Separation anxiety is a normal part of infant and toddler development, though in older children and adolescents, symptoms may reach levels necessitating more careful diagnosis and treatment. Even adults may experience symptoms of the condition. A report by the U.S. Surgeon General states that in order for the symptoms to reach diagnostic threshold, the anxiety must cause excessive distress, affect social, academic or occupational functioning, and last at least one month.
Diagnosis
The Diagnostic and Statistical Manual of the American Psychiatric Association cites a number of criteria for assessment. These include recurrent distress when separated from home or primary caregivers, persistent worry about caregivers, reluctance or refusal to go to school or work, fear of being alone or away from primary caregivers, sleep disturbance, nightmares and physical complaints, such as headaches, dizziness, nausea or vomiting.
Symptoms
Children who experience separation anxiety beyond the typical toddler age often also exhibit depressive symptoms, such as sadness, withdrawal and difficulty concentrating. They often fear death of a loved one or a pet, which are often precipitating factors in the onset of separation anxiety disorder. Illness, traumatic events or natural disasters may also bring about the condition.
Adults affected by separation anxiety may have difficulty with adjusting to change. Moving, marriage or change in employment may exacerbate symptoms. Separation from adult children may be especially challenging. If not treated, separation anxiety may develop into more complicated diagnosis, such as generalized anxiety disorder, panic disorder, agoraphobia or obsessive compulsive disorder.
Treatment
Many effective treatments exist for separation anxiety disorder. According to the National Institute of Mental Health and the American Psychological Association, research suggests that a combination of behavioral and cognitive therapy is most successful in the alleviation of separation anxiety disorder. Behavioral techniques help to monitor and counteract agitation, intrusive symptoms, and halt negative thought processes. Cognitive therapy helps those who suffer from intrusive anxiety understand how their thoughts contribute to the symptoms. In some cases, medication may be warranted.
When considering medication, consultation with a psychiatrist or psychiatric nurse practitioner is advised as she has specific knowledge and expertise in psychopharmacology. The current medication of choice for both adults and children are selective serotonin reuptake inhibitors (SSRIs). Prozac, Zoloft, Celexa and Lexapro are well known examples of this group of medications. For short-term management of anxiety, benzodiazepines, such as Klonopan, Ativan or Valium, may be prescribed but because of the risk of addiction, these medications are used with caution. All medication for anxiety should be consistently monitored by the prescribing professional.
Separation anxiety can be a difficult and debilitating disorder but with proper and individualized treatment, symptom management and recovery is possible.
References
- Diagnostic and Statistical Manual of Mental Disorders; American Psychiatric Association
- Mental Health: A Report of the Surgeon General
- American Psychological Association
