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Coming out of the cave: As life creeps back, some feel dread

  While much of the country is gleefully making dinner reservations again
  and booking long canceled vacations, some are secretly dreading each
  milestone toward normalcy
  By KELLI KENNEDY Associated Press
  April 3, 2021, 6:30 PM
  • 6 min read
  (BUTTON) Share to Facebook (BUTTON) Share to Twitter (BUTTON) Email
  this article

  FORT LAUDERDALE, Fla. -- Dinner reservations are gleefully being made
  again. Long-canceled vacations are being booked. People are coming
  together again, in some of the ways they used to.

  But not everyone is racing back.

  Their stories are emerging as the world begins to reopen — people
  secretly dreading each milestone toward normalcy, envisioning instead
  anxiety-inducing crowds and awkward catch-up conversations. Even small
  tasks outside the home — a trip to the grocery store, or returning to
  the office — can feel overwhelming.

  Psychologists call it re-entry fear, and they’re finding it more common
  as headlines herald the imminent return to post-pandemic life.

  “I have embraced and gotten used to this new lifestyle of avoidance
  that I can’t fathom going back to how it was. I have every intention of
  continuing to isolate myself,” says Thomas Pietrasz, who lives alone
  and works from his home in the Chicago suburbs as a content creator.
  His alcohol and marijuana use also increased during the pandemic.

  Pietrasz says his anxiety has grown markedly worse as talk of
  post-vaccine life grows. He says he got used to “hiding at home and
  taking advantage of curbside and delivery in order to avoid every
  situation with people.”

  As the world edges back toward some semblance of normal life, many
  report challenges like Pietrasz’s playing out in their own lives. The
  time at home — lockdown, dread, fear, isolation — has changed them and
  made existing worries worse or created new ones entirely.

  “It’s been a mix of reactions,” says Amy Cirbus, Director of Clinical
  Content at Talkspace, an online mental health group with nearly 50,000
  current clients. “Some people are very relieved about going back to
  normal. Others are struggling. Many people are experiencing spikes in
  anxiety as they feel they aren’t ready for re-entry.”

  While some felt restricted by the confinement of home, others found
  safety, comfort and even enjoyment there, internalizing the isolation
  into what some psychiatrists consider a dysfunctional baseline of
  behavior.

  Like many others, Pietrasz said his anxiety is largely unrelated to
  catching COVID and more about social interactions. Psychologists say
  fears about leaving home have little to do with reasonable concerns
  about spreading the virus and sometimes can’t be pinpointed or aren’t
  based in reality.

  In some cases, psychologists say the manifestation is subtle, like
  someone who begins making repeated excuses to avoid meeting up with
  friends, even within a safe, socially distanced setting or if they’ve
  been vaccinated. But some cases are more extreme, says Dr. Arthur
  Bregman, a psychiatrist who noticed this phenomenon in his Miami
  practice and dubbed it “cave syndrome.”

  “The people who have the most anxiety disorders in my practice, they
  are the worst-affected. They can’t even get out,” says Bregman, who has
  been studying the 1918 influenza pandemic's psychological impact on the
  world.

  After that lockdown, roughly 40% of the population would be diagnosed
  with what we now call PTSD, Bregman says. “It took 10 years for the
  people to get out of this," he says.

  The pandemic exacerbated issues for those already struggling with
  anxiety, depression and other mental health issues. But some patients
  are experiencing these symptoms for the first time.

  Dr. Julie Holland, a New York psychiatrist, says the pandemic triggered
  new trauma for some, especially in the unpredictable early weeks of
  lockdown as people questioned whether there would be enough food or if
  it was even safe to touch their mail.

  According to a survey in February by the American Psychological
  Association, nearly half the respondents said they felt uneasy about
  adjusting to in-person interactions once the pandemic ends. Shockingly,
  vaccination status had little impact on people’s responses, with 48% of
  vaccinated adults saying they still felt uneasy.

  “You’ve been taught for an entire year to distance yourself from people
  and you’ve learned to be afraid of people because they could make you
  sick or kill you,” Holland says. “There’s no question that it’s easier
  to learn to be afraid than to be unafraid."

  The fight-or-flight physical manifestations like racing heart, trouble
  breathing and feeling dizzy can be terrifying.

  “People who are really free and they’re planning their vacations are
  really upsetting my patients because they’re challenging their level of
  fear and risk tolerance,” says Dr. Sharon Batista, a New York
  psychiatrist who has noticed a spike in patient referrals since the
  holidays.

  Children and teens are especially vulnerable. Before the pandemic,
  17-year-old Erin had lots of close friends, but said those interactions
  slowly waned while on lockdown in the DC suburbs. Now she barely talks
  to them.

  She’s dreading “having to catch up and go through all that small talk
  stuff that nobody likes,” said the high school junior, who has been on
  anxiety medication for several years. The Associated Press is only
  using her first name because she is a minor.

  “A year ago, I went outside hoping I’d run into a friend from school
  and go on an adventure,” she recently posted on social media. “Now, I’m
  terrified to leave the house because I’m afraid I’ll run into a friend
  from school and go on an adventure.”

  Nicole Russell became so fearful of leaving her Miami home that she
  retreated to her bedroom for days at a time, unable to interact with
  others inside the home, including her 11-year-old daughter. It got so
  bad that she was often up all night, sleeping during the day, checking
  social media obsessively and cleaning constantly, even scrubbing the
  floor with a toothbrush .

  “I would not leave my little corridor for days at a time because I
  could not deal with the pressures of talking to other people,” says
  Russell, who left notes to remind herself to shower and brush her
  teeth. “I wasn’t living, that’s for sure.”

  Last Month, Russell even waved off family and friends when they tried
  to plan something small for her birthday last month. “We were forced
  into isolation,” she says, “and now we've grown accustomed to it.”

  Experts say taking small steps over time is one of the most effective
  treatments. The more patients go to the store or see friends, the more
  they’ll discover the forgotten enjoyment of social interactions and
  learn that much of the world is unchanged, making it easier to venture
  out again. Others may need medication.

  Russell, who described herself as “nonfunctional," took some steps in
  that direction recently. She forced herself to take a terrifying trip
  to the grocery store. She saw people laughing and talking, and she was
  inspired.

  She started therapy along with an antidepressant. It worked, she says,
  and within a week things were far better. Now, "I’m up and moving
  around and I want to start catching up with everybody.”

  ———

  Follow Florida-based Associated Press writer Kelli Kennedy on Twitter
  at http://twitter.com/kkennedyAP
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