Separation anxiety in children and adults: what helps

It is common for babies to cling and cry when a parent or carer leaves, and it is a normal part of development. The NHS explains that separation anxiety is a sign that a baby now realises they are a separate person and how much they depend on the people who care for them, and that it is usually a sign of how well you have bonded (NHS, 2026a). Separation anxiety in a child is not a sign that the parents are doing anything wrong (Pregnancy, Birth and Baby, 2025).

Separation anxiety disorder is different. The World Health Organization’s classification (ICD-11) describes it as fear or anxiety about separation from people the person is deeply attached to that is excessive for their age, lasts a long time (for example at least several months) and causes marked distress or problems in daily life. Adults can be diagnosed too, and in adults the focus is most often a spouse, romantic partner or children. It is one of the most common anxiety disorders in young children (WHO, 2024).

In Korea’s 2022 national mental health survey of 6,275 children aged 6 to 17, 3.8% had met the criteria for separation anxiety disorder at some point in their lives (4.4% of 6- to 11-year-olds and 3.2% of 12- to 17-year-olds), but 0.1% met them at the time of the survey; parents answered for the 6- to 11-year-olds (Ministry of Health and Welfare, 2024). Lifetime prevalence counts anyone who has ever had it, so it is much higher than the share who have it now.

mind.io does not offer a separation-anxiety test, and this guide is not a diagnosis. It sets out, from research and official sources, how long separation anxiety usually lasts, the signs and causes of the disorder, what helps at home and at daycare, treatment and separation anxiety in adults. Separation anxiety in pets is not covered. Other kinds of anxiety are covered in Anxiety symptoms.

The NHS says separation anxiety is very common from around 6 months to 3 years: young children may become clingy and cry when separated from their parents or carers, which is a normal stage of development that should stop at around age 2 to 3 (NHS, 2026b). The American Academy of Pediatrics says most babies develop more robust separation anxiety at around 9 months, and some toddlers only start at 15 or 18 months (American Academy of Pediatrics, 2026). Some children go through it later, between 18 months and 2½ years, and some never do (Nemours KidsHealth, 2023), so there is no fixed month when it starts or ends. Fear of strangers is also common between 6 months and 3 years (NHS, 2026a).

It is rare for separation anxiety to continue daily after the preschool years (American Academy of Pediatrics, 2026). But changes such as a new daycare or carer, a new sibling, a house move or tension at home can bring it back or make it worse (Nemours KidsHealth, 2023), and partings can be harder when a child is hungry, tired or unwell (American Academy of Pediatrics, 2026).

Cultures differ in how they view time apart from family. The World Health Organization’s classification says that in cultures where it is normal to stay close to family, distress at separation should not be considered excessive in itself (WHO, 2024).

Depending on age, separation anxiety disorder can show up as persistent worry that something bad, such as being kidnapped, will lead to separation; reluctance or refusal to go to school or work; repeated tantrums or great distress at partings; reluctance to sleep without the attachment figure nearby; repeated nightmares about separation; and physical symptoms such as nausea, vomiting, stomach-aches or headaches when separation is coming (WHO, 2024). Younger children may follow caregivers around even at home, while older children and teenagers may insist on staying home with family rather than seeing friends (WHO, 2024). Children may seem fine when the attachment figure is there, which can make the problem look minor (Elia, 2025). This is not a diagnostic checklist.

What sets it apart from the normal kind is whether the pattern repeats with separations over months, whether there is excessive worry about the attachment figure’s safety, whether separations are persistently avoided, and whether it causes marked distress or problems in daily life (WHO, 2024). The World Health Organization does not fix the duration in numbers (it gives “at least several months” as an example), while the US criteria (DSM-5-TR) use at least 4 weeks for children and teenagers (Elia, 2025; Ministry of Health and Welfare, 2024) and around 6 months for adults (healthdirect, 2024).

Not every refusal to go to daycare or school is separation anxiety. In adolescence especially, school refusal is usually about other things, such as truancy, peer rejection or bullying. If the fear is of speaking in class or of being with peers, it is closer to social anxiety disorder (WHO, 2024), covered in Social anxiety disorder.

In generalized anxiety disorder, people may worry about their family’s safety too, but the worry spreads to many other everyday matters. In agoraphobia, people avoid situations for fear that help will not be available if panic-like symptoms strike, not for fear of being apart from loved ones; in depression, people may avoid leaving home, but almost only during a depressive episode (WHO, 2024). Children can also develop separation anxiety after a frightening event or a death in the family (WHO, 2024). See Anxiety symptoms, Panic attacks and Grief after a death. Reactive attachment disorder is the opposite picture: the child hardly seeks comfort even when distressed (WHO, 2024), whereas in separation anxiety the child seeks the attachment figure intensely. Attachment disorders are covered in Craving affection.

This is not a matter of finding someone to blame. In a meta-analysis of 18 twin cohorts (31,859 people), individual differences in separation anxiety were largely explained by genes (43%) and the shared family environment (17%) (Scaini et al., 2012). These figures describe differences within a population; they do not mean that a set percentage of one child’s separation anxiety is inborn. Children with a cautious temperament towards unfamiliar people and situations (behavioural inhibition) were more likely to develop anxiety disorders later (Sandstrom et al., 2020).

The link between parenting and children’s anxiety was smaller than many assume. In a meta-analysis of 47 studies, parenting explained only 4% of the differences in child anxiety; among its aspects, how much children were allowed to do things for themselves (autonomy granting) accounted for 18%, and warmth for under 1% (McLeod et al., 2007). The World Health Organization also notes that childhood separation anxiety disorder is associated with parenting that does not let a child do age-appropriate things such as dressing or washing alone (WHO, 2024); rather than a cause to blame, this is something families can work on together. When a parent had an anxiety disorder, children’s risk of an anxiety disorder was 1.76 times higher, especially for generalized anxiety disorder, separation anxiety disorder and specific phobia (Lawrence et al., 2019), but studies like this cannot tell genes from environment. Parents looking after their own anxiety is also a way of helping the child (Scaini et al., 2012).

Big changes such as a house move, a new sibling, starting daycare or school, or conflict at home can bring on separation anxiety or make it worse again (Nemours KidsHealth, 2023; NHS, 2026b), and so can the death of a relative, friend or pet or a change of school (Elia, 2025). The outlook is generally good: of 161 twins aged 8 to 17 in the community who had separation anxiety disorder, 80% no longer met the criteria about 18 months later (Foley et al., 2004). But in a meta-analysis reviewing 25 studies (14,855 participants), people who had separation anxiety disorder in childhood were more likely to develop panic disorder later (odds ratio 3.45) and other anxiety disorders (Kossowsky et al., 2013). If it lasts, it is worth getting treatment.

Start by practising short separations, gradually making them longer and moving to less familiar places (NHS, 2026a). Keep goodbyes short and do them the same way each day (American Academy of Pediatrics, 2026), and do not sneak off without saying goodbye (Pregnancy, Birth and Baby, 2025). However sad or worried you feel, smile and say goodbye confidently, because children pick up on tension (NHS, 2026a). Tell your child when you will be back in terms they understand, such as “after nap time and before afternoon snack”, and keep that promise (American Academy of Pediatrics, 2026). Something comforting, like a scarf with your scent or a favourite toy, can help (NHS, 2026a), and when you are back together, give your child your full attention (Pregnancy, Birth and Baby, 2025).

It is better not to go back in or cancel plans because your child is crying and pleading (American Academy of Pediatrics, 2026). Coming back can make things worse, and most children calm down and play soon after the parent leaves (Nemours KidsHealth, 2023). But if your child stays upset for a long time after you leave, or it has gone on for more than a few weeks, ask a health professional (NHS, 2026a).

When starting daycare or preschool, visit together a few times first and begin with short stays (Nemours KidsHealth, 2023; Pregnancy, Birth and Baby, 2025). In a study of 70 infants aged 15 months, attachments stayed or became secure when mothers spent more days helping their child settle in, and securely attached infants actually fussed and cried more in the first days without their mothers (Ahnert et al., 2004). Crying in the first days does not by itself mean there is a problem with attachment. Helping the child form a bond with one teacher can help, and because children who have improved with treatment often relapse after holidays and school breaks, parents are advised to plan regular separations during the time off too (Elia, 2025). If your child strongly refuses one particular daycare or carer and is also sleeping or eating differently, check whether something is wrong there (Nemours KidsHealth, 2023).

When a family changes its routines to ease a child’s anxiety, it is called family accommodation, for example always sleeping next to a child with separation anxiety because they are afraid to sleep alone. The point is not sharing a bed as such but the family’s behaviour and routines shifting so that the child can avoid anxiety (Lebowitz et al., 2020). In a study of parents of 75 anxious children, accommodation was common across all anxiety disorders, was particularly associated with separation anxiety, and was more frequent the more severe the anxiety (Lebowitz et al., 2013). Acknowledge your child’s fear while also showing confidence that they can cope (Lebowitz et al., 2020). But forcing a child into a stressful situation without first talking about what is making them anxious can make things worse (NHS, 2026b).

If your child refuses school or it is affecting school life, talk to the school as well (NHS, 2026b). In Korea, students can also get counselling at their school’s Wee class, which is confidential and free (Korea Policy Briefing, 2022).

Psychological therapy is the main treatment for separation anxiety disorder in children (healthdirect, 2024). In a Cochrane review of 87 studies (5,964 participants) of CBT for anxiety disorders in children and teenagers, 49.4% were free of their main anxiety disorder after CBT, compared with 17.8% on a waiting list or no treatment, though evidence that CBT beats usual care or other treatments was weak (James et al., 2020). In a trial with 43 children aged 5 to 7 with separation anxiety disorder and their parents, 76% of those who had a 16-session CBT programme designed for separation anxiety, including parent training, no longer met the criteria afterwards, compared with 14% on the waiting list (Schneider et al., 2011).

Treatment can also be led by parents. Reviews have found child-only and child-plus-parent treatment to work about equally well, but a parent-led approach can be used even when a child will not take part in therapy (Lebowitz et al., 2020). In a UK trial of 194 children with anxiety disorders, 50% recovered from their main diagnosis when parents delivered CBT at home with a therapist’s guidance, compared with 25% on the waiting list (Thirlwall et al., 2013). In a US trial of 124 children aged 7 to 14 with anxiety disorders (separation anxiety disorder was the main diagnosis for 18%), a programme in which the therapist worked only with parents, without seeing the child (SPACE), did as well as CBT with the child and reduced family accommodation more (Lebowitz et al., 2020).

Medicine is sometimes used when symptoms are severe or psychological therapy is not enough (healthdirect, 2024; Elia, 2025). In a trial of 488 young people aged 7 to 17 with separation anxiety disorder, generalized anxiety disorder or social anxiety disorder, 80.7% improved a lot with an SSRI-type antidepressant plus CBT, 59.7% with CBT alone and 54.9% with medicine alone, and all three did better than placebo (Walkup et al., 2008). But medicines are not suitable for children under 6 (healthdirect, 2024), and experience in very young children is limited (Elia, 2025). Decide about medicine with a child and adolescent psychiatrist.

See a professional if separation anxiety has not improved after a few weeks or your child stays upset for a long time after you leave (NHS, 2026a); if it continues every day beyond the preschool years (American Academy of Pediatrics, 2026); if there are panic-like symptoms such as vomiting or breathlessness before you leave, or constant worry about getting lost or being kidnapped (Nemours KidsHealth, 2023); or if refusing daycare or school narrows their life so much that they cannot be with friends (WHO, 2024). In Korea, paediatricians, child and adolescent psychiatrists, local mental health welfare centres and the mental health crisis line 1577-0199 can help (Ministry of Health and Welfare, 2025), and young people aged 9 to 24 and their parents can use the free 24-hour Youth Counselling 1388 (Korea Policy Briefing, 2024).

If you have thoughts of harming yourself, please reach out to a crisis line right away: call or text 988 in the US and Canada, call Samaritans on 116 123 in the UK and Ireland, or find a line at findahelpline.com elsewhere. If you are in immediate danger, contact your local emergency services.

Adults can have separation anxiety disorder too. In adults, the fear most often centres on being apart from a spouse, romantic partner or children (WHO, 2024). The US criteria (DSM-5) also dropped the old rule that it must begin before age 18 (Silove et al., 2015). In the World Mental Health surveys of 38,993 adults in 18 countries, lifetime separation anxiety disorder averaged 4.8%, and 43.1% of cases first began after age 18 (Silove et al., 2015). In a US adult survey, lifetime prevalence of adult separation anxiety disorder was 6.6%, and 77.5% of those cases first began in adulthood (Shear et al., 2006). It is often thought of as starting in childhood, but starting for the first time in adulthood is not unusual.

Anxious attachment and separation anxiety disorder overlap but are not the same. In a survey of 394 Italian young adults, adult separation anxiety symptoms were linked with anxious attachment but not with avoidant attachment (Bassi et al., 2022), while in a study of 141 people with panic disorder, the link between separation anxiety disorder and attachment style was not strong, and some people who described themselves as securely attached still had the disorder. Of these patients, 49.5% had adult separation anxiety disorder, and separation anxiety symptoms were clearly distinct from agoraphobia symptoms (Pini et al., 2014). Anxious attachment is a tendency in relationships; separation anxiety disorder means the fear is excessive, lasts more than a few months and seriously disrupts life (WHO, 2024). Ways to handle anxiety in relationships are in Coping with anxious attachment, and the attachment style test is not a separation-anxiety test but looks at anxiety and avoidance tendencies in romantic relationships.

Fear of abandonment can also be part of a personality disorder, where it comes with wider difficulties in relationships, emotion regulation and identity, and the two can occur together (WHO, 2024). Checking on a partner excessively or controlling their life can become a safety issue for the partner, even when it stems from anxiety; jealousy and control are covered in Jealousy in relationships.

Research on treatment designed for adult separation anxiety disorder is still scarce: none of 14 adult anxiety guidelines made a specific recommendation on psychological treatment for it (Huang et al., 2025). Psychological therapy is the main approach (healthdirect, 2024), and because adults with the disorder often have other anxiety disorders or depression (healthdirect, 2024), those are looked at too. If the fear of separation has lasted for months and is shaking your work or relationships, see a psychiatrist.

Q. Until what age is separation anxiety normal? A. It is common from around 6 months to 3 years and should stop at around age 2 to 3 (NHS, 2026b). It is rare for it to continue daily after the preschool years (American Academy of Pediatrics, 2026).

Q. My child cries every time I drop them at daycare. Should I slip out quietly? A. No. Do not leave without saying goodbye; keep the goodbye short (Pregnancy, Birth and Baby, 2025). Say goodbye the same way every day, tell your child in terms they understand when you will be back, and keep that promise (American Academy of Pediatrics, 2026). Most children calm down soon after the parent leaves (Nemours KidsHealth, 2023).

Q. How is separation anxiety disorder diagnosed? Is there a test? A. mind.io does not offer a separation-anxiety test. A professional makes the diagnosis by talking with the child and parents about the symptoms and how long they have lasted, and the US criteria use at least 4 weeks for children and teenagers (Elia, 2025). The anxiety check-in (GAD-7) looks at anxiety over the past 2 weeks in adults and teenagers, so it cannot tell you about a child’s separation anxiety.

Q. I get very anxious when apart from my partner. Is it anxious attachment or separation anxiety disorder? A. The two overlap but are not the same (Pini et al., 2014). If the fear is excessive, lasts more than a few months and seriously disrupts work or relationships, it may be separation anxiety disorder, so seek an assessment (WHO, 2024). If not, Coping with anxious attachment may help.

Q. Will separation anxiety turn into panic disorder later? A. The risk goes up, but it is not fixed. Childhood separation anxiety disorder raised the odds of later panic disorder (Kossowsky et al., 2013), yet most children in the community no longer met the criteria about a year and a half later (Foley et al., 2004), and treatment helps (James et al., 2020).

Q. Does my child need medicine for separation anxiety? A. Usually not. Psychological therapy comes first, and medicine is for severe symptoms, decided by a specialist. Medicines are not suitable for children under 6 (healthdirect, 2024).

Q. I am struggling so much that I think about harming myself. A. Please do not carry this alone. Reach out to a crisis line right away: call or text 988 in the US and Canada, call Samaritans on 116 123 in the UK and Ireland, or find a line at findahelpline.com elsewhere. If you are in immediate danger, contact your local emergency services.

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