Separation anxiety

Overview

Kids may refuse school, have stomachaches, or fear sleeping alone.

Symptoms

Common signs:

• Fear of being apart from parents
• Child very upset being apart from a parent

Less common

• Stomachaches
• School refusal

When to get medical care

Causes

Genes, stress, changes.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• Anxious parents
• Big changes

Possible complications

• Anxiety

Diagnosis

A clinician talks with you and your child.

Treatment

Practice short separations.

Self-care

• Keep goodbyes short and loving
• Use a goodbye routine
• Praise brave steps

CBT is the main treatment.

Prevention

To lower your risk or prevent problems:

• Practice short separations

Which doctor treats this

• Start with your child's pediatrician.
• They may send you to a pediatric specialist: a psychiatrist (for medicine) and a psychologist or licensed therapist (for talk therapy).

Living with it

• Keep a regular sleep, meal, and activity routine.
• Tell one trusted person how you're doing, and plan who to call on hard days.
• Limit alcohol and drugs. They often make symptoms worse.
• In a crisis, call or text 988 any time.
• Children may qualify for free early intervention services before age 3, and special education help (an IEP) at school.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Support groups and helplines

• NAMI (National Alliance on Mental Illness): Free support groups and a helpline (1-800-950-6264) for people and families.
• 988 Suicide & Crisis Lifeline: Call or text 988 any time for free, private support in a crisis.

Back to school, work, or sports

• Most people can keep working or going to school.
• Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.
• The Family and Medical Leave Act (FMLA) may let you take unpaid time off for treatment without losing your job.

Children, pregnancy, and older adults

• Adults: Separation anxiety can happen too.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Many mental health medicines are used safely in pregnancy. Stopping suddenly can cause a relapse.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Mood problems can start during or after pregnancy. Postpartum Support International: 1-800-944-4773.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Learn the warning signs and when to call the doctor or 911.
• Keep a list of your child's medicines, doses, and doctors on your phone.
• Tell teachers, coaches, and sitters what to watch for and what to do.
• Take breaks and ask for help. Caregivers need care too.

Outlook

Treatable.

Getting ready for your visit

Bring a list of your symptoms and medicines.

Questions to ask

• How do we help with school drop-off?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Separation anxiety