Understanding Separation Anxiety

Understanding Separation Anxiety

Separation anxiety is a condition in which someone has an extreme fear about becoming separated from a person, place or even an animal. This person, place or animal usually gives them a sense of feeling safe.

It can cause intense anxiety, distress and fear when the person is separated – or even when a separation is anticipated.

While it is most commonly experienced in children when they are separated from a parent or primary caregiver, it can also affect adolescents and adults. The latter typically experience anxiety when separated from their children, spouse, or significant other.

Most children will outgrow separation anxiety and it is considered a normal stage of development in children aged up to six years. However, when separation anxiety occurs in adults (ASAD) and interferes with age-appropriate behavior, it becomes a disorder that needs to be treated.

Separation anxiety disorder (SepAD) is listed in the DSM-5 – the “guidebook” used by professionals for mental health diagnosis – where it is recognized as an adolescent and adult disorder as well.

How common is separation anxiety disorder?

Children aged seven years or older who show signs of being distressed when apart from their caregivers may be diagnosed with SepAD. Around four percent of children aged from seven to 11 are thought to have the disorder. It affects both sexes equally.

In adolescents, separation anxiety is seen in marginally under four percent (3.9%) of those aged 12 to 14 years. But this decreases to only 1.3 percent in teenagers aged 14 to 16 years. 

World Mental Health Survey data revealed the lifetime prevalence rate of adult SepAD to be five percent across all countries. Yet it afflicts seven percent of Americans at some point in their lives, according to one study

More than a third of adults with SepAD had separation anxiety in their childhood.

What are the symptoms of separation anxiety?

depressed regretful image of man standing by the window

Separation anxiety symptoms can be emotional and physical. Some symptoms commonly experienced are:

  • Nausea
  • Vomiting
  • Dizziness and lightheadedness
  • Irritability
  • Panic attacks
  • Headaches
  • Crying excessively
  • Obsessive thoughts
  • Mood swings
  • Muscle tension
  • Stomach aches
  • Sleep disturbances, including insomnia

Those with separation anxiety may also become socially withdrawn, have difficulty concentrating, or show extreme sadness when loved ones are out of reach.

Which conditions co-occur with separation anxiety?

Conditions that commonly co-occur with separation anxiety include:

How is separation anxiety disorder diagnosed?

In the DSM-5, the diagnosis of separation anxiety disorder includes:

Inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following:

•   Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures.

•   Persistent and excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters or death.

•   Persistent and excessive worry about experiencing an untoward event (for example, getting lost, being kidnapped, having an accident, becoming ill) that causes separation from a major attachment figure.

•   Persistent reluctance or refusal to go out, be away from home, go to school, go to work, or elsewhere because of fear of separation.

•   Persistent and excessive fear or reluctance about being alone or without major attachment figures at home or in other settings.

•   Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure.

•   Repeated nightmares involving the theme of separation.

•   Repeated complaints of physical symptoms (headaches, stomach aches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated.

This fear, anxiety or avoidance needs to be persistent – lasting at least four weeks in children and adolescents, and six months or more in adults. It must be seen to cause clinically significant distress or impairment in occupational, social, academic or other important areas.

In addition, it cannot be explained by another mental health problem. For example, a refusal to go outside could be due to agoraphobia, or general worries linked with generalized anxiety disorder.

Who is most likely to have separation anxiety?

Separation anxiety disorder often starts in childhood but it can be triggered in later life. Risk factors include:

Traumatic life experiences

blurred image of traumatized teenage girl inside a room

SepAD is more often seen in people who have experienced a traumatic event or situation, specifically the illness or death of a loved one, divorce, abuse, a more stressful than usual pregnancy or birth, conflict/war, or a natural disaster. These can all trigger separation anxiety.

Attachment style

Someone with an insecure attachment style is more likely to have separation anxiety disorder. Attachment styles describe the different ways people interact and connect with other people, connected to their childhood relationship with their parents or other key caregivers.

Genetic factors

Several experts believe that genetics could also play a part in separation anxiety disorder developing. If biological relatives have anxiety disorders or other mental health illnesses, there is a possibility that these traits may be inherited. This does not mean everyone with a family history will develop SepAD. However, studies show they are more susceptible to developing anxiety disorders than those without these genetic influences. 


Environmental factors such as moving to a new place, starting a new school, or even a change in routine seem to trigger separation anxiety in some people. 

How Tikvah Lake can help you or a loved one

blurred image of man in therapy

Thankfully, there are many treatment options that are proven to help with separation anxiety disorder. These include talking therapy, Cognitive Behavioral Therapy (CBT), learning relaxation techniques such as meditation and deep breathing, support groups, and anti-anxiety medication.

Our team of experts has helped people with all mental health problems, including those involving anxiety. We are here 24/7 to help and support anyone struggling with their mental health and to ensure they receive the care and healing they need for lasting recovery.

Treatment is, naturally, completely confidential. 

Get in touch with us to hear how we can help you or someone you care about with a completely personalized recovery program – starting today.

David Hurst - Tikvah Lake Recovery

About David Hurst

David Hurst has four books published on mental health recovery, including 12 Steps To 1 Hero, The Anxiety Conversation and Words To Change Your Life. He has written for national newspapers and magazines around the world for 30 years including The Guardian, Psychologies, GQ, Esquire, Marie Claire and The Times. He has been in successful continual recovery since January 2002.

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