Depression Childhood Depression The Link Between Separation Anxiety Disorder and Depression By Lauren DiMaria Lauren DiMaria LinkedIn Lauren DiMaria is a member of the Society of Clinical Research Associates and childhood psychology expert. Learn about our editorial process Updated on June 02, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Kajetan Kandler / Getty Images Table of Contents View All Table of Contents Separation Anxiety vs. SAD Symptoms of SAD SAD and Depression What Parents Can Do Adults with SAD Separation anxiety disorder and depression share many symptoms. As a parent, you are probably familiar with separation anxiety—the feeling an infant or child experiences when separated from their caregivers. You may be less familiar with separation anxiety disorder (SAD) and its relation to depression. This article covers the difference between separation anxiety and SAD, as well as the symptoms of SAD. It also discusses how separation anxiety disorder can manifest in both children and adults, and how you can seek treatment for your child or yourself. Separation Anxiety vs. Separation Anxiety Disorder Your infant will likely experience some separation anxiety when you or other caregivers are out of sight. This is normal in the development process and usually begins around eight months and lasts through the child's second year. For an infant, when you are out of sight, you are gone forever. As your infant matures, they will learn through experience that you will return and they will begin to be more comfortable with separations. For children with separation anxiety disorder, however, the thought of you or another caregiver leaving them is so overwhelming that they will do whatever they can to avoid separation. In order for SAD to be diagnosed, symptoms must be severe enough to interfere with a child's daily functioning for at least four weeks. When a child starts to miss out on important things such as school and social activities to avoid a separation, it is considered to be SAD. SAD affects approximately 1% to 4% of children. Adults can also have separation anxiety disorder (though there is more research on how the condition manifests in children). Adults with SAD must have disruptive symptoms that persist for at least six months. Symptoms of SAD Symptoms of SAD include: Persistent worry about being separated from the attachment figure Refusal to attend school or social events for fear of being separated from the attachment figure Worry about something bad happening to the attachment figure even when they are near Refusal or hesitation to go to sleep alone Nightmares involving a theme of separation Excessive worry about being kidnapped, lost, or kept from the attachment figure Complaints of physical ailments, especially when separated from the attachment figure (a headache, bellyache, generalized pain) In children, the attachment figure is most often the parent or caregiver; in adults, the attachment figure could be a parent, partner, or another loved one. What You Should Know About Attachment Styles How SAD Relates to Depression SAD and depression actually share many symptoms. When a child or adult with SAD refuses to engage in activities, they may end up socially isolating themselves—a common sign of depression and anxiety disorders alike. In addition, both SAD and depression may cause physical complaints such as a headache, bellyache, and general pain. SAD and depression may cause sleep problems. People with SAD and people with depression often struggle with rumination on negative thoughts; for people with SAD, these thoughts tend to revolve around something bad happening to their attachment figure. It's also worth noting that anxiety disorders and depressive disorders are commonly comorbid with each other, meaning people often have co-occurring depression and anxiety. If separation anxiety disorder isn't addressed in children, it can potentially lead to other mental health disorders later in life. Research indicates a link between adult separation anxiety disorder and major depressive disorder (MDD). One study found that 41% of adults with MDD in an outpatient psychiatric service also had SAD. Of those with both MDD and SAD, 75% developed SAD as adults. Given the connection between SAD and depression, it is important to be aware of the signs and symptoms of both disorders and to seek out early treatment for your child or for yourself if you are experiencing SAD as an adult. What Parents Can Do for Children With SAD Keep an eye out for additional signs of depression in children, including unexplained crying, feeling misunderstood, withdrawing from family or peers, losing interest in things of former interest, sleeping difficulties, appetite changes and/or weight changes, difficulty concentrating and making decisions, and thoughts or actions of self-harm. Talk to Your Child Try talking to your child when they are at an age-appropriate level. Find out what they are scared of and why they don't want to leave you. What you hear may surprise you. Your child may have a simple complaint, which you can easily remedy. If it is something more serious (they are worried they will never see you again, for instance), it's best to consult a pediatrician. A recent tragic event, such as an earthquake or the death of a loved one, may temporarily disrupt your child's sense of security. In this case, providing your child with some extra attention may ease their anxiety. Prepare Your Child Prepare them for an upcoming event or separation. Explaining what will be happening, who will be there, how long they will be away from you, and how they can reach you may help them feel more comfortable with separation. If your efforts, support, and compassion do not seem to be helping your child adjust to even short separations, try talking to a doctor about their symptoms. If you notice any symptoms of depression in your child, it is important to seek help. Depression is associated with serious short- and long-term consequences such as poor self-esteem, poor academic performance, substance use disorders, and suicidal thoughts and behavior. If your child is having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Talk to a Mental Health Professional If your child's symptoms are persistent, cognitive behavioral therapy (CBT) is the first line of treatment for SAD. A therapist can help your child learn healthy coping mechanisms to handle their anxiety. SAD can result from trauma, such as losing a family member; a therapist can work with your child to address fears that stem from any traumatic incidents. Family therapy may also be recommended. In family therapy, you, your child, and other immediate family members attend sessions together. Your family unit will discover how to best support your child with SAD by learning their triggers, how to handle tantrums or panic attacks, and more. For severe symptoms, children are sometimes prescribed an antidepressant such as a selective serotonin reuptake inhibitor (SSRI). However, antidepressants are not approved for children under six years old. Adults with SAD Cognitive behavioral therapy is also recommended for adults with SAD. A therapist can help you understand the underlying thoughts and beliefs that contribute to your anxiety. Similar to treatment for children with SAD, a therapist will teach you healthy coping mechanisms. Both children and adults can develop SAD as a result of a traumatic experience; a therapist can help you address any past incidents that contribute to your separation anxiety disorder. They may help you to reframe incidents in a more adaptive way. You'll work toward being able to re-engage with the world—attending social events, feeling safe by yourself, and handling anxiety or panic attacks with deep breathing practices, for instance. In addition to therapy, an antidepressant such as an SSRI may be recommended. A Word From Verywell Remember, your child may go through phases when they are more in need of your attention and love, especially during times of significant stress or tragedy. However, it is best to check with a physician if you have any concerns about your child's behavior. In addition, if you are an adult and you have symptoms of SAD, be sure to talk to a doctor or mental health professional about your concerns. There are resources that can help you feel more comfortable and at ease when away from your loved one. 12 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 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Child and adolescent depression: A review of theories, evaluation instruments, prevention programs, and treatments. Front Psychol. 2019;10:543. doi:10.3389/fpsyg.2019.00543 Additional Reading Parenting Q&A: Separation Anxiety. American Academy of Pediatrics. By Lauren DiMaria Lauren DiMaria is a member of the Society of Clinical Research Associates and childhood psychology expert. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Depression Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.