Separation Anxiety Disorder
Separation anxiety disorder involves developmentally inappropriate and excessive fear about actual or anticipated separation from attachment figures, with persistent effects on school, work, sleep, relationships or independence.
Not limited to childhood
A child may refuse school, struggle to sleep alone or develop repeated stomach aches before separation. An adult may avoid travel or being alone, repeatedly check whether a partner, child or parent is safe, or fear that an event will prevent reunion.
Close family bonds are not a disorder. Assessment asks whether fear is disproportionate to developmental level and context and whether it causes substantial distress or limitation.
Signs and assessment
- Marked distress before or during separation, persistent fear that harm will come to an attachment figure, and reluctance to leave home, attend school or work, travel or sleep alone.
- Nightmares or physical symptoms such as headache, nausea or abdominal pain may occur as separation approaches.
- The pattern lasts at least four weeks in children and adolescents and typically six months or more in adults, with careful consideration of culture and genuine safety.
Treatment and support
CBT can help identify feared predictions, regulate anxiety and practise separation gradually. Exposure is planned collaboratively in manageable steps rather than forced. For children, work with parents and school can create predictable transitions, regular attendance and growing autonomy without shame or punishment.
Medication may be considered by a specialist in selected cases, particularly when another anxiety or depressive disorder is also present.
When to seek help
Seek assessment when anxiety persists beyond what is expected for age, repeatedly prevents school or work, disrupts sleep or physical wellbeing, or seriously limits independence and relationships. When fear reflects real violence, abuse, neglect or danger, practical protection comes before treating it as anxiety.