How to Beat the “Expat Blues”: Expatriates and Mental Health

Taking good care of your health and well-being is essential for making life abroad an enjoyable experience. When preparing for their move, expats-to-be usually remember to cross most health-related points off their to-do list.

Have you taken out the right medical insurance for your destination? Do you need any additional immunizations? Are there any particular health risks to be aware of? Such practical aspects are rarely neglected — but what about the thorny issue of expatriates’ mental health?

Let’s Talk Mental Health

Every year, the World Health Organization launches a global awareness campaign for World Health Day (7 April). For 2017, the WHO has chosen to focus on depression, which might affect as many as 300 million people around the globe. This staggering number shows that the impact of mental health problems shouldn’t be underestimated.

Fortunately, the majority of expats won’t have to deal with such a serious illness. In the Expat Insider 2016 survey, only one in eight respondents thought that moving abroad had been bad for their mental health.

However, psychological strain is frequently an unpleasant aspect of expat living. After all, you are uprooting your entire life!

What can you do to keep the normal stress of an international move — such as culture shock — from turning into something rather more worrying? And who can you turn to if you are among those unfortunate 12% who find it hard to cope?

Do Everything in Moderation

The best advice is often the simplest and the oldest: all things in moderation, as the ancient Greek philosophers used to say. When you adapt to a new environment and lifestyle, though, it’s tempting to take your new routines to extremes.

For example, if you have moved because of a great career opportunity, you might be carried away by exciting tasks and added responsibilities. After moving alone to a place where you don’t know anyone yet, you might spend every other night partying in order to get out and socialize, and so on.

Or you could be tempted to do the exact opposite: escape from a stressful day at the office and a niggling sense of loneliness by retreating into your bedroom, a modern-day hermit with a Netflix account.

Neither behavior is a healthy coping strategy: at best, you’ll be overworked and sleep-deprived, or remain isolated; in the rare worst-case scenario, you could increase the risk of burnout, substance abuse, or downward mood spirals.

The trick is to establish a well-balanced routine that works for you. Make sure to get enough rest and healthy food, and to take the time for some exercise and leisure activities you enjoy.

Emphasis on the words ‘you’ and ‘enjoy’: don’t add even more things to your plate just because you feel you should do them. If exploring the local sights in your new home is fun for you, go ahead! If you’d rather sit in a café with a good book for an afternoon, don’t feel guilty for not making the most of your time abroad.

You’re Not to Blame for Feeling Blue

In case your mental health should indeed get worse for a while, don’t blame yourself. There’s still considerable stigma attached to admitting to this kind of problems.

How such illnesses are perceived is dependent on cultural context, too. This can make it more difficult for expats to open up, as they may not know how to talk about their issues.

Moreover, some expatriates might be ashamed of not enjoying the perks of life abroad “properly”: why aren’t they simply grateful for the opportunity to explore another culture, earn a higher salary than back home, or live in a popular tourist destination?

In such situations, try to remind yourself of two salient facts: struggling with a psychological disorder isn’t anyone’s fault; nor is it all “just in your head”. Well, strictly speaking, it is, but that doesn’t mean you are imagining your distress or that its effects aren’t real.

We also don’t know exactly why some people are more susceptible to mental health problems than others, and why some folks are more resilient and bounce back even after intense stress. Just see it as a random predisposition, like some people are horribly prone to hay fever in spring while others have never had an allergic reaction in their entire life.

You wouldn’t blame the hay fever patients for sneezing and wheezing, would you? Then don’t be hard on yourself for suddenly feeling anxious or depressed after moving abroad!

It Takes a Strong Person to Admit to Weakness

Last but not least, don’t be afraid to reach out.

Finding a trustworthy and sympathetic person to talk to can be hard, especially if you aren’t fluent in the local language yet. It’s bad enough to opt for mime when trying to describe the symptoms of gastric flu to a doctor — how on Earth should you ask for help with psychological issues?

Now it’s time to make use of all resources aimed at the expat community. If you don’t think you need professional help, you could start looking for mindfulness activities, self-help groups, or crisis hotlines organized by volunteers. For the spiritually minded, religious congregations could be another starting point since they frequently offer pastoral care.

Furthermore, your home country’s consulate may provide a list of local doctors proficient in your mother tongue, including psychologists and counseling services. If you live in a remote location, or a destination without much of a foreign community, online counseling might be worth a try, too.

Don’t give up yet: the hardest thing is to admit that you are in need of support and to ask for it. Afterwards, it gets a lot easier, and soon you’ll be able to enjoy life abroad just like you always imagined.

(Image credit: iStockphoto)

40 Responses to “How to Beat the “Expat Blues”: Expatriates and Mental Health”

  1. Feeling extremely blue. Been in melbourne for nearly 2years and awaiting p r papers. Not working no confidence.

  2. Hi Debby,

    I’m sorry to hear you are feeling this way. Unfortunately, I have never lived in Australia, so I don’t have any personal experience with how mental health services work there.

    However, the website On Track seems to have some potentially useful resources to get started. It is meant to support GPs and specific patients, including those potentially struggling with depression. They also list related resources all over Australia.

    Perhaps you’ll find some helpful information there. Best of luck!

    Best,
    Margit

  3. Hi Debra,
    I know how you feel – I’m a Scot going through exact same frustrating & depressing nonsense in France. If you’d like to, go see my friend Rich Martin at Martin & Coupe Chiropractic, Melbourne (google it). He’s from there but lived in Glasgow for many years so knows what expat life is like. Maybe the friendliest guy I’ve ever met – I’ll let him know you may pop in for a coffee ☺️
    Sending hugs & courage.
    Big hugs

  4. Hi – thanks for an interesting post.
    Yes, there are times that I feel isolated due to the language issue. As a South African living in Sweden, the language has taken a ‘back seat’ because of Swedes practising their English with me.
    This has impacted on my social life as trying to integrate without the knowledge of the language makes it so much harder. Yes, I know I need to take lessons but I have made an attempt and find it difficult to grasp. I’m 60 so learning a new language is daunting. I have a lot to offer with respect to helping out in the community and sharing my crafts that I learnt back home. Im yet to find a craft club in my neck of the woods, Örebro. Also I would like to meet English speaking ladies with similar interests and would enjoy meeting up for lunch every now and then. Any takers?

  5. I am also 60 and living in the Netherlands. Managing the language but finding a decent job is a mission. Seems all I am qualified for here is manual labour. Moved here to live near my daughter not for a job offer.

  6. @Sabine:

    Have you ever considered volunteering? Depending on where exactly you live in the Netherlands, local NPOs might have need of a fluent English speaker with plenty of professional experience.

    (My apologies if you have already looked into this. I really think that building a new life abroad can get tougher with age — there’s just so much more you leave behind.)

  7. Hi Myrna,

    I’m sorry to hear about your difficulties in building a new social circle in Sweden. I’m afraid that we don’t have an InterNations Community in Örebro. Maybe you could post a thread in the Local Forum of our Stockholm and Göteborg Communities, though. Perhaps other members living in Sweden have friends in the area they could get you in touch with or they know of good local resources for English speakers. Good luck!

    Best,
    Margit

  8. A valuable article thank you

  9. @Marie: Thank you for your nice feedback!

  10. Very timely for me, thank you! Each day in Berlin feels like I’m climbing a small (and some days not so d small) mountain. I came to research for a historical novel, and as we writers like to say, “it’s all material.”

  11. @Susan: Best of luck with your research and your writing project! I hope you’ll beat the expat blues soon.

  12. I’m glad I read this post – made me feel more “normal”.
    I left Australia, my family, beloved dog, studies, career opportunities, etc. and moved to Denmark when I married my Danish husband. Started so strong, confident, and excited to make the most of such a wonderful blessing and opportunity to explore the world and everything it had to offer. As beautiful as I find the country and the people in it, after waiting so long for my Visa to come through, no work (not even volunteer work), no study, few friends (and those I have are busy working and have their own lives to lead), I quickly started to crumble.

    I feel exactly how dear Myrna above stated with trying to integrate into the community with the language and social settings; offering skills and knowledge. I’ve always loved different cultures and languages but it’s difficult at an older age to grasp a new language (I’m 52), especially when those around you want to practise your mother tongue instead (in this case English).
    It’s a shame Myrna and I don’t live in the same town. I’m in Ramløse, just outside of Helsinge, Denmark.

  13. Thank you for sharing your story, Toni! It sounds like there’s some need for a pan-Scandinavian expat support group… 🙂

  14. Very timely for me too! Thanks for posting. I’m an American woman in Kenya and going through lots of tough, personal and spiritual growth. For me, I’m confident I’ll be stronger on the other side but it’s a little tough right now.

  15. @Laurie:

    Thanks for your feedback! Hopefully, things will get better for you soon.

  16. Hi…Yes thanks for posting this article and comments. It just feels better to know that I’m not alone with these issues. I’ve posted a couple of language exchange posters to meet people and learn the language here…it’s helping. I’m in a small village in Austria and integrating seems difficult at times. I’m also older so learning 2 new languages(German and local dialect) is daunting….Thanks again for the posts.

  17. @Lore:

    Thanks for sharing your experience! I can imagine that it’s much harder in the countryside where there are fewer English speakers and other expats than in a major city. (Not to mention baffling local dialects. I once experienced it the other way round: I went to university in the UK and sometimes had trouble understanding some of my fellow students. It made me feel horribly silly: here I was, reading Shakespeare, but struggling to follow a conversation about the caféteria lunch. Very dispiriting!) I hope you’ll keep enjoying the language exchanges — sounds like a great way of making friends.

  18. Thank you! Now a days I am living in Caracas and it is very sad to see what is going on here!

  19. I’m struggling with blues, which is why I moved abroad! So it’s the exact opposite for me. However, after nearly a year abroad, the blues are starting to follow me here, too. My best advice is to get involved in the local activities, not only hang around with the other expats. When you start to know local people, and go to really local events,only then will you start feeling that you are really a part of that place. The life with expats and the life with the locals are 2 completely different experiences, and I would suggest everyone to take advantage of BOTH of them. What does this have to do with the blues? Well, one of the biggest reasons for the expat blues is that expats isolate themselves to their work related circles. Do you only spend time with your work collegues in your home country? Probably not. Also, don’t forget your other interests abroad. You used to play tennis back home? Well, I believe you can find a tennis racket abroad, too. Someone to play with? Be positive, and go to find that someone!

  20. @Sindy: That’s some excellent advice. Thank you for sharing it!

  21. A really relevant and insightful piece, thank you. Even though I’m a counsellor and therefore used to reflecting on my mental health, I wasn’t prepared for the impact of moving to another country where I couldn’t just chat with everyone I met, and of adjusting to a completely new routine.

  22. @Lucy:

    Thank you for your lovely feedback!

  23. I have a situation involving one of my friends. She is from Recife now living in Florida, USA. She is having a tough time. She met and fell in love with a man there. has two children by him but he has made it known he don’t want to have anything to do with her. So she is at a job that barely makes ends meet, 2 young babies. She, I fear is suffering mentally. The only thing that keeps her going is her loving babies, both in diapers. She doesn’t want to go back to Brasil but somehow make a life here. Does anyone have any suggestions or know of some kind of help for an expat such as herself? Any suggestions, I can relay to her and hopefully pull her to success. Does she know I am asking this for her? No, but that has never stopped my big mouth from wanting to help someone I care about. kkkkkkkkkkk

  24. @Tommie:

    That really sounds like a very difficult situation for your friend, and I’m sorry to hear that. Perhaps you could open a thread in our Miami Forum — other members currently living in Florida might now where she could get help (like counseling) or practical support (like a pro bono lawyer, e.g. if she needs help with child support payments).

  25. If anyone needs help with the globe trotter blues, it is my specialty as a double-hatted and bilingual expat coach and ethnoclinician. 14 years of experience in treating it among expats, repats, and global nomads. Don’t hesitate to reach out to me, I am based in Brussels and also consult online through Skype.
    Wishing you well and sending you strength,
    Isabelle

  26. @Isabelle:

    Thanks for sharing!

    (If anyone reading this is wondering about how to get in touch, just clink on the link with her name in the comment above to see her website with her contact information.)

  27. Hi Isabelle, would you send Me your e-mail ? It would be good to have in case I will need some guidence in the future,
    Best from Lisbeth

  28. @Lisbeth:

    I think you can find her contact information here:

    http://www.hemispheres.link/

  29. Hi.
    I really do honestly think its all about how you been beat down in life. I think it is about how you look at life. If you have been depressed you going to take it with you wherever you go. Geographically depression follows you, This rubbish about you will be depressed when you move is rubbish,. If you unhappy in your marriage nothing is going to make it better, maybe a move will make it way better and you can find the man of your dreams

  30. @Linda:

    Thank you for your feedback! I honestly didn’t want to give the impression that *everyone* will be depressed or struggle emotionally after moving abroad. Lot of people do have a great time, but others may find it tough and some may have quite serious problems. I just wanted to encourage those who find it hard to get the support they need so they can truly enjoy their time abroad.

    Sometimes, moving can be a solution to your personal problems (like in the example you give), and at other times it might cause some problems that didn’t exist before. Life’s just unpredictable that way, but there’s no shame in asking for help.

  31. Hello everyone,

    I am expat myself and I live in Maastricht in Netherlands. I moved here two years ago and had difficulties to find a job and adapt a cluture. As I am psychologist myself I decided to start offer psychological counselling to expats in Netherlands. Being a psychologist and expat myself I think we can find easier common ground and connection. Anyone who is interesed can check out my facebook page called International Psychologist Veskioja and contact me. All the best and let´s enjoy our new homecountries:)

  32. Margit, thank you kindly for this post. It’s the first one I’ve opened up and I’m so glad I did. I’m a Scot, been in France 3yrs nearly but still waiting registration to work in my profession. The frustration, isolation and beaurocracy is mind-numbingly painful and I find myself regularly depressed as I have no regular money coming in and have turned into the Netflix hermit. I can’t get out at night as my ‘partner’ (who doesn’t go out either & are on the point of separating) is a chef and works every night so I have to look after my 5yo daughter. Hence a vicious circle of wanting to meet locals & cannot. Your article let me give myself a pat on the back for reaching out to an English speaking counsellor just today. It’s expensive but my mental health has to be worth it. So thank you so much for encouraging me. Love to you.

  33. Hi Julie,

    That really sounds like a tough situation to be stuck in. I hope that the counsellor will help you deal with the frustration and even support you in figuring out some practical matters. I’m glad you have someone to talk to now.

    All the best,
    Margit

  34. Definitely relate to this article. Thank you Margit.
    I underestimated how difficult my move from Toronto to Prague would be in early 2014. I was so excited for the new experience that I did not see the cartoon piano before it fell on me. Thankfully I had my yoga practice to lean on and the relocation was the catalyst to really getting into mediation… which totally saved me. Then I moved to Sweden in 2015 and the un-grounding started again. Again, meditation helped me cope. However, it could not do much for the sleep disruption (due to the lack of sunlight)… that is enough to drive a person crazy. And the Swedish health system is, I have to say, not supportive in handling these issues holistically – you have to get a prescription to buy melatonin!?! And the doctor will hand you anti-depressents with that.
    I am now living in Italy.
    In any case, after the move to Sweden, I self-published a guidebook on how to move mindfully. How To Make Big Moves: Relocate Without Losing Your Mind is available for Amazon Kindle and iBooks, as well as PDF format at https://how-to-make-big-moves.myshopify.com/ … I hope a little promo is OK. I hope my book can help others through the process 🙂
    Sara

  35. @Sara:

    Don’t worry: that e-book link is fine here: after all, it is related to the topic at hand and based on your personal experience as well. It’s the obvious spam that goes straight to the trash folder. 😉

  36. Thank you for the article. I have lived in a few places, mostly English speaking and last year, my husband needed to move to Switzerland for his job. I don’t speak French and I am not sure I really want to, that’s bad I know. I really am struggling here, 10 months in now, no friends, no social life, I’ve offered FREE fitness classes to expat face book pages try to get a bit of a community for expats to meet, but they get removed off face book ” for advertising” that’s happened a few times. My husbands at work all the time, I’m trying to get work ( I have to earn, I. Not a kept wife!!) and clients (I’m a fitness and health coach) and it’s been the toughest place I’ve ever lived with a really closed community. So yes I’ve felt low, lonely, loss of confidence and caused huge conflict with my husband!!…. because he just doesn’t understand what my problem is. I keep trying and keep trying to change my mind set, but I’m so down and feel I’m wasting my life here with this loneliness

  37. Hi Ali,

    Thanks for getting in touch! Your situation does sound rather frustrating, and I’m sorry to hear that. As you mention that you have lived in several English-speaking countries before, perhaps you might want to consider talking to an English-speaking healthcare professional about your situation. The US Embassy publishes a list of medical professionals with English language skills, and it also features several psychologists in the Geneva area (of course, I don’t know where exactly in French-speaking Switzerland you live).

    https://ch.usembassy.gov/wp-content/uploads/sites/131/2017/01/Website-Medical-Service-Providers-1.pdf

    There’s also a nationwide free counseling hotline:

    https://www.143.ch/

    Perhaps you could contact them via email and figure out if they have English-speaking volunteers too or perhaps someone knows of a support group for expats. My best wishes to you!

    Margit

  38. Good day, I need your suggestions with this. Please message me instantly: frans.wikman@gmx.com

  39. Hi Frans,

    Thank you for getting in touch! I’m afraid I’m not quite sure how we can help you. If you have any specific questions, you can reach us via blog[at]internations[dot]org.

    Best regards,
    Margit

  40. Hello all!

    I just stumbled upon this lovely blog because I am doing some research for an upcoming article I am writing. I wanted to reach out to the expat community here, if I am allowed, and say that my colleague and I have recently launched an online mental health practice serving English speaking expats living abroad. We are expats ourselves, and understand how difficult it can be to live so far from home. If you are struggling, please reach out and see how we can help you. Consultations with us are always free and we respond within 24 business hours to all emails (info@therapysolutionsabroad.com). No matter where you are and what you are dealing with, I wish you all the best!

    Respectfully,

    Dr. Nelson

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