Does My Child Have Separation Anxiety Disorder or Bipolar Disorder?

Separation anxiety

Separation anxiety is the excess anxiety a youngster may feel when separating from an attachment figure (typically the parent) or the home. It is part of a child's normal developmental process and begins between six and twelve months of age. In this age-group, separation anxiety occurs because very young children have not yet developed a sense of object permanence. Unlike older children, they don't realize that the fact that they can't see the parent doesn't mean she is not there or is not coming back. As far as a child of this age is concerned, a parent who is out of sight has disappeared.

Mild separation anxiety can occur later in a child's development as well. It's not uncommon, for instance, for kids to have problems separating from their parents at the beginning of nursery school, after a move, after the death of a person or pet, or following some other significant stressful life event. If separation anxiety persists for at least four weeks, however, it is considered a disorder that may require psychological intervention.

Bipolar children, in particular, often show an extreme degree of separation anxiety, which is most common when they are depressed. They may fear being alone in a room without their parents. (One mother told me she has to leave the bathroom door ajar so that her daughter will feel less anxious when she's out of sight.) As we've seen, bipolar children may also resist going to sleep in their own beds by themselves at night due to their intense anxiety and fear of nightmares, being kidnapped, and so forth. These youngsters are often genuinely petrified to be alone. When a bipolar child's mood is stabilized, though, she is often no longer so terrified of being by herself at night, and getting the child to sleep alone is often easier once she is no longer depressed.

School can be an especially difficult area for separation-anxious bipolar kids. Some kids cry and scream and take months to settle into their classrooms. Others are fine until second or third grade or even later, at which point they begin experiencing physical symptoms. In the morning, they may complain of headaches, stomachaches, and sore throats and beg their parents to let them stay home. One strategy that is sometimes helpful is to send the child to school with a picture of the person he misses, so that he can look at it whenever he's upset (though this tactic can backfire for some kids because it only reminds them that the person isn't there).

More on: Bipolar Disorder