Covid-19 and the psychological toll it's taking on students

Social Affairs

Published: 20 Feb. 2022, 16:14 Updated: 20 Feb. 2022, 18:22

Covid-19 and the psychological toll it's taking on students

Prof. Kim Bung-nyun of Seoul National University Hospital, who also heads the Korean Academy of Child and Adolescent Psychiatry, poses for a photo in his office on Feb. 9 during an interview with the JoongAng Ilbo, an affiliate of the Korea JoongAng Daily. [WOO SANG-JO]

Two years of the pandemic and forced school closings have taken a toll on the psychological well being of many students.

This can be seen in the surge in the number of children and adolescents in Korea seeking help for attention deficit hyperactivity disorder (ADHD).

Child and adolescent psychiatry Prof. Kim Bung-nyun of Seoul National University Hospital, who also heads the Korean Academy of Child and Adolescent Psychiatry, collected and compared more than 40 million data points posted by Korean teenagers on social media before and after the Covid-19 outbreak. Kim's research findings showed that these kids worried about having ADHD and also expressed a willingness to get treated.

Professor Kim recently sat down with the JoongAng Ilbo, an affiliate of the Korea JoongAng Daily, to talk about the impact of the pandemic on the mental health of children and adolescents.

Below are edited excerpts from the interview.

Q. Tell us more about these children and adolescents thinking they have ADHD.

A. When my research team analyzed the online activity patterns of students from late elementary school through high school during the Covid-19 pandemic, we found that children started searching about ADHD on their own. That played an important role in the rising number of children visiting pediatric and adolescent psychiatry clinics.

[…] And to understand the background [of this phenomenon], you should know the Korean slang “godsaeng” — a compound word of “god” in English and "saeng," the Chinese character meaning "life." Basically, it means living your best life, like a god — an exemplary life.

When we analyzed the language used by children and adolescents on social media, games and online forum posts, godsaeng was a frequently used word. This means their will to live their lives to the fullest has grown after the outbreak of Covid-19.

How do godsaeng and ADHD concerns relate to one another?

The word that was the most closely associated with godsaeng was “study,” meaning they thought they should get grades good enough to be an example to others.

But Covid-19 blocked that desire. They weren’t able to go to school in the first place. So they tried to [reduce the learning gap] through online classes, but it wasn't easy to concentrate. […] The problem is, they attributed the cause to themselves. They feel they have to live their best lives, but, seeing that they cannot, they think of themselves as worthless and hate themselves. Then, they start searching for information on ADHD, thinking they will find a solution on their own, and look for medication.

The pandemic must have put a great burden on children and adolescents.

That's right. First of all, Covid-19 required more [from these kids] than just self-control. […] Generally, their self-control is interpreted as their time spent sitting still, and that is just 10 to 15 minutes for those aged 3 to 6, 30 minutes for kindergartners, 40 minutes for first grade elementary school students, and it gradually keeps increasing. But online classes mean they have to sit for five to six hours in a day. […] This demanded more self-control from the kids, beyond what they can handle.

On the contrary, Covid-19 took away all [the things that] experience and stimulate them. Play areas disappeared, and the number of friends they could meet decreased. The only thing left was the internet — games and social media. […] So not all children can be diagnosed as ADHD patients just because of their increase in anger and irritation.

Are you implying it's hard to say ADHD has truly increased since the pandemic?

The number of children and adolescents with ADHD remains the same. But the Covid-19 pandemic has caused mental pain for more children, making even normal children show symptoms of ADHD.

Prof. Kim Bung-nyun points to a map of adolescent brain development during an interview with the JoongAng Ilbo on Feb. 9. [WOO SANG-JO]

What’s happening in their brains?

The reason why young people in particular are suffering due to the social consequences of Covid-19 is because of the situation their brains are in. Their brains are under upheaval. In particular, teenagers are emotionally vulnerable due to a temporary reduced functioning of the frontal lobe and a surge in testosterone. And Covid-19 struck at a time when their brains are already vulnerable, causing unbearable mental pain. Once you understand the characteristics of child and adolescent brain development, you’ll be able to understand their problematic behavior.

Oftentimes, the first person a child or adolescent reaches out to in times of need is their parents or caregivers. But according to your analysis, they didn’t. What is the reason?

We should focus on the three emotions that children and adolescents feel toward caregivers since the onset of Covid-19. The first is: They don’t want to be a burden to them. They knew that their mothers and fathers are as tired as they are from the pandemic.

Covid-19 has put a damper on the lives of all generations. […] Already, the household economics have deteriorated, with unemployment and reduced income. In addition to economic difficulties, there were many caregivers who complained of “Corona blues” due to a fear of infection and isolation. […] In the end, one could assume that children kept quiet as they saw the economic difficulties, mental health problems of their caregivers and the worsening relationships between them.

Surely there were some young people who asked for help.

Even those who sought help would often feel there's no good in telling. This is the second emotion children and adolescents feel toward the caregiver. You can often hear children saying their parents are too busy or won't listen to them. Even if the children say they feel depressed, anxious, aren't able to sleep or can't concentrate in class, there was actually no way to help. […] Then they try to solve the problem themselves.

But here, the problem worsens as they make a bad choice — they go astray.

As they get older and advance to higher grade levels in middle and high school, the more they started drinking, smoking, hurting themselves and committing suicide. The search frequency of keywords related to self-injury on social media has more than doubled. Of these, only about 30 percent are led to action. The remaining 70 percent is something similar to attention-seeking behavior. They are indirectly expressing their need for help because they’re having such a hard time.

Why was it caregivers weren’t able to notice?

This is linked to the third emotion: "I can't get caught." If children express themselves in an extreme way, caregivers only scold and criticize them without suggesting any solution, so the children become even more reserved. The problem is that this kind of behavior has social infectivity and can worsen the problem.

How can we overcome this crisis?

This crisis can be turned into an opportunity if caregivers take the time to check on their child and make up for what is lacking. The most important thing is emotional learning through culture, arts and sports activities.

[…] All humans suffer from emotional difficulties due to brain development in their early teens. However, cultural, artistic and physical activities create a defensive front by being able to experience accepting, expressing and developing emotions.

But these activities seem too luxurious amid the overload of studies they are required to do.

I’m not saying they should quit studying. Currently, Korean students spend 90 percent of their time during the day studying, while only 5 percent is dedicated to cultural, artistic and physical activities. I’m saying we should increase this portion to at least 15 or 20 percent. Just with that small increase, they can achieve a healthy and balanced brain development, and based on this experience, they will have a better chance to live happily for the rest of their lives. Childhood and especially adolescence play a big role in this ability. This is because the brain is most capable of accepting artistic sensibilities during this period.

What are some cultural, artistic and physical activities that you suggest?

Listening to good music, reading poetry or books, looking at or making their own paintings and exercising. This also includes online activities, such as games.

[…] The problem is what kind of content they encounter. It is the role of the caregiver to fill their child's brain with good content. Rather than just banning online activities, it is important to let them have access to music and various art activities.

What I suggest is engaging in cultural, artistic and physical activities, centered on physical activities and physical contact. Then, you can restore the emotional development that has been delayed for the past two years.

BY LEE MIN-JUNG, SEO JI-EUN [seo.jieun1@joongang.co.kr]