How to Get Out of an Anxiety Cave, According to a Therapist

Even if you've never heard of an "anxiety cave" before, you might already know what it looks like. Allow us to set the scene: you're heading out for a dinner date with your significant other, when they suddenly text you about a change in plans. Their parents came for a surprise visit, and you're about to meet them for the very first time. You freeze up. The thought of their parents staring at you, grilling you with questions, and putting you on the spot leaves your heart racing. You retreat to your bedroom and make up and excuse to tell your significant other you can't make it. This is an example of retreating into an anxiety cave.

An anxiety cave is a place you go during a period of heightened anxiety. The downside? It's easy to get stuck. Therapist Anna Papaioannou describes the act of retreating into an anxiety cave as "[a] period of disappearing or falling off the face of the earth." Any place could serve as an anxiety cave, whether it's a person's room, or just somewhere that feels comforting and familiar. For some people, anxiety caves offer protection from overwhelming external stimuli, while others seek refuge from the unknown or uncontrollable. No matter what the specific motivation, anxiety caves are incredibly isolating, and Papaioannou notes that they only provide a false sense of safety. If you've ever been stuck in an anxiety cave before, here's what to know about working your way out.

Anna Papaioannou is an integrative somatic trauma therapist and licensed ACA counselor who specializes in anxiety.

Anxiety has many different triggers, but typically, one will experience intense physical or mental symptoms of anxiety before retreating into an anxiety cave. These may manifest physically or mentally — "All [symptoms] are valid and real," Papaioannou says.

Cave syndrome is slightly different from an anxiety cave. The term "cave syndrome" was coined by psychiatrist Arthur Bergman in 2021 as a reaction to the COVID pandemic. Cave syndrome specifically refers to the fear or reluctance to return to public life after isolation. Although somewhat similar, the "anxiety cave" Papioannou describes is a bit more general. She began using the term over 13 years ago to describe her own experience with anxiety and depression, and says that many of her clients refer to themselves "coming out of a cave" after dealing with an episode of heightened anxiety. Given that COVID still poses a threat — particularly for chronically ill and immunocompromised individuals — there are many valid reasons why a person might fear public life post-pandemic. However, both an anxiety cave and cave syndrome can leave a person feeling isolated.

When someone is experiencing anxiety, they can get caught in thought spirals and what-if scenarios that can overwhelm the nervous system and cause a freeze or shutdown response, making it difficult to leave their anxiety cave. Depending on access to resources like therapy, your support network, and emotional regulation tools (i.e. deep breathing, butterfly tapping), someone's stay in an anxiety cave could last a few hours, several days, or even months. If someone doesn't have the support they need, or they feel incapable of handling the challenges that await them, Papaioannou says it can be much more difficult to emerge from their anxiety cave.

Everyone has their own unique set of coping mechanisms and survival resources that they lean on when feeling anxious or unsafe, Papaioannou says. Retreating or isolation can be a valuable resource when you need some space to down regulate your emotions or to process challenges. However, isolation and avoidance exacerbates anxiety in the long term. If you consistently feel unable to leave your anxiety cave, or find yourself neglecting basic self-care and hygiene, consider reaching out to a therapist to help you work through it.

At its core, anxiety is a survival response designed to keep you safe. Your nervous system and brain are constantly listening to and monitoring both your environment and internal world to check for safety, Papaioannou says. If your body detects any signs of danger or dysfunction, this can trigger the fight-or-flight response, along with feelings of anxiety and panic. Try these three somatic techniques to help regulate your nervous system and make you feel more grounded:

You can use one or all of these somatic tools to feel more grounded, regulate your nervous system, or reclaim a sense of safety in your body, but anxiety is not something that you have to deal with or manage on your own. Having a support network such as a friend or family member that you can reach out to can help you to feel seen, heard, and supported. Knowing that your feelings are real and valid allows you to feel less isolated in your experiences.

If you notice that quick tips like the ones mentioned above haven't been working, and that your friend or family member isn't able to offer you the support you need, consider seeing a therapist, Papaioannou suggests — especially if your anxiety is interfering with routine activities and causing physical symptoms. A mental health professional can help with streamlining the process of identifying your triggers and maintaining long-term strategies.

— Additional reporting by Chandler Plante

Jenny Sugar is a former PS staff writer. She reports on all things fitness, but especially loves CrossFit and yoga.

Chandler Plante is an assistant editor for PS Health & Fitness. Previously, she worked as an editorial assistant for People magazine and contributed to Ladygunn, Millie, and Bustle Digital Group. In her free time, she overshares on the internet, creating content about chronic illness, beauty, and disability.