“Everything Seems Unreal”: How Adolescents Cope with COVID-19 Quarantine Experience.

Adolescents were a particularly vulnerable group at the time of the pandemic. Restrictions applied during quarantine brought a lot of stress and challenges for the youth. The aim of this study was to reveal how adolescents cope with challenges faced during the lockdown due to COVID-19. Twenty four 13–17-year-old adolescents participated in a qualitative study using semi-structured in-depth interviews via Zoom. Findings revealed seven themes related to youth coping behavior during lockdown: 1. withdrawal behavior, 2. focus on particular activities, 3. social support seeking within family and via the internet with friends, 4. expression of overwhelming emotions, 5. protest against


Introduction
At the beginning of 2020 the outbreak of a novel coronavirus disease COVID-19 became an issue of international concern (WHO, 2020). In accordance with recommendations, many countries declared quarantine to suspend the spread of the virus. One of them was Lithuania, where the first quarantine was announced on March 16 and lasted till June 16 of 2020. Movement and socializing restrictions were made that changed peoples' daily life.
Adolescents were a particularly vulnerable group at the time of the pandemic. Schools were closed all over the country so all the students had to get used to online learning. Moreover, face-to-face meetings with peers were banned. Being quarantined impeded their age-related developmental tasks, namely the demand for connection with peers and need for autonomy (Ellis et al., 2020). Consequently, it may have caused an experience of induced stress in daily life. That is worrisome as adolescents' cognitive and emotional regulation systems are immature (Zhou, 2020). Moreover, adolescents are more susceptible to mental health problems when faced with stressful events (Qi et al., 2020).
Studies showed the impairment of adolescents' well-being during the lockdown (Singh et al., 2020). During quarantine adolescents had to cope with issues regarding remote learning, maintaining physical health, socializing with friends and family, using technologies and uncertainty issues in lockdown (Scott et al., 2021). Accordingly, they suffered from physical and emotional symptoms, like headache and muscle pain (Branquinho et al., 2020), depression and anxiety symptoms (Orgiles et al., 2021) boredom and loneliness among them (Scott et al., 2021). As a result, adolescents were in need to find coping strategies in order to deal with the new frustrating experience.
Considering the impact of confinement to adolescents' mental health, it is important to hear their own perspective on what was challenging for them and how they coped with stressors, keeping in mind that just a few qualitative studies have been made to understand adolescents' quarantine experience so far (Scott et al., 2021;Branquinho et al., 2020).
Therefore, this study aimed to reveal how adolescents coped with challenges faced during the lockdown due to COVID-19.

Participants
Participants were recruited through local schools and using posts on Facebook with a convenience sampling approach. Twenty four adolescents (12 female and 12 male) from grades 6 to 11, aged from 13 to 17 (M = 15,38; SD = 1,15) participated in the study. None of the participants or their relatives had COVID-19 disease at the time of the interview. All the participants attended school from home via remote learning and had their own computer or shared it with family members. Regarding the home environment, 79.17% had their own room, 16.67% shared it with siblings, and only one participant expressed having felt like not having her own space at home.

Procedure
Prior to conducting an interview, informed consent was sent to the parents. The data were collected from 1 June 2020 to 11 September 2020 using a videotelephony software called Zoom. The interviews lasted from 13 till 92 min (M = 34 min, SD = 19 min).
Interviews were performed using the Biographical Narrative Interpretative Method (BNIM) (Wengraf, 2008) to capture the way each adolescent makes sense of his/her unique experience as it evolved over the time of quarantine.
The interview was structured into three parts. First part -free-form narration (Wengraf, 2008). Participants were asked to tell about their experience during the time of quarantine, freely without interviewers' interruption. In the second part the interviewer asked questions from participants' story, maintaining the flow of the narrative. Lastly, participants were asked 7 questions about the biggest changes during quarantine.
At the end of the interview, the interviewer filled in a demographic questionnaire together with the participant. To avoid secondary psychological harm caused by the interview, adolescents were provided with the information about the possibilities of psychological support during the time of quarantine.
The study was approved by the Psychological Research Ethical Committee of the Institute of Psychology of Vilnius University.

Data analysis
The data analysis of the transcribed interviews was carried out by the research team using the thematic analysis method (Braun & Clarke, 2006) based on inductive coding.
In order to improve the reliability of analysis, two researchers independently coded interviews and formed primary themes. Discrepancies were solved by discussions till the research team came to a consensus.

Results
Data analysis revealed that during the quarantine adolescents used various ways to cope with stress. The most common themes were: 1. withdrawal behavior, 2. attention focusing on the particular activities, 3. seeking for social support within family and via the internet with friends, 4. expression of overwhelming emotions, 5. protest against quarantine restrictions, 6. attempts to maintain "active oneself", 7. search for the personal meaning of the lockdown. 1. Withdrawal behavior. Withdrawal used by adolescents helped them to escape from difficult thoughts and feelings and was particularly used in the beginning and at the end of the quarantine. Participants caught themselves: "not wanting to communicate and tried to retreat to their room" in order to be alone or sometimes "just wanted to lay in bed" or sleep. Adolescents used withdrawal in order to cope with overwhelming emotional experiences and to avoid problems related with school. The school work often seemed "too difficult and overwhelming" and they tried to "leave everything and just forget". 2. Focus on particular activities. Teens revealed that particularly at the beginning of the quarantine they often engaged themselves in one activity, for instance "concentrated only on school tasks" or "stayed in front of the computer" almost all the time. That made young people feel like they are "ruining" themselves even though such concentration probably was helpful to avoid painful feelings of loss, fear and uncertainty. In later stages of quarantine adolescents started to concentrate their attention and time on other activities such as cooking, gardening, sports, music and set goals for themselves. Achievements in such activities made teens feel good and in control during uncertain times of quarantine. 3. Social support seeking within family and via the internet with friends. During quarantine adolescents experienced changes of their social surroundings (loss of contacts with separately living family members, friends and teachers), and in the context of physical distance the need of social support particularly in a nearest family appeared: "I tried to fill the emptiness… when you want to communicate with other friends face to face, with a physical contact. And because you can't, then you can at least try with other family members." Adolescence is a particularly sensitive period for social relations with friends, and the shortcoming of this need was deeply felt. Therefore, young people tried to meet this need through the use of internet platforms ("One day we decided to meet via Zoom and we dressed beautifully and felt like we met at some party. And we listened to the music. It was very fun and it was very good") or tried various internet-based games ("... we played together. We started to communicate via this interesting game").
In general, adolescents felt the need to communicate and used the internet as a substitute for "live" social interaction. However, some of them mentioned that they started to feel "tired" and "bored" and still felt the lack of "real meetings". 4. Expression of overwhelming emotions. For adolescents, quarantine experiences were related to strong emotions, sometimes not very well understood. Some participants revealed that "everything seems unreal", which could be related to emotional distancing. Others emphasized episodic emotional outbursts of crying "tears of despair" and needed a "shield to protect from bad ideas and bad emotions or anger". The way to deal with emotions was often a diary in which they could express their feelings. 5. Protest against quarantine restrictions. Almost all participants expressed that it was hard to follow all the quarantine rules, particularly not meeting friends. This was related to denying and breaking quarantine requirements such as "running from home" and "meeting friends" because as they emphasized that "to be at home is impossible" and that the "computer is not their whole life". Such tension was revealed also in the dreams of teenagers. Common themes were meeting with friends and even efforts to run away from a person whose name was Quarantine. 6. Attempts to maintain an "active oneself". The collapse of a normal daily routine made teens feel lost in their daily lives. Young people said that they often found themselves "not wanting to do anything" because "nothing is required" anymore and it was quite difficult to "concentrate attention". Despite this, they put intentional efforts perceived as "fighting against oneself" to generate solutions to a problem: planning school activity, scaling work and forcing themselves to meet school requirements as well as introducing sports and pleasure activities in daily routine. Such efforts were particularly encouraged by important others and made teens feel proud after their implementation. 7. Search for personal meaning of the lockdown. Adolescents particularly emphasized that during quarantine they experienced a change of values: "I understood the real value of life contact and that technology will never replace it…", "I understood the importance of time" and realized that it is up to them to decide how to use their time.
It was very common for youth to compare the time before the quarantine and during it, and the latter was appraised as instructive: ".

Discussion
The analysis of the narratives in the present study revealed seven themes reflecting adolescents' efforts to deal with life changes during quarantine. In the discussion we examine these themes via the lens of the literature on coping strategies. The first theme revealed adolescents' withdrawal behavior which closely aligns with the avoidant coping strategy which can be beneficial to reveal anxiety in the short-term (Shin & Kemps, 2020). Avoidance strategy was particularly relevant in the beginning and at the end of the quarantine. This could be related to the induced stress experienced by adolescents in the beginning of imposed restrictions and with tiredness at the end of the quarantine. Avoidant behavior usually did not help youth to solve their problems, but this strategy could be important in order to be less sensitive during a crisis.
The second theme which emerged was adolescents' efforts to focus on one activity as a way to deal with lockdown challenges. In the beginning of the quarantine young people mostly drowned themselves in the computer or in school tasks and felt very tired or sometimes even devastated, which could be related to the avoidance coping strategy. This goes in line with data showing that avoidance and rumination have been frequently associated with stronger symptoms of anxiety and depression (Schäfer et al., 2017). Though later on adolescents started to set short-term goals for themselves and it helped them feel more in control. This might be related to the problem-oriented strategy, when a person consciously puts in the effort to eliminate stressors (Shin & Kemps, 2020). Orgiles and colleagues (2021) demonstrated that problem-oriented strategies are related to fewer symptoms and alterations in mood, sleep and cognition.
Social support seeking behavior was the third emerged theme. Quarantine restrictions particularly affected social interactions, which are crucial for adolescents. The youth found themselves in a family again, and interactions within families were necessary to fill the lack of broader social contacts. Ellis and colleagues (2020) noted that family rituals during times of crisis can buffer the influence of stressful experiences on adolescents' mental health. According to the research, the time spent interacting with parents and siblings face-to-face and via video messaging was related to less loneliness and less depression (Ellis et al., 2020;Qi et al., 2020). Our study revealed that keeping interactions via online with peers was also important for adolescents and helped them feel their lives as "normal and usual" as possible in these circumstances.
The forth theme, the expression of overwhelming emotions, revealed the complexity of youth emotional experiences during lockdown. Strong repressed or denied emotions sometimes emerged through dreams or uncontrolled outbursts. Though an active way of expressing emotions gave the feeling of relief. Such a theme could be linked with an emotion-oriented coping strategy as efforts to reduce stress through emotional responses. And the fifth theme in our results, protest against quarantine restrictions (running from home) could be related to the emotion-oriented coping strategy as well. Studies found that using emotion-oriented coping was related to internalising symptoms (e.g. anxiety) and externalising symptoms (e.g. behavioural alterations) (Orgiles et al., 2020). Even though emotion-oriented coping might be challenging for parents, it could be useful for teenagers to get through difficult and stressful times.
The sixth theme revealed attempts of the youth to maintain "active oneself" in the form of making plans or organizing the routine, which could be related to the problemoriented coping strategy. Staying actively engaged was challenging for the youth. Orgiles and colleagues (2020) noted that adolescents' frustration in the context of COVID-19 may compromise strategies such as problem-solving. Nevertheless, successful application of the mentioned strategy helped to increase self-pride and joy. This could be supported by Leipold and colleagues (2019) empirical findings which demonstrated the positive correlations between problem-focused coping and well-being in adolescence.
The most common theme mentioned among adolescents was the search for a personal meaning of the lockdown. Leipold and colleagues (2019) defined a meaning-focused coping as a strategy, which dampens the negative impact of unsolvable problems via cognitive reorganization of meaning and value. Furthermore, a positive attitude towards stressful events could be related to psychological resilience and growth (Kaye-Kauderer et al., 2021).
Altogether, the themes mentioned above reflect the complexity of coping behaviors used by the youth during lockdown. Adolescence is a developmental period when an individual's identity undergoes consolidation, and challenges of the lockdown may shatter its formation. The lockdown may particularly compromise their social exploration process outside the family causing overwhelming painful emotions and requiring various ways of coping. Though certain ways of coping could not be considered better than others, they were all useful for adolescents in order to regulate stress and maintain a positive sense of identity. By doing so, dealing with stressful situations may become part of a growing personality. Lee and colleagues (2016) emphasized that resilient adolescents simultaneously utilized various coping strategies. Therefore, understanding the coping behaviors and helping adolescents reflect their mental states in stressful situations could be effective interventions in order to reduce the risk of future psychological problems.