The Link Between Separation Anxiety Disorder and Depression

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.

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.

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.

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.

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.

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.

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.