Separation anxiety is something many people associate with young children, and for good reason. In early childhood, it is developmentally normal for a child to protest when a parent leaves. Many toddlers and preschoolers cry at daycare drop-off or want to be held when a parent heads out the door. This type of anxiety about separating is usually short-lived and eases as children gain confidence in being apart.
But sometimes, separation anxiety becomes more intense, lasts longer than expected for the child’s age, or interferes with daily life. In those cases, it can be a sign of separation anxiety disorder, a condition that benefits from early support.
Furthermore, although discussed less often, separation anxiety is not just a childhood experience. While it often begins early in life, it can persist into adolescence or adulthood, and it can appear for the first time later in life as well. Big life transitions such as starting a new school, moving away from home, a partner’s travel, or the loss of a loved one can trigger it at any age. The feelings can be intense and are not always about physical safety. Often, the deeper concern is about emotional security and uncertainty about how you or your loved one will cope when apart.
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What Is Separation Anxiety in Children?
In children, separation anxiety refers to excessive fear or distress about being apart from a primary caregiver or loved one. It is important to note that some level of separation distress is a healthy and “normal” sign of attachment in early development. The challenge comes when this fear is so strong, persistent, or disruptive that it interferes with daily life.
Children with separation anxiety disorder may be preoccupied with the idea that something bad will happen to their parent(s) or themselves when apart. These thoughts often come with intense emotional reactions and physical symptoms, and they can make everyday events like going to school feel overwhelming.
Signs and Symptoms of Separation Anxiety in Children
Separation anxiety in children can present in emotional, behavioral, and physical ways. Common signs include:
- Crying, clinging, or hiding to avoid being separated from a caregiver
- Excessive worry about harm coming to themselves or to a parent during separation
- Frequent nightmares about losing a loved one or being alone
- Physical complaints such as headaches, stomachaches, nausea, or even vomiting before separations
- Difficulty sleeping alone or insisting that a parent stay until they fall asleep
- Reluctance or outright refusal to attend school, activities, or social events without a parent
- Repeated phone calls or messages when apart to seek reassurance
- Distress that begins well before the separation and continues long after reunion
When Is It More Than “Normal” Separation Fear?
Typical separation fears usually peak between ages six months and three years, with occasional resurfacing during other transitions such as starting school. These fears generally improve as children develop a sense of trust and independence.
It may be more than typical if:
- The distress lasts for at least four weeks and is much more intense than what is expected for the child’s age
- The fear prevents the child from attending school or participating in age-appropriate activities
- The child’s worry seems out of proportion to the actual situation
- The anxiety causes ongoing physical symptoms or disrupts family routines
- The child has difficulty concentrating, sleeping, or engaging in play because of their worry
For example, a preschooler who cries for a few minutes at drop-off and then begins to play is showing a normal developmental pattern. By contrast, a second grader who refuses to enter the school building for weeks, develops stomachaches every school morning, and cannot be reassured that a parent will return may be experiencing separation anxiety disorder.
What Causes Separation Anxiety in Children?
Several factors can contribute to the development of separation anxiety:
- Temperament: Children who are naturally more sensitive, cautious, or shy may find separations more challenging.
- Life changes: Events such as moving to a new home, starting a new school, the birth of a sibling, or a change in caregivers can trigger anxiety. For instance, a child who was confident at preschool may suddenly struggle after a family move.
- Stressful or traumatic experiences: Hospital stays, serious illness, accidents, or witnessing an emergency can make children more fearful of being apart. A child who was separated from a parent during a medical procedure might become more anxious at bedtime.
- Family patterns and modeling: If a parent expresses visible worry about separation, children may learn to see separations as unsafe. A parent’s own anxiety can unintentionally reinforce a child’s fears.
- Attachment history: Disruptions in early caregiving relationships can make it harder for a child to feel secure when apart from loved ones.
How Therapy Helps Children with Separation Anxiety
Therapy for separation anxiety disorder in children often involves both the child and their caregivers. At Palo Alto Therapy, we use evidence-based approaches such as Cognitive Behavioral Therapy (CBT) and the SPACE (Supportive Parenting for Anxious Childhood Emotions) program.
In SPACE, parents learn to respond to their child’s anxiety with warmth while gradually reducing accommodations that maintain avoidance, such as staying at school with the child or canceling plans to prevent distress.
Exposure therapy as part of CBT can help children face separations in gradual, manageable steps. For example, a child who cannot be away from a parent at all might start with five minutes in another room, then progress to short visits with a trusted friend or relative, and eventually to attending school independently.
For younger children, play therapy can be especially effective. Using toys, role-play, and creative activities, therapists help children express fears, practice coping strategies, and build mastery over anxiety-provoking situations.
Tip for Parents: Create a clear, predictable goodbye routine and use the same language each time. Avoid sneaking away, as this can undermine trust and increase anxiety.
Separation Anxiety in Teens and Young Adults
While separation anxiety is most often associated with children, it can also occur during adolescence and early adulthood. For teens, it may show up as constant texting, frequent phone calls, or reluctance to participate in opportunities that require independence, such as trips, camps, or living in a dorm.
It is important to distinguish separation anxiety from what is often called “failure to launch.” Failure to launch generally refers to a young adult’s ongoing difficulty transitioning into independent living due to a combination of skill gaps, lack of motivation, or avoidance of adult responsibilities. Separation anxiety, by contrast, is driven by intense emotional distress about being apart from loved ones. A teen with separation anxiety might have the skills and motivation to live away from home but feels unable to cope with the emotional discomfort.
Therapy for teens typically combines CBT with gradual exposure, teaching them how to tolerate the discomfort of separation and develop confidence in their ability to manage daily life on their own.
Tip for Teens and Young Adults: Build separation tolerance in stages. Start with shorter, low-stakes experiences apart from home, and gradually increase the length and complexity of those experiences.
Adult Separation Anxiety
Adult separation anxiety can appear for the first time in response to a significant life event, or it can be a continuation of symptoms from earlier in life. It often emerges during times of change such as a partner’s extended travel, a child leaving home, a move away from family, or after the loss of a loved one.
For some adults, separation anxiety is connected to attachment style. Those with an anxious attachment style may be more prone to worry about the safety or availability of loved ones, leading to excessive check-ins or difficulty enjoying time apart. It becomes problematic when it interferes with work, friendships, self-care, or the ability to maintain healthy boundaries.
Therapy for adults may involve CBT to address unhelpful thinking patterns, mindfulness to regulate the body’s anxiety response, and structured exposure exercises to gradually build comfort with time apart.
Tip for Adults: Pair planned check-ins with intentional activities that keep your focus in the present moment, such as exercise, hobbies, or social connections.
When Separation Anxiety Is Linked to Loss or Trauma
Loss and trauma can significantly increase separation anxiety. A child who has experienced the death of a grandparent, for example, may become fearful that a parent will not return from work. A teen who has witnessed a serious accident may panic when friends or family members are out of contact. Adults who have experienced loss, including bereavement or the end of a significant relationship, may become more protective or fearful about separation.
In these cases, therapy often integrates grief counseling with anxiety treatment. This may include helping the person process the loss, understand how grief is affecting their sense of safety, and rebuild trust that separation does not always mean something bad will happen. Exposure strategies are used carefully, at a pace that respects both the grief process and the anxiety.
Therapy Approaches That Help Across Ages
At Palo Alto Therapy, separation anxiety treatment is tailored to each person’s age, life stage, and individual needs. Effective strategies include:
- Cognitive Behavioral Therapy (CBT) to identify anxious thoughts and replace them with balanced, realistic ones
- Exposure therapy to gradually face separations in a planned, manageable way until the fear decreases
- Parent coaching (SPACE) to help caregivers support independence while still offering emotional warmth
- Mindfulness and acceptance skills to manage the body’s physical anxiety response and stay grounded in the present
For children, therapy almost always involves the parents, except in the case of SPACE therapy, and it may include play therapy. For teens and adults, therapy may focus more on independent coping skills and personal insight.
If Being Apart Feels Overwhelming
Life transitions can stir up strong emotions about separation. These changes may be exciting, stressful, or a combination of both, and they can make even temporary time apart feel overwhelming. Feeling this way is not a sign of weakness. It is a sign that you care deeply and that your mind and body are seeking safety.
With professional support, separation anxiety can improve. You can build skills that allow you to face time apart with more confidence, less distress, and greater trust in your ability to cope.
Do you want to learn more about how we can help your family through separation anxiety? Contact us today to book an appointment with one of our Menlo Park, Palo Alto or San Jose therapists.