Bregman Medical Group | Services

Cave Syndrome: The New Covid Disorder

Recently we discussed a new phenomenon in mental health called “Cave syndrome,” a disorder
causing attachment to fear and isolation stemming from the Covid pandemic. Some even liken it
to Stockholm syndrome - except in this case the world was held hostage by a virus.

We know that Cave syndrome affects both introverted and extroverted individuals. We know that
it is treatable with an individualized treatment plan involving some level of therapy and
sometimes medication management.

But what exactly does Cave syndrome consist of? Does this information help us avoid the
pitfalls of such a new and pervasive disorder? Can we employ preventative measures to ensure
resilience during the home stretch of Covid?

Cave Syndrome: A blend of two disorders
Obsessive compulsive disorder is characterized by excessively dwelling on a perceived
problem, and then performing compulsive behaviors to try and quell the anxiety. The classic
example is unnecessary hand washing: “I just saw someone leave the bathroom and then touch
the door handle. What if their hand was dirty? Now I touched the door handle! I might have to
wash my hands a few times to make sure I did a good job cleaning them…”

Even when made aware of an unreasonable compulsion, OCD sufferers are unable to cope with
the resulting anxiety if they don’t do it. It’s because in many anxiety sufferers, the part of the
brain signaling danger overtakes the part responsible for calm rationale.

Covid has no doubt generated a great deal of contamination fears in people with and without
OCD. But due to those same fears, and helped along by social distancing, another issue comes
into the fold.

A related disorder is the well-known agoraphobia. On the anxiety spectrum, sufferers of
agoraphobia commonly avoid potentially “unsafe” situations causing them to stay home in many
cases. This is where Cave syndrome gets its name.

New circumstances, new disorder
Take either of these disorders and put them side by side - it’s a troubling cocktail but it’s not
quite Cave syndrome. The difference between Cave syndrome and two comorbid disorders is
the way we react to anxiety.

With OCD and agoraphobia the danger seems immediate, making it feel like peril is imminent.
The problem with coronavirus is that it doesn’t affect people right away. One may contract the
virus and go a full week without any symptoms. This uncertainty causes a sense of unease. The
OCD says “maybe you have it and don’t even know it!” while agoraphobia is shouting “If you go
out, you may get it and never even know!”

Vaccination, CDC guidelines, and the future
The problem with Cave syndrome is that even after getting fully vaccinated, staying equipped
with a mask, hand sanitizer, and CDC guidelines...people are still attached to staying home.
With new variants and anti-vaccine shills coming out of the woodwork it’s a good idea to stay
vigilant, but people with Cave syndrome take it to the extreme.

There is a real danger that the disorder could morph into a permanent life problem. We have to
leave the house in order to do things. Not everything in life can be delivered. As we transition
back to the outside world, people who have developed Cave disorder face a real challenge in

Exposure, response, and hope
Along with medication management which is necessary in many cases, a certain type of therapy
may help with this particular disorder.

In fact it’s a therapy long used to treat various anxiety disorders. “Exposure response
prevention” involves exposing one’s self to the anxiety-triggering stimuli slowly over time, and
conditioning a tolerance for the uncertainty and discomfort. After a while the panic response
eases and life gradually returns to normal.

In this case it obviously does not mean exposure to the virus! Of course that would be unwise
for anyone to do. However it does mean taking a short walk outside, or a brief visit to the
grocery store, or perhaps a socially distanced meeting with trusted friends. Over time the
excessive worry and avoidance will dissipate. We can start doing what we need to do again in
order to live a full, connected life.

Do you need professional mental health treatment? Bregman Medical Group has decades of
experience treating various disorders. We offer psychiatric and therapeutic services right to your
device! Simply schedule an appointment at or call 305-740-3340.


By BregmanMD | March 30, 2021 | Mental Health

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