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Mental Health

Cave syndrome: “Why am I finding it so hard to adapt to the end of Covid restrictions?”

Struggling to get back to ‘normal’ now Covid restrictions have been lifted in the UK? You’re not alone. An expert explains why we’re finding it hard to get back out into the world again.  

It’s 8pm on a Friday night and 28-year-old Sarah* should be meeting up with her friends for a drink. Instead, she’s sitting on her sofa and settling down to another evening watching Netflix, just as she has every night for the past three weeks.

Ever since the government gave the green light for all legal Covid restrictions to end on 24 February, Sarah’s found herself turning down a flurry of invitations to go on nights out. She can’t bring herself to think about weekends away or holidays abroad. And what’s worse, she’s not even sure why she feels this way.

“It’s so hard to explain,” Sarah tells Stylist. “When we were in lockdown, all I could think about was getting back to my old life. I’d fantasise about going out with my friends again and going on holiday – anything that wasn’t being trapped at home.

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“But now restrictions have lifted, I’m finding it so hard to go out again and see people. I find excuses to avoid meeting up with large groups of friends. I pretended I was ill to get out of a big work event the other day. A lot of my friends are talking about booking summer holidays and jetting off abroad and I can’t even bring myself to plan that far ahead. It’s like there’s something invisible stopping me that I can’t put into words.”

The government’s decision to scrap all Covid-19 restrictions, including the compulsory face mask rule and the legal requirement to self-isolate following a positive test, has raised concerns from many clinically extremely vulnerable (CEV) people in the UK as well as some health experts, particularly as Covid figures start to creep up again.

But Sarah’s situation is different. She has had Covid twice before and is fully vaccinated. For her, something else appears to be stopping her from launching herself back into the world other than a fear of catching the virus. And she’s not alone.

After two years in and out of prolonged periods of isolation, which altered huge swathes of our lives, lots of us haven’t found the freedom we imagined when restrictions finally lifted.

A 2021 survey undertaken by Anxiety UK found 46% of the 900 respondents were concerned about the pressures of socialising once restrictions ended, and a US study by the American Psychological Association found 48% of surveyed adults predicted they’d feel uncomfortable about returning to in-person interactions, despite having been vaccinated.

It all suggests that, for many people, returning to ‘normal’ won’t be as easy as we envisioned during those long, dreary lockdown evenings. Clinical sounding terms are even being used to describe this experience, such as ‘cave syndrome’ and ‘Covid stress syndrome’.

Liz Ritchie, an integrative psychotherapist from mental health charity St Andrew’s Healthcare, has seen an increase in the number of clients coming to her with symptoms of anxiety, particularly social anxiety disorder, as Covid restrictions lift.

“A lot of us expected to bounce back as soon as restrictions lifted, but it’s been trickier because we’re being expected to change habits that have become ingrained over the last two years,” Ritchie tells Stylist.

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“Habits are difficult to break and during the pandemic our brains adjusted to this new normal that was enforced upon us."

Habits are difficult to break, and during the pandemic our brains adjusted to this new normal that was enforced upon us. We had to develop new routines to enable us to interact with the world in a very, very different way. We were navigating things like loneliness, and many of us, sadly, were navigating grief, illness and job losses. As a result, there was economic hardship. We’ve had a lot to deal with and we conditioned our brains for a long time to survive – we went into survival mode. Now we need to recondition our brains to go into thriving mode. It will be very difficult for a lot of people.”

Before the pandemic, 32-year-old Carol* loved her job and the social life that went along with it. “My work friends were my best friends,” she tells Stylist. “I loved going to the busy office and after-work drinks were a highlight of my week.”

Initially, Carol found working from home hard. Without being surrounded by her colleagues, she struggled with loneliness and her mental health suffered. “I hated Zoom calls and only talking to people on Slack,” she says. “I longed to go back to the office. It felt like a huge part of my life had just disappeared overnight.”

Carol’s London office remained closed throughout 2020 and the majority of 2021. However, when she was able to go back and work from the office for two days a week, she found she wasn’t able to revert back to her old life as easily as she thought she would.

“Even though I desperately wanted my old working life back, I found it really hard,” she says. “I had to really force myself to get out of the house. Now, day after day goes by where I abandon going in at all, even though I still don’t enjoy working from home.”

For Ritchie, it’s no surprise lots of us are struggling to adjust back to our old routines. “Integrating back into society can be very anxiety-provoking. It’s like being in a dark room for a long time and suddenly going into daylight,” she says. “It can be very, very uncomfortable.”

Ritchie explains that during the pandemic we created cognitive strategies to manage the restrictions that had been put on us. “Now restrictions have been lifted, we’re required to think outside of the box of what we’ve become accustomed to and that’s hard.”

“We all had to change and adapt to the restrictions,” Ritchie continues. “And it’s natural for us not to want to leave that safe place we created at home, especially if we experienced some sort of trauma during the pandemic, be it illness, grief or financial hardship.”

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According to Ritchie, many of us created coping mechanisms to see us through the isolation and stress of the pandemic. However, these are ‘maladaptive coping mechanisms’ that may not be serving us now the world is opening up.

“During the pandemic, our coping mechanisms helped us become more self-sufficient, particularly on a social level,” says Ritchie. “We created habits to help us live without social interactions and we had to adapt really quickly without any choice. Now, it’s about disassembling those coping mechanisms to enable us to integrate back into the world without feeling overwhelmed, anxious or overstimulated.”

Dissembling these habits built up over the last two years will take time and Ritchie stresses that we shouldn’t rush the process.

“One thing the pandemic has given us is the opportunity to spend time with ourselves and get to know ourselves. A lot of us have never really done that,” she says. “We should use this to make sure we are trusting our own feelings and instincts as we go back into social settings.

“Work within your own boundaries and gradually expand your socialising at your own pace,” says Ritchie. “Start to widen your social interaction little by little and don’t feel under pressure to suddenly dive into this much bigger world that we haven’t been privy to for a couple of years.” 

* Names have been changed 

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