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Common conditions

Separation Anxiety

What is separation anxiety?

What is separation anxiety?

Separation anxiety is the experience of fear and worry that comes with separating from a loved one or even home, and it’s a regular part of childhood. Separation anxiety disorder (SAD) is when that worry becomes all-consuming, making it hard to sleep, go to school, and feel confident and connected in relationships. When excessive, separation anxiety can make you dread leaving home or worry that something terrible will happen to you or to the people you love when you’re not together. These intense feelings of worry can make everyday life challenging, but they don't have to control your life—treatment is available to help you cope and thrive.

Signs & symptoms of separation anxiety

Symptoms

While separation anxiety is common among toddlers and babies, it can actually affect people of all ages. Typical symptoms of separation anxiety include:

  • Physical discomfort like headaches, stomach aches, or experiencing panic attacks when you’re worried about separating from a loved one or family member
  • Lots of worries about being away from home and the people you love
  • Not wanting to ever leave the house because of fear that you might not return
  • Difficulty sleeping without a parent or loved one nearby
  • Trouble being at home alone for fear of bad things happening
  • Nightmares about losing the people you love
  • Constant fears that something terrible will happen to the people you care about
  • Panic attacks when you’re away from loved ones

What causes separation anxiety?

Causes

Big life changes might trigger separation anxiety or make it worse. If someone close to you has died, you might start worrying that this could happen to somebody else in your life. Other stressful events that may worsen separation anxiety include divorce, changing schools, sickness in the family, or any kind of major loss, such as the death of a beloved pet.

Risk factors for separation anxiety

Risk Factors

Some people are more likely than others to experience separation anxiety. The following risk factors may increase your likelihood of developing separation anxiety:

Genetics. You may be more prone to experiencing separation anxiety if someone in your family’s history has had it, as genetics might play a role.

Age. SAD usually starts in childhood, with the average age being 6. But for some, it can continue into or start later in the teenage years and extend into adulthood.

Environment. If you experience a highly stressful event or major disaster that separates you from your family, you may be more likely to feel separation anxiety.

Anxiety disorder. People who are diagnosed with other anxiety or mental health disorders may be more likely to experience separation anxiety.

Prevention

Prevention

There aren’t any definitive ways to prevent separation anxiety, but there are ways to get help for it. As soon as these worries start getting in the way of everyday activities, the best thing you can do is find support from a mental health professional.

Diagnosis

Diagnosis

If you believe you’re struggling with separation anxiety, talking to a provider is a good place to start. They may ask you questions about your worries to see if you fit the criteria for SAD in the DSM-5, a guidebook of mental health conditions widely used by professionals. Sometimes, and with your consent, your provider may speak with the people close to you to better understand your symptoms. They will also evaluate your symptoms to see if they better match those of another disorder.

Treatment

Treatment

Therapy and/or the right medication can help you manage separation anxiety so it doesn’t control your life. Often, it’s a matter of learning what causes this anxiety and finding ways to manage your reactions in the face of big changes or stressful situations.

Talk therapy

The most well-established way to treat separation anxiety is with cognitive behavioral therapy (CBT), a form of talk therapy that helps you reframe negative thoughts, develop strategies to cope with stress, and help you to be more confident and comfortable when separating from loved ones. Other therapies that can help with separation anxiety include family therapy and dialectical behavioral therapy (DBT), which can help you manage overwhelming emotions and learn to practice mindfulness.

Medication

There are also certain medications that can help people manage the symptoms of separation anxiety. Every person is unique—it may take some time, trial and error, or adjustment before you find a medication that works for you. Some common medications for separation anxiety include:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin-norepinephrine reuptake inhibitors (SSNRIs)

The Center for Youth Mental Health at NewYork-Presbyterian

Get Care

The Center for Youth Mental Health is a rich resource, bringing together doctors from Columbia University Vagelos College of Physicians and Surgeons and Weill Cornell Medicine to lead research and treatment programs that give young people the care they need. Learn more.