Category — 2.9 Children with Mental Illness: Separation Anxiety Disorder

Most school-aged children separate easily from their parents, especially when going to a familiar place like school. But for some children, separating from parents is very difficult. They worry when their parents are not around. The child is very worried about being separated from the parent, even when he or she is going to a familiar place, like school or grandma’s house. When the child’s worries become excessive and interfere in the child’s ability to lead a typical life, the child may get diagnosed with separation anxiety disorder.

Separation anxiety is quite common and typical in younger children. It becomes a problem in children who are over the age of 3 years. Many children find it difficult to separate from their parents but they still do well when the parent is not around. This is typical.

Other children worry excessively about being separated from their parents. When they separate from their parents, they usually engage in the following behaviors:

• Temper tantrums (for example, having a tantrum for an hour);
• Crying uncontrollably;
• Clinging to the parent and refusing to let the parent go (for example, by clinging to the parent’s pants or leg (Fig. 1));
• Getting distressed at the thought of being separated from the parent;
• Worrying that if the parent leaves he or she may get hurt or die;
• Refusing to leave the house;
• Refusing to go to school;
• Refusing to go to sleep for fear that the parent(s) is going to go away while the child sleeps;
• Having a panic attack (see full Glossary);
• Exhibiting the physical symptoms of anxiety;
• Exhibiting the mental and emotional symptoms of anxiety;
• May be insecurely attached to the parent.

Figure 1. Clinging to his mother

Having separation anxiety disorder can seriously hurt a  child’s ability to have a happy childhood. That is because children who refuse to leave the house or separate from their parents may miss out on typical middle childhood activities:

• Participating in after-school programs;
• Engaging in leisure activities (such as taking a drawing or swimming class);
• Engaging in sports activities (for example: soccer or basketball practice);
• Hanging out with friends.

Children with separation anxiety disorder need help and support in the classroom. To help the child, the the classroom teacher can:

• Make sure the child feels welcome in the classroom;
• Allow the child to call the parent (how often a child is allowed to do so would be determined by the parent and teacher together, and would follow any recommendations the child’s psychotherapist may have (Fig. 2));
• If the child has a cellular phone, allow him or her to text the parent (whether or not the child should be allowed to use a cellular phone and the frequency of text messaging should be determined by the parent and the teacher in consultation with the child’s therapist);
• Allow the child to have a “security object.” This is something that belongs to the parent (like a watch or a necklace) and that may make the child feel safe. In younger children a common security object is a baby blanket;
• Be patient with the child when he or she has anxiety symptoms (please see reference to physical and mental symptoms, above).

Figure 2. Phoning

Children who have separation anxiety disorder need psychotherapy. Children who receive good psychotherapy are able to overcome their separation anxiety and grow up to lead happy and healthy lives.

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