- Many are expressing anxieties about leaving the house once COVID-19 restrictions are lifted, leading some clinicians to characterize the worries as “cave syndrome.”
- Those with a history of anxiety and/or OCD might be especially vulnerable.
- To help, check in and support people in your community as they start to return to normalcy at their own pace.
You’ve heard of FOMO (fear of missing out), but what about “FOGO”—the fear of going out?
The phenomenon, which Florida-based psychiatrist Arthur Bregman, MD, is increasingly seeing in patients, refers to the avoidance of going outdoors for fear of catching or spreading COVID-19. It’s also referred to as “cave syndrome.”
Caution throughout the COVID-19 pandemic has helped us keep ourselves and our communities safe. But increased access to vaccines may usher in a new period of lifted COVID-19 restrictions and increased ability to socialize with others in the coming months. This return to normalcy can pose challenges for those with a history of anxiety spectrum disorders and obsessive-compulsive disorder (OCD).
A recent American Psychological Association survey found that 49% of adults reported feeling uncomfortable about returning to in-person interactions when the pandemic ends.
Simply put, “people have to adapt to going out,” Bregman tells Get Meds Info. But adapting may prove more difficult for some.
What This Means For You
The U.S. is not quite ready to ease COVID-19 restrictions, since a majority of the country is still waiting to be vaccinated. But as the vaccine rollout picks up speed, you may be feeling anxiety or fear around potentially returning to normalcy or entering public spaces once it’s safe to do so. Once you’ve been fully vaccinated, you can ease back into social settings slowly. Try reaching out to someone in your life who can talk to you about your experiences in public, and help you make small plans that you’re comfortable with.
What Does “Cave Syndrome” Look Like?
When thinking about “cave syndrome,” Bregman says he relates it to agoraphobia, which is often thought of as an extreme fear of being in public spaces. However, the phobia can also characterize fear of being in a situation where you won’t be able to receive help, which can extend to fear of leaving the house.
Agoraphobia is a fear of being in situations where escape might be difficult or that help wouldn’t be available if things go wrong. This fear could be experienced in open public spaces, transit, shopping centers, or just at leaving the indoors, to name a few.
“What we’re seeing is a real mixture,” Dave Smithson, operations director at Anxiety U.K., tells Get Meds Info. “About a third of people are not bothered either way, and a third of people can’t wait to get back out there. Then there’s a third who are still a little bit anxious about returning life to normal.”
Bregman says that he’s seeing increased levels of stress around going out in introverts with anxiety or OCD, or in people who often prefer staying home than going out. People may go long stretches without ever leaving the house, go to great lengths to prevent it, and/or express extreme distress at the thought or action.
FOGO in parents can also have repercussions for kids. “‘I don’t want to take my kid anywhere,'” Bregman says patients have told him. “So then we have a real epidemic of kids who’ve been home for such a long time, locked in.”
Many of his young clients have also expressed wariness about going back to school, for fear that “they’re just going to shut it down again.”
How to Transition Back Into Public Spaces
Bregman says he’s found caring for others in your circle and community is crucial to easing some of that anxiety.
“If we look back at some of the literature from the pandemic of 1918, we see that chronic post-traumatic stress was bad,” Bregman explains. Still, there were some communities that really helped people to step out of the trauma. It’s important to emulate them, Bregman says.
“We need to reach out, for example, to that lady who lives next door. I haven’t seen her in a month,” he offers as an example.
Don’t Go It Alone
Having a companion, or someone in your life who can help alleviate your fears, can help too. This person can give emotional feedback as you gauge your comfort level with resuming public activities.
Bergman encourages clients to ask this companion how it’s going. You could say, “Hey, we went to the park. How was it? Did you have a good time? Okay. We’re making a list of 10 things [to do]. Every few days, we’re going to a new one.”
Emotional feedback is key, Bregman says, because it helps people step out of their heads. “[Fear] gets built up in the people’s minds, but it may not be the same in reality,” he says.
Take Small Steps
If you, a friend, or family member is experiencing anxiety about going out, don’t rush. “Initially, take your time,” Smithson says. “It’s just healthy to gradually take it one step at a time.”
These tips are not a replacement for professional help, however, and if the case is serious, Bregman recommends consulting a mental health expert. Also, when making any changes to daily life, it is important to still adhere to Centers for Disease Control and Prevention (CDC) guidelines. Individuals are still being advised to wear a mask and social distance.
Much of the anxiety might be stemming from a fear that other people won’t follow the CDC guidelines. While that’s out of our control, Smithson has a few specific tips to manage anxiety.
“If you want to go to the pub the week after the restrictions have been lifted, maybe go in the afternoon or the early evening, when it’s a little bit quieter,” he says. “Ease yourself back in, rather than go rushing in at 10 p.m. at night when everyone’s had a few drinks already and is less inhibited than normal.”
Self-help groups online, too, can offer places to talk about anxieties around returning to a somewhat pre-pandemic life.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.