Have you ever seen a child throw a tantrum or cry a lot when separated from a loved one? Sometimes, a child with this behaviour is viewed as ‘spoiled’ or ‘clingy’, but, experts say, it could be something serious. 

In many cases, children with this behaviour are eventually diagnosed with separation anxiety disorder, a syndrome in which a child becomes excessively anxious when separated from parents, or someone close to them. 

According to Mayo Clinic, separation anxiety is a normal stage of development for infants and toddlers. Young children often experience a period of separation anxiety, but most children outgrow separation anxiety by about three years of age. In some children, separation anxiety is a sign of a more serious condition known as separation anxiety disorder, starting as early as preschool age.

Less often, separation anxiety disorder can also occur in teenagers and adults, causing significant problems leaving home or going to work. 

Don’t dismiss the signs

In many societies, due to unawareness, some parents even punish their children for this.

Claire Uwamahoro, a mother of two, shares how she used to punish her youngest child because she believed he was spoiled and demanding.

"When my last born was about one, he started being very clingy, I could not go anywhere without him attached to me, I even started spending the night in his room because he was too afraid to be left alone. I also stopped going to work because he would not allow me. I got many comments on his behaviour from other mothers and people in general, they told me my son was being a "hard to deal with child”, and some told me that I had spoiled him a lot which was the outcome of the behaviour. So I started beating him if he cried or acted clingy,” Uwamahoro shares.

Uwamahoro explains that her son’s behaviour was becoming serious, he started having a lot of fear, he refused to stay in a place alone even in the daytime, and he became extremely attached to his home going as far as refusing to go to school. She was advised by a neighbour who had a child with autism to take her son to a specialist and check if her son was also autistic, and so she took him to a paediatrician who then advised her to take her child to a psychologist at Caraes Ndera Neuropsychiatric Hospital. Her son was diagnosed with separation anxiety disorder and was placed under therapy.

"My son is turning two soon and is still in therapy, I can say it’s improving. I wish parents were more educated on this because sometimes children are ignored and this grows into severe anxiety and other problems,” she says.

Uwamahoro was lucky to receive advice to take her son to a specialist, but many children are still ignored, and considered attention seekers.

Uzziel Manirareba, a licensed psychologist and youth leader at SOS Children’s Villages Rwanda, says that separation anxiety can be something normal in children but also something serious, it is crucial to keep track of a child’s behaviour.

"Children form a kind of attachment to their parents or caregivers, they feel safe when they are with their parents, but when they are away from them they feel anxious, so separation anxiety sets in when a child can’t develop what we call adaptation into that situation,” Manirareba says.

"When this is not observed earlier, children grow with it, which is why you will find an adult having issues with relationships because they are afraid to be left alone or abandoned. This is due to the past experience as a child and it is best to understand this kind of disorder early,” he advises.

Manirareba says that a child who has developed this disorder tends to fear being alone, they won’t eat sometimes and sleep, orphans mostly develop this kind of disorder, and children with parents sometimes, so it is best to look into their relationship to see if it is the cause.

Vanessa Ingabire Igihozo, a psychologist, says that when the behaviour becomes something serious it is best not to ignore it. "It can be diagnosed depending on the symptoms, it is true children tend to be clingy but this disorder is different from being clingy, so if in any case the anxiety or excessive fear starts to disturb the child’s daily activities, then that’s a problem, this means the child does not have normal fear about separation but this fear is excessive, as the child can’t do anything,” she explains.

 Symptoms

According to Igihozo, the common symptoms are:

• Repeated nightmares about separation

• Frequent complaints of headache, stomach-ache, or other symptoms when separated from a parent or other loved one

• Not wanting to be home alone without a parent or a loved one in the house.

• Constant worry that something bad will happen, such as getting lost or kidnapped if separated from parents

• Recurrent and excessive distress about being away from home or loved ones.

Diagnosis

"About diagnosis, it is better to talk to a paediatrician or healthcare provider, I wouldn’t advise a parent to do their own diagnosis. If they have concerns, it is best to talk to doctors in order to be sure,” Igihozo says. 

"Diagnosis also involves determining whether your child is going through a normal stage of development or if the issue is actually a disorder. I recommend going to a paediatrician because after ruling out any medical conditions, the doctor may refer the parent to a child psychologist or psychiatrist with expertise in anxiety disorders,” she adds.

According to Igihozo, to help diagnose separation anxiety disorder, the mental health professional will likely give the child a psychological evaluation, structured interview that involves discussing thoughts and feelings, and will observe the child’s behaviour.

Treatment

This is usually treated with psychotherapy, sometimes with medication.

"Psychotherapy is called talk therapy or psychological counselling, which involves working with a therapist to reduce the intensity of the disorder,” Igihozo explains.

CBT, also known as Cognitive Behavioral Therapy, is a form of psychotherapy for separation anxiety disorder. During the therapy, the child can learn how to face and manage fears about separation and uncertainty. In addition, parents can learn how to effectively provide emotional support and encourage age-appropriate independence, she adds.

"Sometimes, combining medication with CBT may be helpful if symptoms are severe. Antidepressants may be an option for older children,” Igihozo says.

Manirareba warns against jumping to conclusions whenever a child shows different behaviour, the best thing to do is to observe and then take the child to a specialist to check what is wrong and provide professional help.