What are separation anxiety disorder symptoms?

A person with separation anxiety disorder will have three or more of the following symptoms:

• Feel distress when apart from an attachment figure or anticipating separation.
• Worry something bad (like injury or death) will happen to an attachment figure.
• Worry something bad will happen to one’s own self (like getting lost or being kidnapped) that would cause separation from an attachment figure.
• Refuse to leave home or go places like school or work due to fear of separation.
• Fear being alone (including in one part of the home) without an attachment figure nearby.
• Refuse to go to sleep without an attachment figure nearby.
• Have recurring nightmares about being separated from an attachment figure (these might include disasters like fire or murder).
• Have physical symptoms like stomachaches, headaches, vomiting or nausea when apart from an attachment figure or anticipating separation. Adolescents and adults may have heart palpitations or dizziness (these are rare in younger kids).

Recognizing separation anxiety disorder in children

Separation anxiety disorder symptoms can look a little different depending on your child’s age. For example, a preschooler might not know how to put their feelings into words. They may simply get upset. An older child might tell you about their nightmares or describe their fears in detail.

If you force a separation despite your child’s protests, then your child may appear sad or uninterested in whatever setting they’re in (like school). They may have difficulty concentrating on schoolwork and not seem to care about engaging with peers. These are behaviors their teacher might observe.

If away from home for several days (for example, at camp), a child with separation anxiety disorder might get extremely homesick and feel miserable until they’re allowed to leave. It’s also possible for a child with this disorder to show anger or even aggression toward anyone they perceive as keeping them from you.

Recognizing separation anxiety disorder in adults

When you love someone, it’s hard not to worry about them. It’s simply a part of life. But the distress with separation anxiety disorder is out of proportion to the situation. It may also start to interfere with your work or relationships. For example, you might call off work to stay with your loved one or text them often to make sure they’re OK (and worry until they reply).

When you’re living with this disorder, you might not always feel your worries are out of proportion to the situation. Maybe it’s only when your child or partner gets frustrated with your checking on them that you realize your anxiety is more than typical.

What causes separation anxiety disorder?

Researchers don’t know exactly what causes separation anxiety disorder, but they believe it’s likely a combination of genetics and environment. For example, a person might be born with a genetic change (mutation) that affects how certain chemicals in their brain work.

But genetics alone might not be enough to cause a disorder. It’s likely that an environmental factor — like a big life change or an adverse childhood experience — also plays a role. Such factors may cause epigenetic changes, or changes to chemicals attached to your genes that affect how those genes work. For example, certain epigenetic changes might affect how cells in your body “read” genes that control stress response.

Risk factors

A child may have an increased risk of developing separation anxiety disorder if they:

• Experience the loss of someone close to them.
• Go through a stressful situation like their parents getting divorced.
• Switch schools or move to a new place.
• Have a history of anxiety disorders in their biological family.

Risk factors for developing separation anxiety disorder as an adult include:

• Loss of a loved one.
• Illness in a loved one.
• Big life changes, like a move, entering a romantic relationship and becoming a parent.
• Diagnosis of an anxiety disorder as a child.
• Diagnosis of other anxiety or mental health disorders as an adult.

What are the complications of separation anxiety disorder?

Separation anxiety disorder disrupts your life and makes it hard to do necessary and desired things.

Children might:

• Have trouble focusing on schoolwork, causing them to fall behind in classes.
• Have a hard time engaging with peers or joining in social activities.
• Miss opportunities to learn, gain social skills and become more independent.

Adults might:

• Have trouble focusing on work or other responsibilities.
• Encounter conflicts in their relationships, especially with attachment figures.
• Miss opportunities to travel or do other meaningful activities.