Most people feel a pang of worry when separated from their loved ones — a child’s first sleepover, a partner’s business trip, or a parent watching their teen leave for college. But for some, those worries become more than a temporary discomfort. They grow into feelings of persistent fear, physical distress, or a deep sense of unease when apart from people or places that feel safe.
When that anxiety begins to disrupt everyday life, it may be indicative of separation anxiety disorder (SAD), a mental health condition that can affect children, teens, and adults alike. Though often associated with early childhood, many adults experience symptoms of separation anxiety for the first time later in life.
Understanding what separation anxiety looks like, what causes it, and how to treat it can be the first step toward feeling grounded again. This guide explores the signs, causes, and treatments of separation anxiety, offering insights for both individuals and parents looking to support their child.
What is separation anxiety?
Separation anxiety disorder is a mental health condition characterized by intense fear or worry about being apart from someone or something you’re deeply attached to, such as a partner, family member, pet, or home. This anxiety can lead to avoidant behavior, like reluctance to sleep alone or refusing to go to school, often disrupting relationships, work, or social life.
In children, brief periods of clinginess or crying at drop-off are developmentally appropriate. These feelings of separation anxiety typically begin around 6 to 12 months of age, when babies develop object permanence and realize caregivers can leave, peaking between 10 and 18 months before easing by age three. When these fears persist, worsen, or reappear later in life — often after stress, loss, or major transitions — they may signal SAD rather than a typical developmental phase.
Separation anxiety in adults often looks different than it does in children. It may involve constant worry about a loved one’s safety, difficulty traveling or sleeping alone, or avoiding commitments that require being away from an attachment figure or safe place.
What are the causes of separation anxiety?
There is rarely a single cause of separation anxiety. Instead, it tends to develop through a mix of biological, environmental, and psychological factors.
Common contributors include:
- Genetics and brain chemistry: People with a family history of anxiety or mood disorders may be more predisposed to developing separation anxiety.
- Early childhood experiences: Inconsistent caregiving, early loss of a caregiver, hospitalization, or other separations can shape how a person learns to feel safe (or unsafe) being apart.
- Stress and life transitions: Events like a breakup, a child leaving home, relocation, or grief can activate fears around separation.
- Attachment style: Children with SAD commonly lean toward anxious-ambivalent attachment traits, where they feel anxiety when their caregiver is gone and may struggle to fully feel comforted when the caregiver returns.
- Traumatic events: Experiences such as accidents, natural disasters, or witnessing violence can heighten fears of separation or loss for children and adults alike.
These factors overlap with broader causes of anxiety — such as chronic stress, genetics, and trauma — but separation anxiety is distinct in its focus. While general anxiety involves persistent worry across many areas of life, separation anxiety centers on the fear of being apart from a specific person or place that provides a sense of safety.
What are the common symptoms of separation anxiety?
There are emotional, cognitive, behavioral, and physical symptoms of separation anxiety. Some people experience all of these, while others may notice just a few.
Emotional and cognitive symptoms:
- Persistent worry about losing loved ones or something happening to them
- Intense fear of being alone or separated from home
- Intrusive thoughts about loved ones experiencing accidents, illness, or abandonment
Behavioral symptoms:
- Avoiding travel, social events, or work obligations that involve being apart from loved ones
- Excessive check-ins (calls, texts, visits) with loved ones
- Difficulty concentrating or relaxing when separated
- Sleep disruptions — needing to fall asleep with an attachment figure nearby or frequent nightmares about separation
Physical symptoms:
- Stomachaches, headaches, nausea, or fatigue before or during separation
- Rapid heartbeat, shortness of breath, or restlessness before or during separation
These symptoms often overlap with other forms of anxiety. What sets separation anxiety disorder apart is that the distress specifically centers on being apart from attachment figures or familiar, safe environments.
How to recognize separation anxiety in children
Children naturally go through phases of separation distress, like crying when parents leave for date night or starting a new school year. However, persistent or intense fear may signal something more.
Common symptoms of separation anxiety in children include:
- Excessive distress when a parent or major attachment figure leaves or in anticipation of departure
- Persistent worry about losing a major attachment figure or possible harm happening to them (e.g., illness, injury, death)
- Refusal to go out, away from home, to school, or elsewhere because of fear of separation
- Reluctance or refusal to sleep away from home or to sleep alone
- Repeated nightmares involving separation
- Frequent physical complaints (stomachaches, headaches) before or during separation
As Yxis Gonzalez, LMHC, LCMHC, a Grow Therapy clinician, summarizes,
“In children, separation anxiety often shows up as tantrums, clinginess, refusal to go to school, or physical symptoms like stomachaches or headaches when away from parents. They might become tearful or fearful at even short separations.”
What are the risk factors of separation anxiety?
Certain factors can make someone more likely to develop separation anxiety, including:
- Family history of anxiety, depression, or trauma
- Childhood adversity or loss, such as parental divorce or death
- Having caregivers who are low in warmth and high in overprotection or intrusiveness, limiting the child’s autonomy and independence
- Major life changes like moving, starting a new job, or becoming a caregiver
- Abandonment trauma or past relational instability
- Co-occurring conditions (e.g., generalized anxiety disorder, panic disorder, or chronic stress)
Importantly, these are risk factors, not causes. Many people experience transitions or losses without developing separation anxiety — it is the combination of stress, coping skills, and emotional support that determines how resilient someone feels.
How is separation anxiety diagnosed by healthcare professionals?
If separation fears begin to disrupt work, school, or relationships, a mental health professional — such as a psychologist, therapist, or psychiatrist — can assess whether they meet criteria for separation anxiety disorder (SAD). Clinicians use the DSM-5-TR to guide diagnosis and ensure consistency. For children, symptoms must last at least four weeks and cause clinically significant distress; for adults, symptoms must persist for six months or more.
During the assessment, providers typically:
- Conduct a clinical interview to explore symptoms, triggers, and history
- Evaluate how long the anxiety has lasted
- Determine if the anxiety is developmentally inappropriate (e.g., beyond what’s typical for a given age)
- Rule out related concerns such as generalized anxiety, panic disorder, or depression
Diagnosis is never about labeling. It’s about understanding what is happening so that the right support and treatment plan can be put in place.
What is the best treatment for separation anxiety?
The good news: separation anxiety is highly treatable. Many people see significant improvements through evidence-based therapy, lifestyle adjustments, and medication when clinically indicated.
Evidence-based treatments for separation anxiety include:
- Cognitive behavioral therapy (CBT): Helps identify anxious thoughts and replace them with more balanced perspectives, while gradually facing feared separations in management steps.
- Exposure therapy: A component of CBT that helps people practice tolerating distance from attachment figures or places while implementing calming techniques.
- Medications: Medications such as selective serotonin reuptake inhibitors (SSRIs) are often used to help manage symptoms and are typically combined with therapy. In some cases, other medications like SNRIs or, rarely, short-term benzodiazepines may be considered; however, benzodiazepines carry a risk of dependence and are used cautiously.
- Parent-child interaction therapy (PCIT): A structured approach where caregivers learn skills to strengthen the parent–child relationship, reduce anxious behaviors, and support their child in practicing coping strategies during real-life situations.
- Lifestyle changes and coping strategies: Making small changes to your daily routine can help reduce the impact of anxiety symptoms, including:
- Building predictable routines
- Using grounding or mindfulness exercises to calm the body
- Stay physically active and get adequate rest, which helps regulate mood and stress
- Maintaining a healthy diet, which may include reducing caffeine, sugar, and alcohol consumption
How to find a therapist for separation anxiety
Separation anxiety is a reminder of how deeply humans are wired for connection. When that connection feels threatened, our minds and bodies can react powerfully. With understanding, patience, and professional support, relief is possible.
Whether you’re navigating your own anxiety about separation or supporting a child through theirs, help is available — and it works.
If you’re ready to take that first step, explore therapy options through Grow Therapy’s network. Here’s how to start:
- Visit the find a therapist page on Grow Therapy’s website
- Search for licensed providers who specialize in anxiety disorders or attachment
- Ask about their approach. For example, do they use CBT, mindfulness, or family-based interventions?
- Consider whether in-person or virtual sessions best fit your needs
*If seeking help for a child experiencing separation anxiety, look for a therapist trained in child and adolescent therapy and parent collaboration.