Picture this: you’re a stay-at-home parent to a three-year-old boy. Your spouse works two jobs to support cost of living. You both agree that it’s important to set aside time to cultivate intimacy in your marriage so your spouse takes time away from work for a romantic date night. Your normal babysitter can’t make it on such short notice, but sets up an arrangement for you with a trusted friend with great babysitting references.
Date night arrives and you reassure your son that you will only be a few hours away from him, yet he seems clingier than normal. The door bell rings and the two of you head to the door to greet the new babysitter. You introduce yourself with a bright smile on your face and before you can introduce your son, he is throwing a tantrum on the floor, kicking and screaming at the top of his lungs. The babysitter insists that date night should commence and your spouse agrees so you go about date night, worrying about your son because this is not the first time he’s had a hard time being away from you. In fact, it happens more often than not. You ask yourself what is causing his separation anxiety, how can you help him overcome this anxiety, and if there will be repercussions for this later in life.
According to the DSM-5, separation anxiety disorder (SAD) is placed under the category of anxiety disorders. children with this disorder have a lot of anxiety associated with being away from attachment figures. This can include parents and physical objects that are comforting to the child. The child exhibits low self-esteem, shyness, sensitivity, and are nervous about situations outside of their comfort zone. He or she may become overwhelmed with worry and fears about negative outcomes from being away from the attachment figure to which they cling tightly (Hooley et al, 2017). They may exhibit behavior such as tantrums and clinginess. Physiological symptoms may include stomachaches, headaches, and nausea associated with having to be apart from their attachment figure (Ehrenrich et al, 2008).
Separation anxiety does not only affect the individual diagnosed with it. It can affect the entire family dynamic, especially when siblings are involved. If the child with SAD becomes demanding of parental attention, it can take away quality time with other siblings and cause some rivalry. It can also be difficult for parents to find alone time or even time to cultivate their marriage (Ehrenrich et al, 2008).
According to Ehrenrich and colleagues (2008), SAD is thought to be caused by both nature and nurturing factors. Individuals may have a genetic disposition to anxiety in which imbalances with serotonin and norepinephrine occur (Stanford Children’s Health, 2018). It may also be a learned trait if parents have a tendency to be anxious or if they do not promote autonomy within the child. SAD may also develop following a situation that may cause grief, such as the loss of a family member or a beloved pet (Hooley et al. 2017).
In many cases, children outgrow their separation anxiety (Hooley et al, 2017). However, in some cases, this does not happen. Childhood SAD increases the risk of an individual to carry the disorder into adulthood if left untreated (Mohatt et al. 2014). Adults with a history of childhood SAD are at higher risk for developing depression, panic disorder, and agoraphobia (Ehrenrich et al, 2008).
Treatment includes medications of the selective serotonin reuptake inhibitors (SSRIs) in conjunction with cognitive-behavioral therapy (CBT). Together, the treatments have shown evidence of positive effects than either treatment by itself (Mohatt et al. 2014).
