‘Cave syndrome:’ Why some people may choose to stay home even after COVID-19 ends

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Toronto, Ontario (CTV Network) — With warm weather approaching and the promise of a “one-dose summer” on the horizon, many Canadians are making plans for the summer and fall, eager for life to get back to pre-pandemic “normal.” But not all Canadians are happy to see the end of lockdown life brought about by COVID-19 restrictions.

The term ‘cave syndrome’ has been bandied about in news headlines and on social media, a term being used to describe people who may not be so willing to resume normal life when the COVID-19 pandemic sees its end. But while it may accurately describe people’s genuine struggle to return to normal lives as restrictions ease, psychologists say it’s a term that oversimplifies and pathologizes things.

“It’s not a syndrome because there could be any number of reasons why people are choosing to stay at home,” Steven Taylor, clinical psychologist at the University of British Columbia, told CTVNews.ca in a phone interview.

This term is gaining popularity before the pandemic has even ended, and it’s still too soon to tell how much we’ll continue to be affected once the crisis is over.

“At this point it is really hard to assess or understand how severe these issues are because the whole thing is still ongoing,” he said. “So someone could be fairly anxious right now about leaving the home, but once the pandemic is over, that person might be fine.”

And at this stage in the pandemic, there is no clear ending. What might be the end for one person, won’t be the end for another.

“The end of the pandemic is going to be different for everybody. In all likelihood the pandemic is going to evolve into an endemic,” Gordon Asmundson, clinical psychologist and professor of psychology at the University of Regina, told CTVNews.ca in a phone interview.

He said that the term ‘cave syndrome’ is too broad and encompasses any reason someone might have for not leaving their home, including finding it more convenient to work from home, or cheaper to do online post-secondary schooling.

“Some of those reasons may be adaptive reasons, so they’re not really symptomatic of anything,” he added.

With a term that includes so many reasons for not wanting to leave the house, or ease COVID-19 restrictions, it could overlook more serious diagnoses at play.

“A key consideration is whether leaving the cave is an inconvenience or an emotional burden, and almost insurmountable challenge, and in the latter case, there might be other diagnoses that are more specific and helpful,” said Asmundson.

It could prevent people from realizing their issues with leaving the house are more severe than general convenience and enjoying alone time. It could mean missing that someone is staying home because of depression or a panic disorder.

“If you call this a syndrome, then the problem is that you might have missed some of the other disorders,” said Taylor.

And there’s no need to give a diagnosis to something that creates a feeling of inconvenience more than anything else.

“If it’s an inconvenience, but doesn’t really affect your functional ability, then those things shouldn’t be pathologized,” said Asmundson.

It also over emphasizes the mental health issues that psychologists expect to see after the pandemic comes to an end. Early on in the pandemic, Taylor and Asmundson worked together on the impacts of what they call COVID Stress Syndrome, a term used to describe the overwhelming and life-disrupting fear of infection and the consequences of a COVID-19 infection.

“It can over pathologize ordinary anxiety and it’s ordinary and normal and expected to be anxious during COVID-19,” said Taylor.

He doesn’t believe the general stress of the pandemic will have staying power for most people.

“Most people will pick up where they left off and bounce back, but not everyone,” said Taylor. “This is a big issue at the moment, trying to estimate the proportion of people who will come through this stressful event and will need psychological help and it’s really hard to predict.”

This isn’t to say that the pandemic hasn’t had negative effects on mental health for Canadians.

“The pandemic is having a greater impact on people who have these pre-existing conditions. And then in some people it’s creating new conditions, like post traumatic stress disorder, particularly in frontline workers,” said Asmundson.

And part of the challenge now is that for most of the pandemic, people with anxiety and panic disorders have been able to stay home and avoid the things that might cause them anxiety, which could actually worsen things.

“Avoidance is one of the key fuels to the fire of anxiety and stress,” he said. “It’s a really effective coping strategy in the short term, you avoid what stresses you out, you feel better, but in the long term the avoidance comes at a cost and you start missing out on opportunities to learn that you often overestimate the amount of threat that’s out there.”

Paying attention to how you feel after restrictions have lifted will be very important for those who might be feeling more anxious than usual. If restrictions have lifted but you still fear a trip to the grocery story, it may be something more serious.

“Once the restrictions have lifted and it’s gone weeks or months and you’re still inside and you’re still very frightened, that might be an indication that you might need some help, particularly if the anxiety is interfering with your life,” said Taylor.

If you find yourself overwhelmed in the weeks and months after the COVID-19 pandemic comes to an end, or at least when restrictions are lifted, there are free resources available online that Asmundson says are just as good as in-person therapy.

“One of them is called Mind Shift through Anxiety Canada, is freely available and it’s an evidence-based online app that people can actually log into and it’s like your own personal therapist on the phone, except it’s not a person, it’s a program,” he said.

While ‘cave syndrome; might be a catchy name, it doesn’t do justice to the reasons people may not want to leave the house, and tries to diagnose people who don’t want to return to a pre-pandemic “normal.”

“It really overlooks the diversity and reasons why people don’t want to go out. It seems to psycho-pathologize all of us who don’t want to return to exactly the way things were before.”