Cave Syndrome

Are you dreading resuming social activities when the pandemic subsides? If so, you might find the idea of "cave syndrome" validating.

I first read about "cave syndrome" in a recent LA Times article. The term was coined by the Florida psychiatrist Dr. Arthur Bregman. He used this phrase to refer to patients who were afraid to go outside or interact socially with others due to the extensive amount of time they have spent inside during the COVID global pandemic. People experiencing this fear may dread interacting with others outside their household, being in public places such as grocery stores or theaters, or otherwise congregating in crowds.

Let me start by explaining that "cave syndrome" is an informal term that has not been studied scientifically. It does not appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a "big book" of mental health disorders often used in the U.S. to define diagnoses. Using the phrase "cave syndrome" is akin to using the phrase "cabin fever" to refer to someone who has been cooped up inside and needs a breath of fresh outdoor air. Although it resembles agoraphobia in some ways, the connotation of "cave syndrome" is a bit different because it's more specific to our current historical moment of the global COVID pandemic.

A Syndrome by Any Other Name

That being said, sometimes people appreciate being able to have a name for their experience. Being able to talk about it in short-hand—being able to say "I'm experiencing cave syndrome" rather than needing to belabor a lengthy explanation—can facilitate communication and understanding. People also sometimes find it validating to connect with others who share their experiences—a connection that can be facilitated by naming that experience. Thus, although not an official mental health diagnosis, there is a way in which "cave syndrome" can be a helpful, beneficial concept in our current societal moment.

My main purpose in writing this blog post is to share the idea of "cave syndrome" and offer validation for people who may be experiencing it. Sometimes, it just helps to know that you are not alone and that your experiences make sense.

So, let me say loud and clear… You are not alone, and your experiences make sense!

That Whole Global Pandemic Thing

Newsflash: the people of planet earth have been going through a global pandemic. People's experiences of this event have varied widely based on their country of residence, race or ethnicity, health status, socioeconomic status, level of education, employment sector, temperament, worldview, etc. The disparities along racial and economic strata have been particularly painful.

People's experiences of the pandemic have also varied widely based on their respective response to government decision-making, such as stay-at-home orders, lockdowns, or health and safety guidelines. Clearly, there has been a wide spectrum of human behavior in response to these.

Seeking Relief?

Here are 68 coping skills to try for anxiety or depression today

Miraculous Adaptation

At the time of my writing this post (April 2021), many people have been living for more than a year under highly unusual circumstances: not touching other people, not seeing other people face-to-face, wearing masks, social distancing, being extra aware of hand-washing, etc.

Even given these highly unusual circumstances, however, I do marvel that human beings are remarkably adaptive creatures. Our bodies and brains are endowed with a miraculous capacity to adapt to the circumstances they find themselves in. If you have experienced lockdown in the past year of this global pandemic, whether on a short-term or long-term basis, it makes perfect sense that your body and brain may have adapted to suit that circumstance and help you survive it.

Especially if you are someone who resonates with the "cave syndrome" experience, you may feel safer—even happier?—spelunking within your home cave rather than venturing out and about into the world. Recognize that this capacity for adaptation is actually a strength. That calibration ability is part of how your body and brain are wired to help you survive in any environment. We have literally been sent the #saferathome message, and you have internalized that and adjusted accordingly.

Venturing Out from the Cave

The difficulty arises, however, when you find yourself facing new circumstances once again. Perhaps you might need to resume some of the social interactions you engaged in prior to the pandemic. Perhaps you might need to face—gulp—a crowded multitude of people in the public square.

[I am not going to make any assumptions about where you live or the relative degree to which your geographic region is faring poorly or well with regard to the pandemic. I am also not going to offer any forecast regarding where we are headed globally or nationally. These are all outside the scope of this blog post.]

Whether this year or five years from now, the time will come when the scientific data in your region indicate that you can gradually resume some relative degree of modified social activities—especially if you have been fully vaccinated. There is hope of being able to emerge from "cave syndrome" and reengage socially again. Even if you struggled with social anxiety prior to the pandemic, this is overcome-able with time, patience, and concerted effort.

Adapting Anew

For details on how to gradually reintroduce yourself to social interactions when the time is right for you, see my How to Overcome Social Anxiety post. The same general principles can apply when emerging from "cave syndrome": clarify values, modify thoughts, set realistic goals, gradually break down the anxiety-avoidance cycle, reflect and reward, rinse and repeat.

Remember that the same capacity for adaptation that helped you adjust to lockdown can help you reacclimate to social interactions once again. Present your body and brain with the circumstances they need to adapt to, perhaps slowly over time, so they recalibrate to suit the new demands of the environment (in this case, social interaction). Eventually, you can be on cruise control in how you are adjusting to your new normal, with cave-dwelling just a distant memory in your rearview mirror.

Seeking Relief?

Here are 68 coping skills to try for anxiety or depression today

References & Credits

Photo by Tom Gainor on Unsplash

Photo by Erik Mclean on Unsplash

Photo by Nicolas Häns on Unsplash

Photo by Jonatan Pie on Unsplash

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Dr. Parke is a therapist who provides therapy to high-achieving teens and college students in-person and online in California. Cities served include Fullerton, Brea, and Yorba Linda; zip codes served include 92835, 92823, and 92886. © 2023 Jackie Parke, Psy.D. All rights reserved.