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2. Take the Panic Attacks Quiz!
3. Generalized Anxiety Disorder (GAD) Slideshow Pictures

Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• What is separation anxiety disorder?
• What are the symptoms and signs of separation anxiety disorder?
• What are causes and risk factors for separation anxiety disorder?
• How is separation anxiety disorder diagnosed?
• What is the treatment for separation anxiety disorder?
• What happens if separation anxiety disorder is left untreated?
• Where can I find more information on separation anxiety disorder?
• Separation Anxiety Disorder At A Glance
• Patient Comments: Separation Anxiety - Symptoms
• Patient Comments: Separation Anxiety - Cause
• Separation Anxiety Index

• Infants show stranger anxiety by crying when someone unfamiliar approaches. It is a normal stage of development that usually starts at about 8 months of age and abates by 2 years of age.
• Separation anxiety as a normal life stage first develops at about 7 months of age, once object permanence has been established. It is at its strongest at 10-18 months of age and usually subsides by 3 years of age.
• Separation anxiety disorder begins in childhood and is characterized by worrying out of proportion to the situation of temporarily leaving home or otherwise separating from loved ones.
• Approximately 4%-5% of children and adolescents suffer from separation anxiety disorder.
• Examples of separation anxiety disorder symptoms include school refusal or school phobia, resistance to going to bed at night, and physical complaints in reaction to actual or anticipated separation from primary caretakers.
• Professionals trained and experienced in assessing mental health in children will likely interview the child and parents separately and ask about symptoms of anxiety, screen for other mental-health conditions, and recommend the child receive a full medical evaluation.
• Separation anxiety disorder is likely caused by the combination of genetic and environmental vulnerabilities. Risk factors include low socioeconomic status, family histories of anxiety, and mothers who were stressed during pregnancy.
• A majority of children with separation anxiety disorder have school refusal as a symptom. Up to 80% of children who refuse school qualify for a diagnosis of separation anxiety disorder.
• Counseling is usually considered the best treatment method compared to medications. Types of counseling used to treat separation anxiety disorder include behavioral, cognitive, and individual psychotherapies, as well as parent counseling and guiding teachers on how to help the child.
• SSRIs like fluvoxamine are considered the safest and most effective medications to treat separation anxiety disorder, followed by tricyclic antidepressants (TCAs), with benzodiazepines as a last resort.
• Children with separation anxiety disorder are at higher risk for developing other mental-health problems, particularly anxiety disorders.

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National Institute of Mental Health. "Behavioral Therapy Effectively Treats Children With Social Phobia." Dec. 17, 2007.

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Walkup, J.T., M.J. Labellarte, M.A. Riddle, D.S. Pine, L. Greenhill, R. Klein, et al. "Fluvoxamine for the Treatment of Anxiety Disorders in Children and Adolescents." New England Journal of Medicine 344.17 Apr. 26, 2001: 1279-1285.