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Extreme Toddler Separation Anxiety

Separation Anxiety in Overdrive

By Amalah

Hello, I’m writing because I’m absolutely desperate for help. My youngest has been an extremely high needs baby, right from the get go. Her extreme separation anxiety started at 6 weeks old (I wish I was kidding, I’ve never seen anything like it) where she would scream and scream and scream if anyone but me held her…. including her father. She refused a bottle so I couldn’t go out. All the advice I got was “oh she’ll drink it if she’s hungry enough”. Yeah right! At 3 months old she went 7 hours without a drop of milk while I was having a surgical procedure.

She’ll be 2 years old in 2 weeks and things have gotten a lot better in most areas, especially sleep. Until recently. I went on a 5 day vacation leaving her with her dad, and then a few weeks after I got back suddenly bedtime is a disaster. She will literally kick and hit and scream for upwards of an hour if anyone but me attempts to put her to bed, but if I come in she will calm right down.

Bath time is also a nightmare and that has gotten worse over time instead of improving . She’ll stand in the tub and just scream and scream and say over and over “I all done! I don’t like it!”.

If I leave her with a babysitter she loses her mind for hours on end.

It’s gotten to the point where my doctor ordered bloodwork to rule out any underlying issues, all normal. ASD has also been ruled out and we’ve experimented with all sorts of different nap/bedtimes.

How can I alleviate such extreme anxiety? Or do I just have an insanely clingy and sensitive kid on my hands? I’m exhausted!

Any advice you have would be greatly appreciated!
Signed, tired and desperate!

So I write all of this with the usual caveat that I am not a doctor or a recognized/qualified expert in this topic, but having dealt with various early childhood issues with anxiety/atypical development, I’m going with my gut here and want to suggest you take your daughter for further evaluation, preferably by a child psychologist who specializes in anxiety in very young children. Because this just isn’t reading as “typical” separation anxiety.

My favorite book on anxiety in children (Tamar Chansky’s Freeing Your Child From Anxiety) doesn’t really talk about children as young as your daughter (most of the anecdotes and strategies are geared at preschool and up), but it goes cover separation anxiety and its more serious, pervasive form of Separation Anxiety Disorder (SAD). Children with SAD, as Chansky explains it, “rather than building confidence with successive separations, experience each separation as a crisis.” They simply do not feel safe without their parents (and often even a single preferred parent), and when they are separated, they experience genuine terror and distress. The babysitter is a dangerous stranger keeping me from Mommy, bedtime is saying goodbye FOREVER, danger danger Will Robinson, etc. As these separation-as-crises build and repeat, rather than eventually making the usual “Mommy goes away and Mommy comes back” connection, there’s a glitch, and the child eventually becomes consumed with worry over separations that haven’t even happened yet. 

Thus, kids with SAD have a more-terrible-than-usual time separating for preschool or babysitters, and sleeping alone in their own bed is also a nightly exercise in terror. They’re more than just “clingy,” because in their minds they are literally clinging for dear life. 

Again, ALL OF THESE fears and anxieties can exist at a “normal,” developmentally appropriate level. Lots of toddlers go through a preferred parent phase and cry when Mommy drops them off at Grandma’s house and HELL YES, they will fight and cling at bedtime as if their life depended on it…all without it rising to the SAD or intervention-needed level.

But what you’re describing sounds like a child who has lived with a very severe form of separation anxiety for almost her entire life with little improvement, and lots of backtracking whenever there’s an extended but necessary separation. The endless screaming and fight-or-flight responses, the not eating for seven hours at three months old, the “loses her mind for hours on end” — these are red flags to me that her fears go beyond what would be considered “typical.” The bathtime panic might not seem directly tied to the separation anxiety, but sounds an awful lot like a very sensitive child who is genuinely terrified of Bad Things Happening. (And according to Chansky, children with SAD often will go on to develop other anxiety or panic disorders later in life, because they’re living with such constant fear that their parent will leave/get sick/die, and thus never really experience feeling safe.)

And okay, stopping now to once again add that I AM NOT and CAN NOT diagnose a child over the Internet based on a few short paragraphs. And I don’t want you to start panicking over panic and jumping to worst-case scenarios — anxiety, at any level, is a completely treatable thing!! And just like any developmental quirk in early childhood, the earlier the intervention, the better. So please, get her evaluated by someone who specializes in this stuff ASAP. And since this has been a noted issue since six weeks of age, don’t let anyone just write your concerns off because of her age now, telling you that she’ll still just “grow out of it” or something — push if you have to, advocate the hell out of the situation.

(I also want to add that “ruling out” — or even diagnosing, except in the more severe cases — ASD before two years old is…not always going to be really accurate. That gets a touch of side-eye from me, TBH. My high-functioning ASD kid has been in Early Intervention since your daughter’s age and didn’t get the official Spectrum diagnosis until he was almost 8. Based on your letter my gut is definitely leaning more on the anxiety disorder spectrum than the Autism version; just tossing this out there to suggest that maybe you take her elsewhere for further evaluations because this stuff just isn’t that cut-and-dry at this super young age.)

A good psychologist or therapist will understand what’s going on in your daughter’s brain and help you “rewire” it together, helping her feel safe and make the necessary connection of “Mommy goes away and Mommy comes back and NOTHING BAD IS HAPPENING TO ME” that she’s not yet making on her own. They’ll help you forge (in time) successful separations that aren’t full-on physiological crises for her, and help her form positive connections to adults that aren’t you. And they’ll help you navigate other anxiety triggers, like bedtime and bathtime, in a more knowledgeable, hands-on way than some stranger on the Internet.

As an adult who has struggled with GAD (Generalized Anxiety Disorder) on and off throughout life, I promise you this is a treatable thing that can be conquered with a little help. And no matter what the diagnosis or reason behind your daughter’s ongoing anxiety, you will never regret getting that little bit of help as early on as you can.

Photo source: Depositphotos/Klanneke

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Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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Comments

  • Mary

    This might be the silliest suggestion, but my kid absolutely could not watch me leave or conceive of going to bed without me or consume a bottle of milk or any of it for more than two years.

    And then she watched Daniel Tiger sing “grown ups come back” and I’m not kidding, a switch flipped in her brain. She has strong feelings about which parent handles midnight wake ups and she experiences reasonable anxiety sometimes about me going out. But it’s night and day.

    So, that’s my tip. Show her the “grown ups come back” episode of Daniel Tiger over and over until you’re ready to switch it out for a potty training or baby sister one.

  • Susie

    This will sound weird, but your child sounds like my little brother. He was miserable as a baby- constant screaming, wouldn’t go to anyone but Mom, etc. Nine year old me was left with quite an impression. Around age four someone finally tested his vision. My brother had ludicrously bad sight from birth, so the only person he trusted was the one he smelled the most- his mama. Have y’all tested her vision?

  • guest

    I second Amy, you need a different provider to check her out. Find a good child psychologist (if possible – I know that can be really hard to find in some areas) and see what they can do to help give you some strategies to cope with this and help her.
    Definitely get her vision and hearing checked. As for the bath, there is no reason she has to have a bath by herself. Just take her in the shower or bath with you. I have several old plastic measuring cups that are permanently on the floor in my shower, because my littles come in with me, and they can entertain themselves endlessly with those so I can still wake up in my shower.
    I also recommend that Daniel Tiger episode. We got custody of a 2.5 year old relative this year. We had never met him before, and it was less than 2 weeks from hearing about him to him being dropped off at our house, and his separation anxiety was naturally high, as he had been left by everyone his whole life. The first day I had to go back to work, his look of sheer delight to see me when I got home was heartbreaking. He genuinely didn’t think I’d come back. My older children had been big fans of Daniel Tiger, so I was already familiar with the episode and we did a lot of, “Mommy will come back. Mommies always come back.” and so on. Bedtime was a total nightmare, even for me putting him to bed, because that is when his mother used to leave him, so he was convinced that if he went to sleep, I would be gone when he woke. It was a nightly routine of two or more hours of him kicking and screaming and completely fighting sleep, and me trying to soothe him. Anyway, we have done LOTS of “Mommy comes back.” and “Mommy will see you in the morning.” and other small variations of that. I’ve been looking for a good child psychologist in our area for months, but the only one who took kids as young as him retired recently (we aren’t in a big city), so we have just been having to struggle through it, although I recently started seeing my old psychologist again. She can’t see him, but I can talk to her and she can give me ideas to implement. She suggested wrapping his pillow in an old t-shirt that smells like me. I’d suggest you might also try the same thing with your daughter. I hope you find what works for her soon. It is so hard to watch your baby scream in terror like that and not be able to do anything. And it is exhausting being the parent who has to be there ALL THE TIME. Do what you need to to rebel in a healthy way if you need to. I died my hair and started wearing it in a fauxhawk. My mom asked me why I wanted to look like a punk, and I just told her that I feel weighted down with the responsibility sometimes. I can’t just go and take a weekend away – well, ok, I could, but it would seriously set him back so I choose not to – and so I need to rebel in a way that doesn’t actually have me lashing out and running away. My older kids just think I’m slightly weird, but I look in the mirror and see someone else. My own tiny bit of escapism.
    ((hugs)) and good luck!

  • Helen

    What Amy said. Also, when you find a therapist (and good luck with that, even in a big city it’s not easy I’m afraid) insist they do an actual evaluation, not set you up with half-assed therapy from semi-qualified therapists who don’t know what they’re dealing with and blame everything on your parenting skills (don’t let them tell you it’s your parenting skills). The good news, in our case, was that things got a whole lot better once we’d had a proper assessment, got good therapy, and begun medication.

  • Felicity Marie

    Oh this sounds tough. I have a little one, now a few years older than yours, who is very similar. (And we also heard a lot of “she’ll grow out of it”. She didn’t.) It sounds like your kiddo is very anxious. There’s no way to say, based on what you wrote, what specific diagnosis she might fit into, but it’s definitely a concerning level of anxiety. And it can be alleviated, and treated! You will definitely be able to help her feel better. Find a licensed psychologist (PhD or PsyD) who specializes in children to evaluate her and consult with you about some strategies. Your pediatrician may have a list of referrals. And I totally agree about the Daniel Tiger song! We sing it alllll the time in my house. 🙂 Good luck!

  • guest

    Oh, also, is she getting her 2 year molars? That could be the reason for it seemingly ramping up lately. I know my little guy always gets more anxious and clingy when he doesn’t feel well. And the 2 year molars can be brutal. Maybe a teething necklace or some Tylenol can help ease that part?

  • Guest

    *side-eyeing the side-eye about ruling out ASD at her age*

    Honestly, if they gave her an appropriate screen for it, there’s not a whole lot of point in RE-screening her for it in the near future. I mean, sure, it may be worth checking back in on in a couple of years if there are other ASD-like features, but you can certainly say it’s been ruled out as something she can be diagnosed with RIGHT NOW and that it makes sense to pursue other, more likely diagnoses. I mean, I hear you, my kiddo passed the MCHAT — kind of, sort of, barely — and then went on to have autism, so I know from both professional and personal experience that you’re correct about diagnosis at this age involving a good amount of guesswork, but can we work from the assumption that she saw someone appropriate to screen and was not given tons of false information about what the rule-out means or doesn’t mean? If it was ruled out, appropriately, for now, that means pursuing anxiety treatment is more sensible than pursuing ASD treatment. Which is good information to have. And was appropriate for a professional to do, even given generous margins for error at that age.

    *side-eye posters side-eyeing the professionals she’s seen thus far*

    I don’t know why people are assuming her current providers are incompetent? Like, literally, what she’s said is that the PCP did bloodwork to rule medical causes out (which suggests PCP is taking it seriously) and someone ruled-out ASD (for now), and all of that sounds… completely appropriate? I mean, yes, by all means, ask for a referral to a specialist, but I wouldn’t be too concerned about the folks you’re seeing now unless a LOT more is going on than what you wrote here. (Or unless your mommy gut dislikes them, in which case, by all means, switch.)

  • kat

    Agree with my side-eyeing buddy – must we always assume that professionals are incompetent? Sometimes they don’t spend as much time as we’d like, sometimes they don’t catch everything all the time in every patient, sometimes they discount a parent’s “gut” BUT…sometimes they don’t. Sometimes they are knowledgeable, compassionate people who do the best they can in a 30 minute appointment with the tools they have. And (at least in my (apparently abnormal?) experience) they often are correct. Sounds like these folks did they best they could given their medical focus, and now it’s time to move into a new field – psychologists/therapists. I agree with Amy, this doesn’t sound like a typical level of anxiety. And while some kids do “grow out of it”, not doing so doesn’t make her (or you, OP) wrong or broken. It just means she needs tools she doesn’t yet have, and support that she isn’t getting yet. Hopefully you can find a great partner to help you navigate, and keep trying!

  • Katie

    This sounds so familiar. My oldest had what we thought was severe separation anxiety essentially from birth. We struggled along until I read an article about Sensory Processing Disorder when she was about three. When I brought it up to my ped she quickly referred me to a great therapist (OT). Progress was not immediate, but after several months of weekly therapy, there was definite improvement. All in all, we continued in weekly therapy for about 18 mo, and although she still clearly has extreme anxiety in a few situations, we are able to use the strategies we learned in therapy to address them. Good luck to you, I know how utterly exhausting this can be. There is hope!