Millions of anxiety-ridden Americans are suffering from 're-entry fear', leaving them terrified of social interactions as post-pandemic mental health crisis looms
As the vaccination program continues to rollout at speed, workplaces re-open, and sporting and cultural events welcome spectators back, millions of Americans are secretly dreading a return to being around crowds of people and having awkward catch-up conversations.
According to a recent report from the American Psychological Association (APA), nearly 50 per cent of Americans reported suffering from the phenomenon known as 're-entry fear'.
The condition can make even small tasks outside the home — a trip to the grocery store, or returning to the office — feel overwhelming.
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 Russell 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.'
Nicole Russell, of Kendall, Florida, says that she is fearful to leave her home and retreated to her bedroom for days at a time
Nicole Russell is one of millions of Americans experiencing 're-entry fear', which can make even simple tasks like grocery shopping feel overwhelming
Restaurants are now allowed to welcome indoor diners back at up to 50% capacity, however 're-entry fears' may cause many to remain sequestered in their homes
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.'
Thomas Pietrasz, who lives alone and works from his home in the Chicago suburbs as a content creator, 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.'
His alcohol and marijuana use also increased during the pandemic.
'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.'
Like many others, Pietrasz said his anxiety is largely unrelated to catching COVID and more about social interactions.
Amy Cirbus, Director of Clinical Content at Talkspace, an online mental health group with nearly 50,000 current clients, says people are feeling a mix of reactions.
'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.
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.
More than 100 million Americans have now had at least one vaccination for the coronavirus, and many venues and workplaces are reopening
Bartender Daniel Vazquez disinfects the bar at Picos restaurant in Houston, where Governor Greg Abbott ended state mandates for Covid-19 safety measures last month
A woman is inoculated with the Moderna Covid-19 vaccine at a mass vaccination event hosted by Unity Health Care, at Walter E. Washington Convention Center in Washington on Saturday, Despite the success of the vaccine rollout, millions of Americans remain fearful about reintegrating into society
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 per cent 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 the survey by the American Psychological Association, vaccination status had little impact on people's responses, with 48 per cent 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.'
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.
