- Bethany, how old is your son, Nico?

- He is three.

(light jazzy music) - Three.

What is drop-off like for him, when you have to drop him off somewhere?

- He likes the idea of going to school and then we get to school and he opens the gate and he opens the door.

And then I say, "Okay, I'll see you in a little while."

And then he goes, "No, don't go!"

When he gets upset, you usually are like, "Peace!"

- Sometimes.

Sometimes, it just turns into a whole thing.

(light music) He'll cling, and it's really, really, really hard.

But most times I just give him a kiss and a hug and leave.

- And it works?

- The teacher always texts me right after "He was fine 10 minutes after you left."

- This represents a little bit of separation anxiety.

Did Nico do this when he was nine months old?

Eight to nine months when we usually see it for the first time?

- Yeah, the screaming at the top of his lungs no one can hold me, but you stage?

Yes.

- That's another word for it.

- It was like the second he could tell mama, not mama.

That was the first time it started.

- Did it get better afterwards?

- It got better after like a few months.

- Generally speaking, and again, this is not the case for every single kid.

This is not some golden rule.

We usually see children at around eight or nine months develop that stranger danger.

They're like, oh my gosh, familiar, protective face, not familiar, protective face.

I don't want to be around this stranger.

It totally happens.

But then when kids are about one, some are between one and two, they're like, whoa this world is amazing and I can explore it.

I don't need my parents.

- I got places to go.

- I got places to cruise.

- [Bethany] I gotta go there.

I gotta go there.

- But then a little bit later on they start to understand, okay, this is the world.

But this is the protective place I live in.

And I actually need my parent for survival.

Now, I should say that kids can become whiny, irritable or fearful when their parents leave them starting as early as around eight or nine months.

And it's normal for infants and toddlers to go through this.

Kids usually outgrow it around three or four years old.

But again, every child is different.

Sometimes toddlers will become clingy, irritable and demanding when they reunite with their parents.

This type of anxiety isn't separation per se because it's more based on a child needing that protection and security from their parent after they spent time apart.

- But what is the deal?

What is making them do that?

- We're literally wired for attachment.

One way we think about it is it's almost like a fight or flight response.

Like parent is leaving!

There goes my source of protection, shelter and nutrition, and kids panic.

All of a sudden adrenaline kicks in, pupils dilate.

They cry, sweat, scream, go into a fit.

They freak out.

Some studies suggest the hypothalamus and amygdala, the good old fear and emotional centers might be at play here.

- So it's a survival thing really.

- Now how about some quick tips to help with separation anxiety.

These may come in handy, whether you're dropping your child off at daycare, grandma's, a friend's house, whatever.

It's all about giving your child reassurance and a sense of safety.

Rituals can really help with this.

Keep the goodbyes quick, give your child your full attention and love, but keep it brief.

Try not to keep running back for hugs, even if they cry.

- The important thing is to not let him feel insecure.

So if the fear is that I'm not coming back, I reassure him so often, I'll be back, I'll be back.

We have little songs about it - Make a routine and try to keep the timing consistent.

Let your child know when you'll be back to pick them up and make sure you're on time.

- I say things like in just a little while, I'll see you in a little while, so that he knows it's really not that long of a time before he sees me again.

I feel like, staying and I'm hanging out an extra 10, 15 minutes makes it much harder to separate.

Give him a chance to self-soothe, rather than be there to help him soothe.

- You might try to schedule those separations for after naps or feedings.

Since kids are more likely to feel separation anxiety when they're tired or hungry.

You could even talk to your daycare about having your child bring a favorite toy or object with them.

The more predictable the situation, the less fear and anxiety.

And hopefully your little one will learn to embrace their newfound independence.

Sometimes it manifests in different ways, especially with the anticipation or the lead up to possible separation.

For example, in some older children, it might not be clinging to the leg and crying and don't leave me, it might be a stomachache in the middle of the school.

It might be a headache.

It might be anxiety.

It might come across as something that doesn't immediately seem like separation anxiety, but stems from the fact that the protective figure is no longer there.

If one of your friends said to you like, hey my eight year old for the past week is all of a sudden really sad about going to school, what would you think, as a mother?

- I feel like if it was Lulu, and she's eight, and she was behaving that way, I would be very concerned.

And I would check out what's going on at school.

What's going on in her environment?

Who is she spending time with?

Is she ever alone with anybody?

I would definitely find out what's going on.

- Yes, we tease out, absolutely.

Bullying, a situation that the child's uncomfortable with.

Are they staying with a guardian that doesn't treat them well?

And then once all those are taken out of the equation you then look to see, is it separation anxiety?

When we start talking about it as a clinical condition and we use that word separation anxiety disorder that's usually when we're talking about older children.

- You've ruled out all the- - You ruled out all the other things.

Kids are now heading into six, seven eight years old or later, though we can even see this with preschoolers.

They're having these symptoms for a long period of time.

It's debilitating them.

It's affecting parent's ability to separate from them, to go to work, to go out.

It's affecting children's ability to go to school.

It's affecting their schoolwork, then playing with friends.

That's when you really start talking about- - That's when you add the disorder and that's when you certainly want to seek treatment.

- I was gonna say, at the very least at that stage that's when you really want to talk to a professional and see what can be done.

- I can see how if that went on for extended periods it would probably be really tough.

- In some kids, we need to try something that's like cognitive behavioral therapy, and this can help children learn to recognize their fear and anxiety and manage it.

Then there's exposure therapy, which is a form of cognitive behavioral therapy, where you increase, slowly, incrementally the amount of time you're spending away from your child in those situations.

There's also something called parent child interaction therapy, which considers how parenting style and behavior impact how a child deals with their anxiety.

The idea is for both the parent and kid to work on improving these interactions.

However, in some cases, separation anxiety can be really bad.

Some of these kids may actually need prescription medication, which is okay.

You know what?

If it's not handled early in children, it can actually progress into adolescence.

Regardless of what it is, it's important that your individual child is listened to and that your healthcare professional is looking at all the variables.

Is it ruining date night for mom and dad?

Is it ruining vacations?

How does it affect your life?

All of these questions.

- Well, what is date night?

- No date night?

- Do parents leave and do something fun alone?

Oh my gosh.

Can you write me a prescription for that?

- I'm just gonna shut my mouth.

- I'm going to give it to Lulu and Nico and be like, Dr. Alok said we can get outta here, peace!

- You have to live your life.

You gotta live your life, mama.

♪ My life ♪ You just left me hanging.

- 'Cause I was living my life in my head.

(swelling crescendo) (light music)