiety disorder may be present. Reports indicate that SAD occurs equally
in males and females. However, studies suggest that males experiencing
symptoms of SAD are more likely than females to be referred for help and
receive treatment. The first symptoms of SAD usually appear around
the third or fourth grade, but this is not always the case. Typically,
the onset of symptoms occurs following a break from school such as holidays or an extended illness.
It is estimated that about 4 percent of younger children have SAD, while
the estimate for adolescents is slightly lower. Children of parents
with an anxiety disorder are more likely to have an anxiety disorder.
What
are the symptoms of separation anxiety disorder?
The following are the most common signs of SAD. However, each child
may experience symptoms differently. Symptoms may include:
•
refusal to sleep alone
• repeated nightmares with a theme of separation
• excessive distress when separation from home or family occurs
or is anticipated
• excessive worry about the safety of a family member
• excessive 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
• muscle aches or tension
• excessive worry about safety of self
• excessive worry about or when sleeping away from home
• excessive “clinginess,” even when at home
• symptoms of panic and/or temper tantrums at times of separation
from parents or caregivers
The symptoms
of separation anxiety disorder may resemble other conditions or psychiatric
problems. Always consult a licensed mental health provider for a diagnosis.
How
is separation anxiety disorder diagnosed?
A child psychologist or other qualified mental health professional usually
diagnoses anxiety disorders in children or adolescents following a comprehensive
psychiatric evaluation. Parents who note signs of severe anxiety in
their child or teen can help by seeking an evaluation and treatment
early. Early treatment can often prevent future problems.
Treatment
for separation anxiety disorder...
Specific treatment for separation anxiety disorder will be determined
by your child's clinician based on:
• your child's age, overall health, and medical history
• extent of your child's symptoms
• your child's tolerance for specific medications, procedures,
or therapies
• expectations for the course of the condition
• your opinion or preference
Anxiety
disorders can be effectively treated. Studies have found that about
96% of children with SAD who were referred for treatment were free from
the disorder when re-evaluated 3-4 years later. Treatment should always be based
on a comprehensive evaluation of the child and family. Treatment recommendations
may include cognitive behavioral therapy (CBT) for the child, with the focus
being to help the child or adolescent learn skills to manage his/her
anxiety and to help him/her master the situations that contribute to
the anxiety. CBT is the most studied psychosocial treatment for SAD.
Many studies have demonstrated the general effectiveness of CBT for SAD. Some children may also benefit from treatment with antidepressant
or anti-anxiety medication to help them feel calmer. Medication alone
is never considered the treatment of choice given the highly likely
of relapse for individuals who receive medication without psychotherapy.
Parents play a vital, supportive role in any treatment process. Family
therapy and consultation with the child’s school may also be recommended.
Prevention
of separation anxiety disorder...
Preventive measures to reduce the incidence of separation anxiety disorders
in children are not known at this time. However, early detection and
intervention can reduce the severity of the disorder, enhance the child’s
normal growth and development, and improve the quality of life experienced
by children or adolescents with separation anxiety disorder.
Our
doctors who treat separation anxiety disorder include:
Drs.
Goldberg,
Kurland,
Lauretti,
Devlin and
Berkman.
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