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Separation Anxiety Disorder

Unraveling the Mystery of Separation Anxiety Disorder: A Compassionate Guide to Understanding, Managing, and Overcoming SAD.

Separation Anxiety Disorder

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    Separation Anxiety Disorder (SAD) is a condition marked by the overriding fear of being separated from a caregiver or loved one. It’s most common in children but can continue into adulthood. Research from the Canadian Paediatric Society, showed 9% of children reported an anxiety disorder in 2019, with SAD being the most common.

    If a child suffers from Separation Anxiety Disorder, they’re more likely to experience physical and mental health issues during their adolescent years (CAMH). With its many symptoms and potentially damaging effects, addressing the underlying issues is central to successfully treating the disorder and ensuring the individual can form healthy attachments later on in life.

    Well Beings Counselling works with children, adolescents and adults with SAD, providing effective therapeutic approaches that help individuals learn vital coping strategies to combat negative thought patterns successfully. With a range of counsellors and psychotherapists available throughout Canada, you can begin your healing journey today.

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    Separation Anxiety Disorder in children

    All babies suffer general separation anxiety because they’re fully reliant on their caregivers during the early months of their lives. However, while most children grow out of it and learn that their caregivers will return to them, others might continue to struggle. 

    Separation anxiety becomes a disorder when the child doesn’t have age-appropriate reactions to being away from their parents. The symptoms become more intense and can often impact the child’s ability to socialize, develop academically and become independent. 

    If left untreated, the symptoms can continue into adolescence. 

    The symptoms of SAD in children

    Children can experience a range of symptoms, depending on how severe their separation anxiety is and how it manifests. Anxiety disorders can result in both mental and physical symptoms, causing significant interruptions to daily functioning.

    Mental and emotional symptoms include: 

    • A fear of bad things happening when separated from loved ones. For example, the child might fear getting lost or being abducted. 
    • Worrying that their family members will experience adverse events when they’re away. Some children might be anxious about their caregiver passing away or becoming unwell. 
    • Not wanting to be left alone. Some children might throw temper tantrums or cry when their caregiver leaves them at nursery or school. 
    • Following parents or people, they’re attached to around the house.  
    • Experiencing nightmares, with dreams about separation scenarios and a parent’s death being the most common (Springer Link).

    Physical symptoms include:  

    • Stomach aches, diarrhoea and nausea. 
    • Nocturnal Enuresis (bedwetting). Children over five are more likely to deal with frequent bedwetting when they have an underlying anxiety disorder (NCBI).
    • Panic attacks 
    • Aggression – which usually occurs when the child is upset about being separated from their caregiver. 
    • Breathing problems can turn into full-blown panic attacks. 

    Separation Anxiety in Adults

    Prior to 2013, Separation Anxiety Disorder wasn’t recognized as a condition that impacts adults, but that changed when it was included in the DSM-5 – due to the lasting psychological symptoms it causes in adults. 

    While the condition manifests differently in adults, it can still impact daily functioning and cause long-term damage to the individual’s social relationships, work life, and independence. 

    SAD in adults is often more complex than in children, as the person can fear losing a friendship, spouse or any other person they’re attached to.

    Some people might experience mild symptoms that aren’t readily noticeable, while others can find their anxiety has a direct impact on their loved ones. 

    Mental and emotional symptoms include: 

    • Feeling intense distress when separated from attachment figures, such as spouses and loved ones. 
    • Constant fears about losing loved ones, including through death, illness and relationship breakdowns. 
    • Worrying that being separated from attachment figures will result in personal harm. 
    • Avoiding work or social activities due to fears of being away from loved ones. 
    • Following attachment figures around repeated phone calls and texts.
    • Frequently seeking reassurance about the stability of personal relationships. 

    Physical symptoms include: 

    • Tension headaches and migraines when dealing with separation stress. 
    • Sleeping problems, including insomnia or persistent fatigue. 
    • Nausea and diarrhea. 
    • Panic attacks. 
    • Shaking and trembling. 
    • Heart palpitations.

    The causes of SAD in Children and Adolescents

    Separation anxiety is natural in babies but can continue into childhood and adolescence if young children don’t successfully develop through these stages. There are several causes for SAD, including personal loss, instability and anxious parents. 

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    Parental absences

    Research published by CDN, showed children who have experienced grief due to the passing of their parents are more likely to suffer from SAD and other emotional issues. 

    However, parental absences can also occur when there’s a divorce or their primary caregiver begins full-time work. If the child or caregiver has to go into the hospital, it can also result in feelings of anxiety. 

    Foster children or young people in care are also likely to deal with separation anxiety, with the Heart of Adoption

    Changes in environment

    Humans crave stability and routine, but children find it particularly challenging when their environments change. Moving to a new location away from other relatives and friends can be a significant contributor to Separation Anxiety Disorder. 

    Some children might find it hard to settle at a new school and crave the routine and stability their primary caregivers offer. 

    Parental influences

    Anxious parents are more likely to pass on the same psychological issues to their children. An article from Medical News Today explores how parents with anxiety can impart their negative thinking patterns to children. 

    If a parent constantly worries about their child, it’s natural for the child to fear certain events, as the coping skills we learn during our formative years impact how we deal with separation in later life. 

    Parents who suffer from mental health issues or alcohol dependencies might struggle to give their children a safe and stable environment. 

    The causes of SAD in adults

    As with children, Separation Anxiety Disorder can be the result of numerous influences in adults. In some cases, it carries on from childhood, but adults can also be susceptible to it after experiencing a traumatic event or stress. 

    Development during childhood

    While separation anxiety can go into remission, children who experienced it are more likely to do so as adults. The main reason for this is they didn’t learn any coping mechanisms, so that minor setbacks can trigger the disorder again. 

    However, research also shows that previously anxious children can be well-adjusted adults if they receive the proper support and therapeutic intervention (PubMed).

    Parental influences

    Growing up with an anxious parent can mean children experience unhealthy relationships, which carry on in later life. While some studies suggest a genetic predisposition to anxiety disorders, they can also be a result of parents not being able to give their children stability. 

    If a young person grows up in an overly protective environment, they might struggle with independence after leaving home. 

    However, children who grow up without secure parental relationships might develop an Insecure Attachment Style, which could impact their relationships later in life. 

    Traumatic events

    There are a range of events that can cause separation anxiety, including the death of a parent – even in adult life. Grief due to the death of a spouse or long-term partner is also common, as well as relationship breakdowns. 

    If a partner cheats, it can cause severe anxiety, while losing a treasured friendship might lead to people becoming more anxious about the other relationships in their lives. 

    Getting fired or changing to another work location can also have negative impacts. 

    Pre-existing psychological issues

    A study from Science Direct concluded that people suffering from Major Depressive Disorder are more likely to have separation anxiety. Depressive symptoms can often include withdrawal and disordered thinking, which inevitably raise anxiety levels. 

    Certain personalities are also more likely to deal with separation anxiety. For example, natural worriers get more anxious than calmer individuals, and a traumatic event might impact them more severely.

    The long-term effects of SAD

    Separation Anxiety Disorder can have long-term effects on an individual’s relationships, academic achievements, work performance and general emotional well-being. 

    The symptoms often worsen when left untreated, requiring more intensive therapeutic interventions. 

    While some people don’t want to seek treatment, being proactive with SAD can prevent the following from occurring:

    • Unstable relationships: Children might struggle to maintain friendships, while adults can experience frequent break-ups and instabilities. 
    • Social isolation: The fear of abandonment can lead people to avoid building relationships with others, resulting in isolation. 
    • Performance issues: Individuals preoccupied with their relationships might struggle to reach performance objectives at work by focusing on their education. 
    • Substance abuse: Some people try to self-medicate their anxiety, often drinking or using illicit substances. This can result in addictions and physical effects, such as liver disease. 
    • Quality of life: Dealing with constant anxiety and having to face setbacks in relationships can significantly impact a person’s quality of life and result in depression. 

    Why is it essential to seek support from a professional?

    With its long-term effects and ability to dramatically impact your mental health and emotional well-being, seeking medical advice is a vital first step when you’re dealing with SAD symptoms. 

    Failing to seek help can result in the symptoms worsening and lead to other issues, such as depressionrelationship issues and other anxiety disorders. 

    Assessing and diagnosing Separation Anxiety Disorder

    As SAD can manifest differently in adults and children, it’s often diagnosed differently. For example, parents might seek support for a child, or a healthcare professional might notice issues during routine checkups. 

    Adults can often present with other symptoms, such as depression or substance abuse, and further investigation can lead to an SAD diagnosis. 

    Diagnosing children

    Once your child goes to a healthcare specialist, they’ll ask questions about how they deal with separation and explore their symptoms. As general separation anxiety is common in babies and toddlers, the symptoms need to impact the child’s daily functioning severely. 

    To assess how they deal with separation, the professional might ask to observe them away from you, which lets them analyze how the child reacts. 

    Once the clinical interview is over, the specialist might want to test your child for physical conditions that might display as SAD, including: 

    • Addison’s Disease 
    • Congenital Adrenal Hyperplasia
    • Cushing’s Syndrome 

    If the child is out of the general separation anxiety age and their symptoms persist for a minimum of four weeks, the specialist will offer a diagnosis. 

    Diagnosing adults

    Adults are often more challenging to diagnose, especially as the condition wasn’t recognized until 2013. However, clinicians usually follow set steps to ensure you receive a correct diagnosis. 

    Clinical interview

    The therapist will ask questions about your history, including the symptoms you experience and when they’re most present. Understanding behaviour around spouses, parents, and friends is also beneficial, as this can help therapists rule out other conditions. 

    Assessing your symptoms can also highlight whether another diagnosis is more likely. Still, your therapist will also want to know about other conditions, such as depression, as they increase the likelihood of anxiety disorders. 

    It’s also important to rule out physical conditions (the same as with children). 

    The DSM-5 assessment

    For an adult to receive a SAD diagnosis, they have to fulfil different criteria on the DSM-5. The diagnostic criteria list a range of symptoms, including a person’s extreme worry and distress over being away from an attachment figure. 

    Depending on how a person meets the criteria, the professional will offer a diagnosis and discuss the next steps. 

    Treatment options for Separation Anxiety Disorder

    There are numerous treatment options available for children and adults with Separation Anxiety Disorder, with therapy and medication being the most common. 

    While medications can reduce the symptoms and provide some comfort, therapy is a long-term solution that teaches individuals to address the underlying causes of the disorder and change their thinking patterns. 


    Older children and adults might take medication to reduce panic attacks and stabilize their moods. The most popular medicines for anxiety disorders are SSRIs, which boost the brain’s serotonin levels and are known to improve low moods. 

    Anti-anxiety medications can also be an option for adults and older children who deal with panic symptoms regularly, but they’re not a long-term solution. 

    Cognitive Behavioural Therapy (CBT)

    Often considered the gold standard of therapy, CBT teaches individuals valuable coping skills that help them deal with negative thinking and change thought patterns. 

    Cognitive Behavioural Therapy is effective for children and teens as it’s a systematic approach that encourages thinking in the present. 

    The sessions are less intense than many other therapies, and an experienced counsellor can empower your child to control their emotions. 

    Adults can also benefit from CBT, and having individual online counselling can help you change your habits. 

    Family therapy

    Family therapy can also be beneficial for parents to learn how to support their child and work through the negative reactions from separation. Couples can also have online group sessions to discuss their relationship and adopt ways of supporting one another. 

    For example, if one person has SAD, their spouse might not understand the effects it has on their life. In such cases, couples counselling ensures relationships become stronger as each person can learn how to support the other, resulting in positive changes. 

    Helping a child with SAD

    While therapy can help change your child’s thinking patterns, being proactive at home can aid the process and ensure better results. The following techniques can make it easier for your child to adjust: 

    • Create a goodbye routine that makes your child feel more comfortable. 
    • Make sure your child trusts you by sticking to your promises. For example, ensure you’re not late if you say you’ll be there at a particular time. 
    • Leave them with a babysitter they know and feel comfortable with. 
    • Understand that long-term changes take time, and patience is key. 

    Coping mechanisms for adults with SAD

    Adults can often feel they don’t have much support with Separation Anxiety Disorder, but educating yourself about the condition and following your therapist’s treatment plan can help you combat the symptoms and learn healthier ways to deal with anxiety. 

    There are several things you can do at home to help you manage your anxiety better: 

    • Make time for self-care. Whether taking a bath, doing your favourite hobby or anything else, ensure you always have time to do something that relaxes you. 
    • Monitor your stress and keep a journal of when your anxiety is at its worth. 
    • Follow the advice of your therapist and make sure you practise the coping exercises they give you. 
    • Be willing to learn more about SAD so you can identify your triggers. 
    • Practice mindfulness to help you focus in the moment and not let your anxiety take hold. 

    Access support today

    The first step in the therapeutic journey is often the hardest, but Well Beings Counselling will support you through every step, providing impactive therapeutic services. We’re specialists in online counselling, offering a convenient service for people who might not want to travel for face-to-face therapy. 

    You’ll receive a detailed assessment and bespoke counselling approach fully tailored to your needs in the comfort of your home. 

    Our therapists are fully qualified in their chosen specialisms, and once you sign up, we’ll match you with the perfect counsellor. They’re based all over Canada, including Downtown Toronto, Downtown VancouverOttawa, and many other locations

    We’d love to hear from you if you want a consultation with an experienced intake coordinator. Whether individual counselling, couples therapy or support for the entire family, we’re here to help. 

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    1. Canadian Mental Health Association (CMHA): Offers resources and information on mental health, including anxiety disorders.
    2. Anxiety Canada: Provides information, tools, and resources for managing anxiety.
    3. Kids Help Phone: Offers professional counselling and support for young people.
    4. Well Beings Counselling: We have a comprehensive directory of therapists across Canada. You can filter by city, type of therapy, and issue (including anxiety).
    5. Your Family Doctor or Pediatrician: Can offer referrals to mental health professionals and provide information on treatment options.

    Embarking on the journey of understanding and healing from Separation Anxiety Disorder is courageous. Remember, this journey does not have to be taken alone. There are many hands extended in support and hearts that understand. May each step be guided by compassion, understanding, and hope.

    Frequently Asked Questions

    Yes, most of our counsellors are fully flexible and can accommodate online, in-person and phone sessions. If you'd like a local counsellor, you can view therapists by their location. Just head to the locations section on the menu, or feel free to contact us for advice. 

    It's always a good idea to get yourself - or your child - checked out by a doctor, as some physical conditions can be confused for anxiety disorders. Once a doctor performs the necessary tests, they'll offer a diagnosis and advise on different therapy options. 

    Your home is probably your safest and most secure environment, and online therapy can be highly effective. You'll still have a real-time conversation with the counsellor, and research shows that online therapy is just as productive as in-person sessions. 

    You can read more about the benefits of online therapy in our How Effective is Online Therapy guide. 

    We work with a range of health insurance providers, so you might be able to claim money for your sessions. However, the average cost for Well Beings Counselling ranges from $160 to $300, depending on the type of therapy you choose and its duration. 

    You'll find more information about pricing structures here

    Childhood trauma can have a lasting impact on your life, and our professional therapists will work with you to identify the issues and promote healing. We can also help you move on from a narcissistic parent and adopt healthier relationships

    No matter what you are struggling with, we are here for you.

    No matter what you are struggling with, we are here for you.

    Picture of Pareen Sehat MC, RCC

    Pareen Sehat MC, RCC

    Pareen’s career began in Behaviour Therapy, this is where she developed a passion for Cognitive Behavioural Therapy approaches. Following a Bachelor of Arts with a major in Psychology she pursued a Master of Counselling. Pareen is a Registered Clinical Counsellor (RCC) with the BC Association of Clinical Counsellors. She specializes in CBT and Lifespan Integrations approaches to anxiety and trauma. She has been published on major online publications such as - Yahoo, MSN, AskMen, PsychCentral, Best Life Online, and more.