The entire journey of facing the wrath of the pandemic has been extremely challenging for each and every individual being. Widespread outbreaks of the disease covid-19 is known to be associated with a vast range of discrete effects that includes not only physical but also emotional, social and psychological. The series of reactions that have been noted regarding people’s mental health conditions, in such a scenario is worth researching upon. The aroma of uncertainty that has emerged from the pandemic has led to stress, anxiety, frustration and a change in the overall behaviour. The unpreparedness of the population for the forced social isolation has left a strong negative impression on people’s minds. A comparatively new and less occurring psychological condition, named cave syndrome has been developed by mental health professionals. After several observations through surveys, cave syndrome as a condition has gained considerable recognition in recent times. Though it is not acknowledged as an official disorder yet, it stands as a unique emotional issue in itself. Cave Syndrome can be described as deep anxiety in response to re-enter the community. It is a strong reluctance to go outside and participate in social activities. This syndrome drives one to remain comfortable in their own space. 

The pandemic episode has instilled a heavy fear into the minds of people which has been directly associated with going outside. Experts have noticed an overestimation of the risk of getting infected on part of some people which is the main source of cave syndrome. Jacqueline Gollan, a professor of psychiatry and behavioural sciences at Northwestern University has maintained that adjusting to life after lockdown is going to take a good amount of time. This is because the changes have created an anxious attitude towards different spheres of life. A February 2020 article in The Lancet presented evidence of avoidance behaviours from empirical studies conducted during the 2003 SARS outbreak in China. One study found that 26% of respondents had steered clear of crowded enclosed spaces and 21% had avoided stepping outside for a few weeks after being quarantined. The article also cited another study to suggest that the act of avoiding crowds had been transformed into long-term behaviour and that these people’s return to normalcy had been delayed by many months. The mindset that continues the fear and an attitude is the desire to control and a desire for certainty in our environment. Both of these factors are easily fulfilled in one’s home and hence it is in a way, rewarding.

Alan Teo, an associate professor of psychiatry at Oregon Health and Science University, attributes cave syndrome to three factors: habit, risk perception and social connections. According to him, habits of wearing masks, restricting social outings and avoiding physical interactions has turned into a pattern of responses that is very difficult to break. Another phenomenon is the difference between actual risk and perceived risk. The latter is high among people with cave syndrome. Social connections is another one of the factors as with increasing work responsibilities people hardly find time for social events and a lockdown imposed on social places makes it easier to participate in relaxation time inside one’s home. The massive development in the technological field plays an essential role as with the help of online tools and applications, one can meet their personal and work-related needs. Different over the top platforms, video games and television programs act as a collective source of entertainment. Delivery of processed food, grocery items and medicines are also just a click away. Education and work-related assignments, meetings and documentation can also be easily executed with the help of a good internet connection. These indirectly act as a reinforcement to the tendency to continue to stay in our own shells for as long as possible.

Professionals in the field of mental health have researched cave syndromes and devised some innovative strategies that can help one’s feelings of uncertainty towards the outside world. The MAV system was used by experts in training the people who feared stepping out. This system involves mindfulness where making oneself aware of the underlying trouble is important. The focus is paid to the things that have been bothering someone the most. The next step is to develop a healthy attitude towards one’s prior experiences of social activities. Lastly, the system suggests one visualise the goals and aspirations that they wish to achieve once they are out of their so-called ‘cave.’ Another technique to improve the condition can be to practice social skills and to engage oneself in downward social comparison. This can help one to feel less anxious about their current emotional state. A behaviour-based approach called the exposure and response prevention method has also been suggested as a way to gradually get used to the outer world without repeating the responses they usually display. This approach of adapting to their feared situation and control of responses is a slow process that can take time. 

Many studies at present are being conducted to further explore the causes and treatment options for improving symptoms of cave syndrome. Although it has not received a formal diagnosis, few people are displaying some symptoms of this condition. Hence, it is absolutely necessary to focus on the psychological impact of the pandemic. One of the very important pieces of advice that clinicians presented was to remember that it is completely normal to have a condition like cave syndrome because the struggle each citizen has gone through during the pandemic can easily have a traumatic response. They also commented that with time, practice, patience and a little courage there are real possibilities of proper as well as holistic improvement. 

– Urveez Kakalia & Debanjana Banerjee.