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Fully vaccinated but anxious about a return to normal life? You may have ‘cave syndrome’

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She’s now fully vaccinated, and many New York City bars and restaurants have reopened. Yet Ms. Bustamante says she doesn’t feel ready to return to her pre-pandemic jaunts to the city, and she is only comfortable meeting friends there one-on-one, preferably outdoors.

“You look at social media, and you see some people out there having all that fun,” says the 49-year-old product-management consultant in suburban Rockland County, N.Y. “I can’t picture myself in that picture.”

Ever since the Centers for Disease Control and Prevention gave the all-clear for vaccinated people to gather indoors without masks and resume pre-pandemic activities, many have eagerly returned to dining inside restaurants, attending parties and flying to see friends and family. (And plenty of people already were doing so before.) Yet for others, returning to their former lives—and much of the outside world—is proving tough after more than a year of relative isolation.

Instead of feeling freedom, many say they fear plunging back into socializing—and are awkwardly declining invitations out, avoiding throngs of people and dreading, or even putting off, the return to workplaces.

The phenomenon is common enough that it has come to be called “cave syndrome” on social media and in some psychiatry circles. “Cave syndrome really means that people are just nervous about going out because they’re going to be infected,” says Coral Gables, Fla., psychiatrist Arthur Bregman. He coined the nonmedical term earlier this year after some of his patients expressed sometimes crippling fears of going out in society though they are fully vaccinated.

Dr. Bregman says cave syndrome ranges in degree, from vaccinated individuals who are cautious but take part in limited social interaction to those who choose not to go outside at all. He distinguishes between immunocompromised people who aren’t able to reap the full protective effects of the vaccine and remain vulnerable to Covid-19 and those who, data show, have considerable protection from the vaccine.

The growing spread of the Delta variant has been substantial enough for places including Los Angeles and Israel to reinstate indoor mask requirements in recent weeks, prompting more anxiety among those already uneasy about re-entering society. And in contrast to the CDC’s guidance, the World Health Organization also recently reiterated its world-wide guidance that everybody should wear a mask indoors.

Constantly changing information about Covid-19 as well as shifting and sometimes contradictory guidance from government health officials have likely exacerbated fears, Dr. Bregman says. Although data show that vaccinated individuals who catch the Delta variant are very unlikely to need hospitalization, “there’s still this monumental fear and distrust that people have that they’re going to get sick, and so they stay inside,” he says.

Meanwhile, Covid-19 restrictions continue to be dismantled in many places, adding to the confusion many feel about what’s safe social practice. This week, England officially dropped almost all coronavirus restrictions, including mask requirements and size limits on gatherings, in a bet by the government that mass vaccination will stop another deadly Covid-19 wave. Canada said Monday that it would allow fully vaccinated Americans to enter the country for tourist activities beginning Aug. 9, more than a year after closing the border to most travelers.

Studies suggest many people will need time to adjust to newly reopened society. In a June survey by Ipsos and the World Economic Forum, the majority of 12,497 adults in nine countries—including the U.S., France, Japan, Mexico and the U.K.—said they would likely continue social distancing and wearing a mask in public after being vaccinated.

In a March study by the American Psychological Association, nearly half of 3,013 adult Americans surveyed by Harris Poll said they felt uneasy about adjusting to in-person interaction once the pandemic ends. Vaccinated adults were just as likely as those who weren’t vaccinated to say they were uneasy.

Andrew Ruiz, a 32-year-old technology analyst who lives in Fort Myers, Fla., has been fully vaccinated since April. He says he remains socially cautious and in October plans to skip New York Comic Con, which he has attended since 2014.

“It’s just knowing how it’s in an enclosed space,” he says. “I want to play it safe and not be in a big crowd.” Plus, he isn’t ready to get on a plane, he says, especially with news of the Delta variant’s spread. “It’s probably best for me to just wait another year and see if things die down then,” he says.

Fear of the virus alone isn’t keeping some from re-entering society. Some holdouts got used to living in their bubbles and are reluctant to give up some of the positive aspects of spending more time at home, says Paul S. Appelbaum, professor of psychiatry, medicine and law at Columbia University.

“That has become a comfortable pattern reinforced by the fear of the unknown out there,” he says. “‘Won’t it feel weird when I get back on the subway? Won’t it feel strange when I walk into the office?’ The familiar feels safe, and the unfamiliar always carries a little bit of anxiety.”

Eoin Hamilton says he “had a knot in my stomach the entire time” while celebrating his 43rd birthday with family at a hotel in Dublin in early July. It marked the first time Mr. Hamilton, a graphic designer, had been in a crowd after spending the past 18 months of the pandemic mostly at home with his wife and children in Ballivor, a small village about an hour from Ireland’s capital.

“Everybody else seemed to be absolutely fine, but inside I was just losing it,” says Mr. Hamilton, who has been vaccinated for months. “I had a feeling it might be a bit weird, but I was not expecting it to be that bad.”

More than the virus itself, “it’s the anxiety of being around people again because you’ve been conditioned to stay away from people,” he says, adding that the experience made him vow to continue social distancing. “I used to love being in a massive group of people, having a few pints, but now I don’t want to be around people anymore.”

Eileen Ybarra, a 44-year-old librarian in Los Angeles, got her second vaccination shot in April and started to shop in-person again and see some family members. But she still isn’t comfortable going to movie theaters or dining indoors.

“It’s a mix of I don’t want to get sick in general, and perhaps I feel maybe more than a little traumatized from the past year,” she says. “I’m giving myself time to get back into basically more or less normal life.”

She has recently been “in the slowly re-entering phase,” she says, eating indoors for the first time earlier this month for a family birthday celebration. But Los Angeles’s recent orders to mask up in most indoor spaces again has once more undermined her confidence in venturing out.

“Now I feel kind of like, Well, I guess?” she says. “It’s kind of strange.”

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Assemblywoman Michelle Solages Leads Efforts to Recognize Holidays Celebrated by Hindus, Sikhs, Janis, Buddhists, and Muslims in NYS

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