Separation Anxiety

How Separation Anxiety Develops

When your baby was first born, you likely noticed that he or she adapted pretty well to other caregivers. This is typical for most infants. You probably felt more anxiety about being separated than your child did when you first left him or her with a relative, babysitter, or a day care provider! As long as their needs are being met, babies younger than 6 months typically adjust well to other people.

Sometime between 4-7 months, a baby typically develops a sense of object permanence, and begins to learn that things and people exist even when they're out of sight. This is when babies typically start to play the "dropsy" game, when they drop things over the side of the high chair, look for them, and expect the adult to retrieve what they've dropped (which, once retrieved, get dropped again!).

The same thing occurs with their parents. Babies realize that there's only one of you, and when he or she can't see you, that means you've gone away. However, at this point, your child doesn't yet understand the concept of time and doesn't know if or when you'll come back. So whether you're in the kitchen, in the next bedroom, or at the office, it's all the same to your toddler. You've disappeared. Your child will do whatever he or she can to prevent this from happening.

Between 8 months old 1 year old, your child is growing into a more independent toddler - yet he or she is even more uncertain about being separated from you. This is when separation anxiety typically develops, and your child may become agitated and upset whenever you try to leave him or her. Whether you need to go into the next room for just a few seconds, leave your child with a sitter for the evening, or drop off your child at day care, you may find that your child cries, clings to you, and resists attention from others.

The timing of separation anxiety can vary widely from child to child. Some kids may experience it later, between 18 months and 2-1/2 years of age. Some may never experience it. And for others, there are certain life stresses that can trigger feelings of anxiety about being separated from a parent: a new child care situation or caregiver, a new sibling, moving to a new place, or tension at home.

How long does separation anxiety last? It varies from child to child. And it also depends on the child and how the parent responds. In some cases, depending on a child's temperament, separation anxiety can be persistent from infancy and last through the elementary school years. In cases where the separation anxiety interferes with an older child's normal activities, it can be the sign of a deeper anxiety disorder. In cases where the separation anxiety appears out of the blue in an older child, it can be an indication of another problem that the child may be dealing with, like bullying or abuse.

Keep in mind that separation anxiety is usually different from the normal feelings an older child has when he or she doesn't want a parent to leave. In those cases, the distress can usually be overcome if the child is distracted enough, and those feelings will not re-emerge until the parent returns and the child remembers that the parent left.

And your child does understand the effect his or her behavior has on you. If you come running back into the room every time your child cries and then stay with your child longer or cancel your plans completely, your child will continue to use this strategy to avoid separation.

What You May Be Feeling

During this stage, you're likely to experience a host of different emotions. It may be gratifying to feel that your child is finally as attached to you as you are to him or her. At the same time, you're likely to feel guilty about taking time out for yourself, leaving your child with a caregiver, or going to work. And you may start to feel overwhelmed by the amount of attention your child seems to need from you.

Try to keep in mind that your child's unwillingness to leave you is a good sign that healthy attachments have developed between the two of you. Eventually your child will be able to remember that you always return after you leave, and these memories will be enough to comfort him or her while you are gone. This also gives your child a chance to develop his or her own coping skills and a little independence.

Making Goodbyes Easier

There are a number of strategies you can use to help ease your child (and yourself) through this difficult period.

• Timing is everything. Try not to start day care or child care with an unfamiliar person between the ages of 8 months and 1 year, when separation anxiety is first likely to present itself. Also, try not to leave your child when he or she is likely to be tired, hungry, or restless. If at all possible, schedule your departures for after naps and mealtimes.
• Practice. Practice being apart from each other, and introduce new people and places gradually. If you're planning to leave your child with a relative or a new babysitter, then invite that person over in advance so they can spend time together while you're in the room. If your child is starting at a new day care center or preschool, make a few visits there together before a full-time schedule begins. Practice leaving your child with a caregiver for short periods of time so that he or she can get used to being away from you.
• Be calm and consistent. Create a goodbye ritual during which you say a pleasant, loving, and firm goodbye. Stay calm and show confidence in your child. Reassure him or her that you'll be back - and explain how long it will be until you return using concepts your child will understand (such as after lunch) because your child can't yet understand time. Give him or her your full attention when you say goodbye, and when you say you're leaving, mean it; coming back will only make things worse.
• Follow through on promises. It's important to make sure that you return when you have promised to return. This is critical, and there can be no exceptions. This is the only way your child will develop the confidence that he or she can make it through this time.

As hard as it may be to leave your child while he or she is screaming and crying for you, it's important to have confidence that the caregiver can handle it. It may help both of you if you set up a time that you will call to check in with the caregiver, maybe 15 to 20 minutes after you leave. By that time, most kids have calmed down are playing with other things. Don't let yourself give in early and call sooner!

If you are caring for another person's child, and that child is experiencing separation anxiety, it's a good idea to try to distract the child with another activity or toy, by being outside, or with songs, games, or anything else that works. You may have to keep trying to distract the child over and over until something just clicks with the child.

Also, it's a good idea not to mention the child's mother or father, but do answer the child's questions about his or her parents in a simple and straightforward way. You might say: "Mommy and Daddy are going to be back as soon as they are done dinner. Let's play with some toys!"

It's Only Temporary

Try to keep sight of the fact that this phase, like many others, will pass. If your child has never been cared for by anyone but you, is naturally shy, or has other stresses, such as a new sibling or a health condition, then it may be worse than it is for other kids. Most kids eventually outgrow it.

At the same time, you should trust your instincts. If your child refuses to go to a certain babysitter or day care center or shows other signs of tensions, such as trouble sleeping or loss of appetite, then there could be a problem with the child care situation.

If intense separation anxiety lasts into preschool, elementary school, or beyond and interferes with your daily activities, it's a good idea to discuss this with your child's doctor. It may be a sign of a more rare but more serious condition known as separation anxiety disorder.

Kids with separation anxiety disorder fear being lost from their family members and are often convinced that something bad will happen when they're apart. It's a good idea to talk with your child's doctor if your child is showing signs of this, which include:

• panic symptoms (such as nausea, vomiting, or shortness of breath) or panic attacks before a parent leaves
• nightmares about separation
• fear of sleeping alone
• excessive worry about being lost or kidnapped or going places without a parent

For most kids, the anxiety of being separated from a parent passes without any need for medical attention. But if you have concerns, talk to your child's doctor.

Updated and reviewed by: Michael J. Harkness, MD
Date reviewed: July 2005
Originally reviewed by: D'Arcy Lyness, PhD