- How post-traumatic stress disorder follows North Koreans all the way south
She defected from North Korea 15 years ago, crossing over into China, Vietnam, and Cambodia before finally reaching and entering South Korea. The process was “relatively” trouble-free. There was one thing she had not expected, however -- the constant, reoccurring nightmares that followed her for three years.
|Nam Young-hwa, a North Korean defector who is now head of the Women’s Association for the Future of Korean Peninsula, stresses the need for providing mental health support for defectors, during an interview with Korea Biomedical Review.|
“I was never tortured or taken away in the North. I didn’t experience any traumatizing pain. However, after Kim Il-sung, the founder of North Korea, died, many people starved to death and died for other reasons. I did undergo the troubling times then,” said Nam Young-hwa, a North Korean defector.
Nam’s family was an upper middle class, and she was part of the elite. She majored in chemistry and worked as the secretary for an agricultural organization - a sign of wealth and independence uncommon for North Korean women. But no amount of individual wealth could protect her from the economic and social hardship that plagued the nation.
“After experiencing national famine and crossing over to China and into South Korea, I started having nightmares for three years. I was afraid someone would hunt me down, and it felt like someone was coming to get me. I dreamt North Korean police was raiding my house in the North,” she said.
Nam was not the only defector suffering from such dreams that persisted.
“It’s said that 100 percent of North Korean defectors have these dreams of being chased or getting tracked down,” Nam said. “But we thought these were just dreams. We realized only much later that this was a cause for medical treatment. We didn’t even know about the word ‘trauma’ or ‘stress.’”
These constant, reoccurring nightmares, Nam would find out seven years after arriving in South Korea, were the symptoms of post-traumatic stress disorder, known as PTSD, a mental health condition triggered by a terrifying event that leads to flashbacks, nightmare, and severe anxiety.
For those who dealt with more traumatizing experiences, the nightmares are worse and more prolonged. Many North Korean defectors, while getting to South Korea, wander around in China and Southeast Asia. Women particularly are more vulnerable to specific dangers along the way. Human trafficking, sexual violence and harassment, and physical abuse are all realities for North Korean women trying to reach South Korea.
Most defectors are unable to recognize the PTSD symptoms due to a lack of education and ingrained stigma regarding mental illness. In North Korea, the mentally sick are taken to what is known as Hospital No. 49. Located inside a remote mountain, families can visit them every few months. Patients are branded as crazy and segregated from the rest of society. The only people to ever get mental health treatment are those who have severe symptoms, often from schizophrenia.
For these reasons, North Korean defectors are mostly unfamiliar with mental health and treatment “You can’t tell a North Korean defector that they have a mental health issue because that’s like telling them they need to be shut out from society,” Nam said.
However, studies show many North Korean defectors suffer from common mental health issues such as depression, anxiety, insomnia, and post-traumatic stress disorder. The big difference between South Koreans and North Koreans was how they recognized and reacted to these illnesses.
Nam recalled how her friend committed suicide, most likely because she, like many North Korean defectors, not only suffered from little financial or social support in the South but also dealt with untreated symptoms of depression, anxiety, and PTSD.
“My friend called me, telling me she missed me. I was able to find a job. She was living off of unemployment fees. She wanted to visit me at work. I told her to come, but she canceled on me last minute, promising that she would visit the week after,” she said. “A few days later, I got a phone call telling me my friend had committed suicide.”
The funeral, she remembered, had little friends in attendance. Nam also recalled her struggle with depression while trying to get a job in South Korea.
“I wanted to work in society as all North Koreans do. But I was in poor health. I would go to the doctor, complaining of aches and pains but had no physical illness, which is common for many defectors. These turned out to be symptoms of depression – but I didn’t know it then,” she said.
To get a job, Nam applied more than 20 times but were turned down. Some thought that the title “North Korean defector” was a poorly written joke.
“I didn’t want to live in this society where no one wanted me. In the North, I majored in chemistry, and I was well off. Here, no one recognized me, no one wanted to hire me, and it felt like I had no abilities,” she said. “I began to become pessimistic and isolated, and a sense of fear grew.”
One day, she was looking down from an 11-story building, about to end her life. She pulled back after thinking about her family. Her thoughts led her to a nearby hospital to the department of internal medicine where she explained what was going on in her mind.
“The doctor told me three things: don’t stay at home, do what you want to do, and often play with friends. Even though the doctor didn’t give me a diagnosis, I realized many years later that it was depression,” Nam said.
By speaking with other North Korean defectors, she found that they, too, experienced nightmares and symptoms of depression. Some had reoccurring dreams for up to 10 years. Nam started researching mental health and psychiatry, finding suicide stems from untreated symptoms of depression, PTSD, and anxiety, and treatment is critical.
“If we had recognized that North Korean defectors suffered from severe depression and trauma early on, then we would have been able to make some treatment plan. If I had known about these kinds of things, I would have taken my friend to the hospital and got her treated for severe depression,” Nam said.
Since then, Nam has worked to educate other defectors. Nam now holds four titles in South Korea, including CEO of the Women’s Association for the Future of Korean Peninsula, a sexual harassment consulting center, trauma treatment center, and suicide prevention center at the National Medical Center. Her primary objective is to help others like her.
Although much has been improved with the services provided by the National Medical Center, Nam noted more has to be done.
“People from Ulsan, Busan, and Daegu come to the National Medical Center in Seoul, which means medical institutions and provincial governments should pay more attention and help defectors get help,” said Nam. “The Ministry of Gender Equality and Family should pay particular attention to the suffering of women [defectors] who have suffered sexual and physical abuse.”
“Education for North Korean defectors is especially important,” she said. “Depression - I went through it too. I tell my friends, I understand you.”