4 signs that your kid has separation anxiety issues, according to psychologists

• All kids can feel sad when leaving their parents, but if this persists, it could be separation anxiety.
• Outbursts, trouble sleeping, and headaches or stomach aches can be signs of separation anxiety.

Separation anxiety disorder affects up to 4% of kids. But what's the difference between a child that's just anxious about going to sleepaway camp and a kid that has severe separation anxiety that needs to be addressed?

It usually comes down to whether the anxiety is so significant that it stops kids from doing fun and important activities including attending school. If that's the case, then it might be time to get professional help, says Ann Lagges, an associate professor of clinical psychiatry at the Indiana University School of Medicine.

Separation anxiety doesn't typically come out of nowhere. There's usually a trigger, like attending a new school or welcoming a younger sibling can set off separation anxiety, Lagges says.

And while separation anxiety is expected for kids 3 years or younger, if your child is older than this and you think they're struggling with separation anxiety, here are some tell-tale signs to confirm your suspicions and how to help ease your child's anxiety.

1. Tantrums or outbursts

Some kids with separation anxiety display behaviors like throwing a tantrum when it's time to say goodbye to their caregivers, says Maggie Canter, a clinical psychologist in the Department of Psychiatry and Neurobiology at the University of Alabama at Birmingham.

"That can be really tricky, because a lot of times we'll be like, 'oh, he's having an outburst at soccer practice, so we're gonna have to leave soccer because his behavior is inappropriate,'" Canter says. "And at the same time, that is kind of in a way giving into the anxiety. If he didn't want to separate from the parent to go to soccer practice, then by leaving practice we're saying, 'oh, anxiety, that outburst was good, we got what we needed.'"

2. Worry that something bad will happen

A child with separation anxiety might stress about something bad happening when they're apart from their caregivers, Lagges says.

For instance, a child might worry about being kidnapped or fear that their parents will get into a car accident.

"It's normal for kids to bring stuff like that up once in a while, but kids with separation anxiety, it gets to be pretty pervasive and constant," Lagges says.

3. Inability to sleep alone

A lot of kids go through phases where they don't want to sleep alone at night. But if a child is absolutely unable to sleep without parents around, and that persists after several months, that might be a sign of separation anxiety disorder, Lagges says.

Sometimes, parents will give in and let their child sleep with them for the sake of a good night's rest. But this just perpetuates the problem, Lagges says.

"Parents aren't going to sleep as well if they've got a child in with them, and just for everybody to be able to have their own space and privacy at night can be really important," she says. "That is an important developmental task, for kids to learn how to be able to sleep in their own bed."

4. Headaches and stomach aches

Many symptoms of separation anxiety are mental, but sometimes, stress and anxiety cause physical problems, too.

If you notice your child has a lot of unexplained stomach aches, headaches, or vomiting before a planned separation, that could indicate separation anxiety, Lagges says.

What to do if your child experiences separation anxiety

If you think your child may be experiencing separation anxiety, pay attention to how disruptive their symptoms have become.

If your child's anxiety significantly affects their day-to-day activities, it might be time to get help, Lagges says.

Note, though, that it's normal for kids to go through phases, including phases of clinginess. Wait a few weeks to see if things improve on their own. If after a month, your child's symptoms are the same or have worsened, visit a mental health professional, Canter says.

Most treatments for separation anxiety revolve around therapy, which can include:

Teaching kids to do 'safe but scary' things

In therapy, kids might talk about what the difference is between safe and dangerous activities, and how doing safe but scary things means being brave, Lagges says.

"We always want to make sure kids know we're never going to ask you to do something that's dangerous," she says.

Anxiety management tools

"Brave talk" is "the young child version of cognitive therapy," Lagges says.

When in a stressful situation, "The child can remind themselves, 'I know I'm safe, I'm in my bed, my bed is nice and cozy, mom and dad are right next door, I can go to sleep.'"

In therapy, kids can also learn deep breathing exercises, like "birthday candle breaths," or certain forms of progressive muscle relaxation to help them calm down when they get anxious, Lagges says.

Exposure-based cognitive behavioral therapy

Exposure therapy, as the name suggests, is where you gradually expose yourself to what causes you anxiety so that you may overcome it over time.

For example, a child who is afraid to sleep alone might start exposure therapy by having their parent sit beside them as they fall asleep. Then over time, the parent backs their chair farther from the bed each evening until eventually they don't sit in the room with the child at all, Lagges says.

Another example is if a child is very attached to their mom, Canter recommends having another loved one — like Dad — babysit instead of a stranger. Then, introduce a babysitter after the child gets more comfortable being away from mom, Canter says.

"The most important part of this, though, is that it is gradual," Lagges says, since drastically altering a routine could cause even more anxiety.

And treatment plans don't have to last forever: in fact, for many kids, therapy may only require one or two sessions as long as interventions are being appropriately implemented at home, Canter says.

Don't allow kids to avoid stressors

It's natural to want to make your kid feel better when they're upset. But if you let your child avoid stressful environments like school because they're upset, they won't ever learn that they can overcome their fears, Lagges says.

"If a child is saying, I don't wanna go to school, I want to stay here with you… parents can help by reminding their kids, you know, 'your job is to go to school, mom's working from home or dad's working from home but your job is to go to school,'" Laggees says.

"Try to steer their talk and their internal self-talk to things that maybe they like about school. Say, 'you know, when you go to school you say you like your teacher, you get to see your friends…' helping the child to focus on the positive aspects of the thing they're trying to avoid."

Set up a goodbye ritual

Anxious kids thrive when they know what to expect.

"Have a goodbye ritual," Canter says. "That can be saying, 'I love you, have a great day at school, and I'll see you when you get home at night' – whatever it is, but having the same thing you say every time. Or maybe it's a hug or a secret handshake or a high five or something, where they're like, 'okay, this is what we do every day.'"

Praise your child

Make sure that you compliment your child when they face their anxiety.

Say something like "'You do such a great job, I know you were really nervous to go to school today, and I'm really impressed you were able to stay all day,'" Canter says. "Finding positives that you can praise helps the child feel good about how they were successful."

Insider's takeaway

Kids with separation anxiety get upset at the idea of being away from their parents, which might lead to tantrums or your child refusing to sleep alone. Separation anxiety can be treated with therapy, as well as lifestyle changes implemented by mom or dad.

"It will get better with time," Canter says. "Whether it's something that just gets better on its own or if it's something that requires seeking some extra support… it's something that can be treated and can get better."