Separation Anxiety Disorder

Separation anxiety is normal in very young children (those between 8 and 14 months old).

Kids often go through a phase when they are "clingy" and afraid of unfamiliar people and places.

When this fear occurs in a child over age 6 years, is excessive, and lasts longer than four weeks, the child may have separation anxiety disorder.

Some children also develop physical symptoms, such as headaches or stomach aches, at the thought of being separated.

The fear of separation causes great distress to the child and may interfere with the child’s normal activities, such as going to school or playing with other children. [2]

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Separation anxiety disorder occurs because a child feels unsafe in some way.

Take a look at anything that may have thrown your child’s world off balance, made them feel threatened, or upset their normal routine.

Common causes of separation anxiety disorder in children include:

Change in environment:

• Changes in surroundings, such as a new house, school, or day care situation, can trigger separation anxiety disorder.

Stress:

• Stressful situations like switching schools, divorce, or the loss of a loved one including a pet can trigger separation anxiety problems.

An overprotective parent:

• In some cases, separation anxiety disorder may be the manifestation of your own stress or anxiety.
• Parents and children can feed one another’s anxieties.

Insecure attachment:

• The attachment bond is the emotional connection formed between an infant and their primary caretaker.
• While a secure attachment bond ensures that your child will feel secure, understood and calm enough for optimal development, an insecure attachment bond can contribute to childhood problems such as separation anxiety. [3]

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Separation anxiety disorder most often begins in childhood, but may continue into the teenage years and sometimes into adulthood.

Risk factors may include:

• Being female.
• Life stresses or loss that result in separation, such as the illness or death of a loved one, loss of a beloved pet, divorce of parents, or moving or going away to school.
• Certain temperaments, which are more prone to anxiety disorders than others are
• Family history, including blood relatives who have problems with anxiety or an anxiety disorder, indicating that those traits could be inherited.
• Environmental issues, such as experiencing some type of disaster that involves separation. [1]

Pathogenesis refers to the development of a disease. It’s the story of how a disease gets started and progresses.

This is the entire journey of a disease, encompassing the cause but going beyond it.

Pathophysiology, on the other hand, focuses on the functional changes that occur in the body due to the disease. It explains how the disease disrupts normal physiological processes and how this disruption leads to the signs and symptoms we see.

Imagine a car accident. Pathogenesis would be like understanding how the accident happened – what caused it, the sequence of events (e.g., one car ran a red light, then hit another car). Pathophysiology would be like understanding the damage caused by the accident – the bent fenders, deployed airbags, and any injuries to the passengers.

In simpler terms, pathogenesis is about the "why" of a disease, while pathophysiology is about the "how" of the disease’s effects.

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Separation anxiety disorder is diagnose when symptoms are excessive for the developmental age and cause significant distress in daily functioning.

Symptoms may include:

• Recurrent and excessive distress about either anticipating or being away from home or loved ones.
• Furthermore, Constant, excessive worry about losing a parent or other loved one to an illness or a disaster.
• Constant worry that something bad will happen, such as lost or kidnapped, causing separation from parents or other loved ones.
• Refusing to away from home because of fear of separation.
• Not wanting to home alone also without a parent or other loved one in the house.
• In detail, Reluctance or refusing to sleep away from home without a parent or other loved one nearby.
• Lastly, Repeated nightmares about separation.

Other symptoms

• Frequent complaints of headaches, stomachaches or other symptoms when separation from a parent or other loved one anticipate. [1]
• Child may shadow you around the house or cling to your arm or leg if you attempt to step out.
• Refusal to go to school in order to stay with the caregiver.
• Bed wetting.
• Repeated temper tantrums or pleading. [2]

Separation anxiety disorder may associate with panic disorder and panic attacks repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes.

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Diagnosis

As with adults, mental illness in children is diagnosed based on signs and symptoms.

If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination.

Although there are no laboratory tests to specifically diagnose separation anxiety disorder, the doctor may use various tests such as blood tests and other laboratory measures to rule out physical illness or medication side effects as the cause of the symptoms.

Role of Psychiatrists

If no physical illness is found, the child may be referred to a child and adolescent psychiatrist or psychologist, mental health professionals who are specially trained to diagnose and treat mental illness in children and teens.

Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a child for a mental illness.

The doctor bases his or her diagnosis on reports of the child’s symptoms and his or her observation of the child’s attitude and behavior. [2]

Complications are what happen after you have a disease. They are the negative consequences of the disease process.

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Most mild cases of separation anxiety disorder do not need medical treatment.

In more severe cases, or when the child refuses to go to school, treatment may be needed.

The goals of treatment include reducing anxiety in the child, developing a sense of security in the child and the caregivers, and educating the child and family/caregivers about the need for natural separations. Treatment options that may be used include:

Psychotherapy:

• Psychotherapy (”talking” therapy) is the main treatment approach for separation anxiety disorder.
• The focus of therapy is to help the child tolerate being separated from the caregiver without the separation causing distress or interfering with function. [2]

Cognitive Behavioral Therapy (CBT):

• Through CBT, children learn how to recognize their anxious feelings and their physical responses to anxious thoughts.
• They learn to identify their triggers and the thought patterns that contribute to their anxious feelings.
• Through a variety of techniques, children learn strategies to manage their anxious thoughts and feelings and cope with their emotions. [4]
• It works to reshape the child’s thinking (cognition) so that the child’s behavior becomes more appropriate.

Family therapy:

• Incorporating parents and other family members into the treatment process can improve outcomes for the child.
• In family therapy, parents and siblings can learn new ways to interact with the child and tease out patterns of behavior.
• They can also learn useful strategies to help the child when anxiety spikes. [4]
• Family therapy also may help teach the family about the disorder and help family members better support the child during periods of anxiety. [2]

Play therapy:

• Younger children can have difficulty connecting the dots between thoughts, feelings, and actions.
• For these children, play therapy can help them demonstrate and process their emotions and learn to cope with them.
• Relaxation training is essential for children and adolescents struggling with separation anxiety disorder.
• Deep breathing, guided relaxation, and progressive muscle relaxation can also help children and adolescents learn to self-soothe during anxious times. [4]

Medication:

• Either Antidepressant or other anti-anxiety medications may be used to treat severe cases of separation anxiety disorder. [2]

If symptoms continue to negatively affect your child also make it difficult for your child to attend school or even leave the house, medication might help.

Overall, It’s important to seek a medication evaluation from a child and adolescent psychiatrist, because medications can have significant side effects for children. [4]

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Lycopodium:

• Lycopodium is also one of the remedies that useful for the anxiety felt in anticipating something.
• Anticipatory anxiety a common problem experience by school children.
• The child who needs Lycopodium experiences their anticipatory anxiety in their stomachs with, not only tummy pains, but with a lot of wind and bloating.
• The key feature, however, is the contrast between their behaviour at home and that at school.

Staphysagria:

• Children can find it very difficult to talk about their experience of bullied also the problem might only manifest itself through illness.
• Moreover, Staphysagria a very commonly indicate remedy for a child who is being bullied.
• The key features which should lead you to think about it are noticing that the child bottles up his or her anger which can then explode briefly from time to time.
• In detail, In between the explosions of anger they can appear to be very sweet, happy children.
• Besides this, Indignation is the other key feature of the state which indicates the need for Staphysagria.
• Lastly, The child will use the phrase “It’s not fair!” or “I don’t deserve this!”

Apis Mellifica:

• These children are industrious, busy children at school who have quite a different energy from their classmates.
• They like to organise everyone also can be very bossy.
• Think of the queen bee. Additionally, This is how they are.
• They can also be very jealous children.
• Besides this, This might be when the bossiness turns to bullying.
• Just as the queen bee will admit no rivals into the hive, so will the child who needs Apis be competitive and engaged in power struggles for dominance in the classroom. [6]

Pulsatilla:

• Pulsatilla child is gentler and more clingy and fearful.
• They often stay close to their parent or carer in the consulting room and although they may want to play with a particular toy, will only do so if Mum or Dad sits on the floor with them.
• They have a core weakness that makes them sensitive to a perceived possible abandonment by a parent and this sensitivity can play a major role in the child’s psychological make-up. [7]

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Frequently Asked Questions

What is Separation Anxiety Disorder?

Separation anxiety disorder is a condition in which a child becomes fearful and nervous when away from home or separated from a loved one usually a parent or other caregiver to whom the child is attached.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Separation Anxiety Disorder?

• Lycopodium
• Staphysagria
• Apis Mellifica
• Pulsatilla

What are the 6 signs of Separation Anxiety Disorder?

• Anticipating or being away from home or loved ones
• Constant, excessive worry about losing a parent or other loved one
• Constant worry that something bad will happen
• Refusing to be away from home
• Frequent complaints of headaches, stomach aches
• Repeated nightmares about separation

What causes Separation Anxiety Disorder?

• Change in environment
• Stress
• An overprotective parent
• Insecure attachment