Anxiety

Separation Anxiety and The Older Child

When my son was two, he screamed any time I left the house.

Tears would flow and ruin my makeup every single day on the way to work. I was never really sure how to process all the emotion that welled up inside me, hearing his cries.

He’s only two.

It’s developmentally appropriate.

He needs to learn he can live without you and that you will always return. 

He’ll be fine two minutes after you leave. 

Everyone told me it was just a normal part of childhood.

But it didn’t seem normal.

No other mother I knew had a child who struggled so much with separating.

As he grew, some ages and stages were better than others.

When he was five, I would breathe a sigh of relief when I closed the door behind me and there was no tantrum.

When he was eight, he wanted to sleep over at a close family friend’s house. He had a blast.

It seemed like separation anxiety was slowly, but surely, becoming a thing of the past.

Separation Anxiety And The Older Child

Then puberty hit and along with the increase in hormones came massive brain chemistry changes that sent my sweet boy spiraling into depression and eventually, mania.

When we went in for a neuro-psych evaluation, the doctors asked me a ton of questions about his level of anxiety and his ability to separate. I answered them honestly, but with a lingering shame.

No, he will no longer use the bathroom alone.

He cries for me all night long, just like when he was a baby.

When he tried to go to his friend’s house the other day, he had a panic attack in the car and we had to turn around and come home. 

He is like my shadow again. He doesn’t want to let me out of his sight.

I tried to leave last week and he tackled me, crying and clinging, begging me not to go. 

He met the diagnostic criteria for separation anxiety disorder before we were even half way through the evaluation.

Is Separation Anxiety Disorder A Real Diagnosis?

It is.

And in my experience, it causes significant impairment in everyday life.

The DSM-5 has very specific criteria for this diagnosis.

The criteria for a diagnosis of separation and anxiety disorder include the following:

  1. Developing inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following:
  • Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures.
  • Persistent and excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters or death.
  • Persistent and excessive worry about experiencing an untoward event (eg. Getting lost, being kidnapped, having an accident, becoming ill) that causes separation from a major attachment figure.
  • Persistent reluctance or refusal to go out, be away from home, go to school, go to work, or elsewhere because of fear of separation.
  • Persistent and excessive fear or reluctance about being alone or without major attachment figures at home or In other settings.
  • Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure.
  • Repeated nightmares involving the theme of separation.
  • Repeated complaints of physical symptoms (eg.headaches, stomach aches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated.
  1. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults.
  2. The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning.

 

For my son, this anxiety is greater than any other he experiences. It is a constant, perceived threat that haunts him every single day.

I think I am beginning to understand a bit.

Because he struggles with maintaining control of himself, including his own mind at times, it is terrifying to think of being left alone.

What if I feel like I want to kill myself? I need you here, Momma.

I can’t do it by myself. I get too frustrated and I might destroy something. 

My brain doesn’t always let me be calm. What if I start panicking and you are gone?

My sweet boy is aware enough of his challenges to know he needs help. And help comes in the form of his primary caregiver – me.

I am the one who knows what to do if he has a panic attack.

I am the one who knows how to help him in a fit of mania.

I am the one who directs him to breathe deeply, sip water and pet his dog.

Of course, he wants to ensure I am around. When I look at it from his perspective, it actually makes sense.

As we treat his other disorders, we are also increasingly able to help him learn how to separate appropriately. As his anxiety decreases, his mania subsides and his body feels like his own again, he is more willing to take risks like falling asleep alone, toileting independently, and saying goodbye without terror when I leave for the grocery store.

It is not easy.

It is not easy for either one of us.

I am sharing this today because I have not found a resource for older children and separation anxiety.

I don’t have a list of things that make a difference. This isn’t a Top 5 Things To Do To Help kind of post. We are just trying to figure this out, one day at a time.

I am sharing this because it’s exhausting to feel ashamed about your 11 year old’s need to have you in the public restroom with him. It’s discouraging to feel like you have somehow caused and enabled this level of anxiety.

It’s lonely.

Separation anxiety in older children is a real thing.

It’s rooted in clinical anxiety disorder and is just as real as any other diagnosis or challenge.

Your child is not the only one. My child is not the only one.

We are not alone.

Somehow, this feels like enough for now.

14 thoughts on “Separation Anxiety and The Older Child

  1. Yes, yes, and YES! To all of this. We don’t deal with separation anxiety to the extremes that you face with your sweet boy, but it is definitely a battle that we fight on a daily basis. Today for instance, the bus was a ‘No Go’…so we wait until life feels a little bit less scary and I will drive him to school instead. I will likely stay for at least an hour while he transitions…he is in a specialized Autism program with only 4 other kids and a lovely, compassionate Christian teacher who I would have hand picked for him. My hope is that with each success he has -even if he only ends up going to school for an hour- his brain will slowly begin to re-shape it’s thinking and we can build on each success. And in the mean time, I will drink another cup of coffee and pray for the grace and strength to face each moment….and I pray this for you too!!!

  2. We are currently experiencing this with our 7 year old who has autism. He has not been able to go to school for the last month or so, and we are just starting to get him back in a routine by going for the last hour of the day. I have to be with him of course and we stay in an empty office and spend some time reading favorite books with one of his teachers. But at least we are there. Baby steps! We are also just beginning meds for the anxiety.

    This is such a hard thing to see our kids go through. I’m so grateful for your blog Shawna, it really does help to know there are others out there going through the same struggles. Thank you for sharing.

  3. Praying for you and your younger son, dear Shawna. As always, thanks for being so honest. You have such a gift for writing about your lives!

  4. My daughter does not have ASD that I am aware of although some of her behaviors might be on the
    Spectrum. She does have anxiety that her Dr and I have recently identified but I think she has had it for years but I treated it like inappropriate behavior. Now that I recognize it she is medicated and yes, I am guilty of catering to those behaviors. She also has Down Syndrome and is nonverbal. When she was 3 months old her dad left and we never saw him again. At 5 years old her brother died, at 11 her grandpa died and her Grandma came to live with us. At 13 Jasmine had a stroke, at 18 she graduated from high school and has little to no contact with friends and teachers and at 21 her grandma died. Jasmine has been sleeping in my bed since her grandma died. She is ambulatory but in public places she has to sit in her wheel chair. It’s like it’s her safe place. Before the wheel chair, if we went into a restaurant, she would back up against a wall with a deer in the headlights look and her whole body would tremble. At the dentist and eye doctor, she has the exam in her wheel chair! I DO understand anxiety! Prayers for you and your son!

  5. Separation anxiety is a huge struggle for my 13 year old boy. He’s made progress but I understand the shame and wondering if you have somehow caused this. When he was around 8 years old we had 2 people from the children’s ministry come to our house and talk about how he needed to be in Sunday school without me. His psychologist offered to write a note explaining that his anxiety was real and we had to take things slow. I have tried to push him in the past and that actually undermined all the progress he had made. He can now go to his class alone but he still has a long ways to go. I didn’t know it was a real diagnosis. Thank you!

    1. Oh Gail, my heart hurts over the way your church handled your son’s anxiety. Please know, you are not alone (in anything that you have shared!). And it sounds like you are taking things as they come and giving your son the time and space he needs to learn to cope. I am 100% sure that is the best we can do in these circumstances.

  6. Have you heard of PANS (Pediatric Acute-onset Neuropsychiatric Syndrome)? It may be worth testing your son for this if you haven’t already.

    1. I have. We have discussed it over the past year several times, but it seems as though his symptoms came on over the course of almost a year, and he doesn’t display OCD tendencies at all. There is so much we don’t know about this, and so many doctors are resistant to trying.It does appear that more research is changing how they diagnose, so we may take another pass at it. Thank you for sharing this!

  7. Thank you for this post- I didn’t know this even had a name. I have had my boy hide my boots, tear my coat out of my arms and cling to me crying and sobbing while I literally run out the door to get to work. He’s ten years old. He still can’t go to sleep unless me or dad are physically in the room. These are the least of his problems quite frankly– but they are the ones I”m ashamed to even mention to the doctors, because I thought i must have done something wrong as a mom. But every attempt to draw appropriate “boundaries” like it seems I am supposed to draws such hysteria that I feel like I am torturing him. Thank- you for this– you put something into words I didn’t know how to talk about.

    1. I am so grateful that you took the time to share your experience. Your son sounds a lot like mine. Please know, you are not alone. And it is so, so hard. I’m in it with you, Momma.

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