Symptoms and Signs of Separation Anxiety

Medical Author:
Medically Reviewed on 12/16/2021

Doctor's Notes on Separation Anxiety

Separation anxiety is recurrent and excessive distress that goes beyond that expected for the child's (younger than 18 years) developmental level with impending or actual removal from a child's attachment (mother, father, or caretaker, for example) over a period of at least 4 weeks. Signs and symptoms of separation anxiety may include the following:

  • Emotional temper tantrums
  • Clinging to parents
  • Feeling anxiety
  • Refusal to do things that require separation
  • Reluctance to fall asleep
  • Nightmares
  • Homesickness
  • Violent activity during and/or after separation
  • Extreme and severe crying
  • Poor school performance
  • Refusal to go to school
  • Failure to interact in a healthy manner with other children
  • Psychosomatic physical illness such as headaches, dizziness, nausea, vomiting, cramps, stomachache, muscle aches, and heart palpitations

The causes of separation anxiety are unclear. It is developmentally normal in a mild form in infants and toddlers under age 4 when removed from primary attachment figure(s) like their parents. Researchers suggest overly fearful children at a young age may eventually develop this disorder. Other researchers suggest that altered sensitivity to endocrine influences may play a role. Others suggest bullying and recurrent social rejection may contribute to separation anxiety development. A medical professional should be consulted as diagnosis and treatments are complex and may require additional tests to rule out certain medical diseases.

What Are the Treatments for Separation Anxiety?

Treatment for separation anxiety involves psychotherapy. Occasionally, medication may be used:

  • Talk therapy
  • Psychological counseling
  • Cognitive behavioral therapy
  • Medications: antidepressants
  • Combinations of the above

Diagnosis is important as doctors may find additional mental health problems. You and your doctors need to discuss which therapy(s) is best for your child.


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.