Episode 4:
Working through the emotional aftermath as a survivor

*The series is based on the real-life experience of Kim Nam-young, a JoongAng Ilbo reporter currently living with post-traumatic stress disorder (PTSD). The following articles are written from Kim’s first-person perspective.

To Readers

I have PTSD.

As a reporter on the social affairs desk, I covered the Itaewon disaster on Oct. 29, 2022. Since November of the following year, I have been receiving treatment regularly. I attend psychiatric counseling sessions and take medication every day.

I am only revealing the illness now, more than two years later, not because I have overcome it. This is not a story about recovery, but a record of living through the illness. To be honest, I still do not know when, or if, I will overcome it.

Instead, I want to talk about the time I have spent living alongside PTSD. Even now, I continue to work as a policy and social affairs reporter while exercising, traveling and going on with daily life.

If someone is hesitating to see a doctor, I hope this piece can help. I also hope we can become a society where people do not feel forced to hide emotional pain and trauma.

Breaking down for the first time

"How can a person do something like that?"

After forcing out those words, all I could do was cry silently. Tears streamed down my face. My doctor pushed a box of tissues toward me across the table without saying a word.

I cried for the first time in my doctor’s office on Dec. 13, 2024, despite having visited countless times before. I didn’t even shed a tear when I talked about my PTSD symptoms.

Four days earlier on Dec. 9, 2024, Lee Sang-min — the then Minister of the Interior and Safety — had stepped down from office. In his farewell message, he wrote, "Every moment was truly happy."

Those words, coming from one of the key officials held responsible for the Itaewon disaster on Oct. 29, 2022, hit me harder than I expected. Hearing what felt like a statement devoid of responsibility only deepened my pain.

During my appointment, I began talking about him and suddenly found myself overwhelmed by emotion.

PTSD is an illness of memories, but it is also an illness of emotions.

Guilt, fear, anxiety, depression, helplessness, sadness and anger — these negative emotions are amplified as if someone has turned a loudspeaker toward them.

I do not feel these emotions every moment of every day. But sometimes they rise unexpectedly to the surface and take hold of me.

Fortunately, medication has helped me keep them under control.

The emotional aftermath of PTSD

PTSD is not simply a state of heightened emotional sensitivity.

For a long time, I wondered why I reacted so strongly to things that seemed minor. It was only through treatment and time that I realized it was not a matter of willpower; it was a consequence of physical changes in the brain.

Trauma disrupts the brain's internal balance, according to psychiatrist Bessel van der Kolk, who wrote "The Body Keeps the Score" (2014).

He explained that when PTSD develops, the balance between the amygdala and the medial prefrontal cortex is dramatically altered, making emotional regulation and impulse control more difficult.

Brain imaging studies have shown that intense fear, sadness and anger activate regions involved in emotional processing, while the medial prefrontal cortex, which helps regulate those emotions, becomes far less active.

When this happens, the brain's inhibitory systems stop functioning properly, according to van der Kolk. People become startled by loud noises, fly into a rage over minor disappointments or freeze when lightly touched.

Looking back, that was exactly what happened to me.

Loud noises startled me far more than they should have. Casual remarks could send my emotions spiraling. I "thought" that I was safe, but my body reacted differently.

It was not that I had become a different person. It was my brain that had adapted itself to perceived danger.

① Guilt

The guilt of surviving that day has never fully left me.

At the scene of the Itaewon crash, I had two choices: Should I be a reporter or should I be a rescuer?

Even as I reported from the scene, I watched people desperately trying to resuscitate those who had stopped breathing. I thought, countless times, whether I should be helping them instead of doing "my job."

I was filing stories from the scene, but I just couldn’t shake the feeling. Moments of indecisiveness passed. I felt like human garbage interviewing survivors about what had happened and how they were doing.

After the funerals ended and the immediate aftermath subsided, the guilt only grew stronger. For a long time, it was one of the reasons I could not bring myself to seek treatment.

I was a survivor too, yet it felt wrong to place myself in that category.

Even after PTSD symptoms began resurfacing about a year later and I started receiving regular treatment, that feeling did not go away.

I have never deleted a single photo from that night in Itaewon. Doing so felt like a betrayal, as if I would be punished for daring to erase those memories.

Even if everyone else forgot, I felt that I shouldn’t. And that obsession stuck.

② Fear

For nearly three years, the word "Itaewon" itself struck me with fear.

The feeling became particularly intense every October, around the anniversary of the disaster. Seeing the word on a banner, in a headline or in a work email was enough to scare me. And at those moments, I had to briefly collect my breath and look away.

I also once became enraged with a friend who sent me an article about the disaster. I snapped and told the friend never to send me anything like that again.

Even now, to be honest, it is a word I can confront only after taking several deep breaths.

Flashbacks and nightmares are the moments when fear grips me most tightly.

A flashback is not simply remembering — it feels as if the event is currently happening again. Images from the past replay with startling clarity, as if I am watching a film.

Nightmares do much the same thing.

The moment one begins, I am trapped in the past. Once the sights and sounds from that night wrap themselves around my mind, everything feels as if it has been put on pause.

So when a flashback comes, I sometimes shake my head on purpose in an attempt to escape it.

③ Anxiety

The best way I can describe anxiety is feeling unable to plant my feet firmly on the ground.

The feeling that reality isn’t real came irregularly. Because I was constantly on edge, I remained in a state of heightened alertness.

Though things have gradually improved, certain triggers still pull me back to where I once was.

Anxiety often leads to insomnia.

One reason I returned to the hospital was that I was having trouble falling asleep. Even when I managed to fall asleep, I would wake up repeatedly throughout the night.

④ Depression and helplessness

Depression is a complicated thing.

The depression that accompanies my PTSD is like chewing gum stuck to my shoe.

Treatment taught me that depression is not what many people imagine it to be. It is not simply feeling sad or complaining about life. Instead, thoughts about life's meaninglessness begin to surface more often. Things that once brought excitement — like finding a new restaurant or visiting an amusement park — gradually lose their appeal.

A hopeful future becomes harder to imagine.

Every October, when the depression reaches its peak, I become especially drained. I try to force myself to stand up again, repeatedly telling myself that I have to keep going.

On Oct. 29, 2024, I took the day off from work. I originally planned to bring flowers to Itaewon and pay my respects.

When the day arrived, however, I could do nothing. I just lay in bed staring into empty space. I could not sleep. Messages poured into my phone, but I could not bring myself to read them. My body felt heavy, even though I was not physically ill.

⑤ Anger

"This is surely going to be made into a movie someday,” said someone standing behind me at the disaster scene.

I was furious. I felt as if I might hit the person. I turned around but could not tell who had spoken.

What made me angriest was the insults directed at the victims.

Whenever I came across comments saying the victims had "died while out partying" or that they were somehow the kind of people for whom such a thing was inevitable, I felt a surge of anger so intense it made me nauseous.

The idea that mocking the dead had become a kind of cruel sport in Korean society was difficult to accept.

Around the time novelist Han Kang received the Nobel Prize in Literature for "Human Acts” (2014) in October 2024, which is based on the Gwangju Democratic Uprising that happened on May 18, 1980, I told my doctor that I finally understood where some of my anger came from.

I said that as someone from Gwangju, I had always found it unbearable seeing people mocking the Gwangju Democratic Uprising to this day.

It seemed to me that the same pattern of ridicule had extended to the Itaewon disaster.

Once again, I witnessed the history of sacrifices never being fully acknowledged, which not only leaves wounds on society but also on individuals as well.

What ultimately allowed me to endure these storms of emotion was, of course, the combination of counseling and medication.

But just as important was the unwavering support of the people around me.

The story continues to the fifth episode, "Episode 5: Small gestures that help and words to avoid for those living alongside PTSD"

BY KIM NAM-YOUNG [[email protected]]