Depression, anxiety, and other mental health disorders have been on the rise since the start of the Covid-19 pandemic. But expats were at higher risk for depression than other people even before the pandemic. Leaving your country is a big step and can be an adventure, but it also can make you feel isolated and miserable.
Let’s take a look at what causes expat depression, how to spot it, and what to do about it if it strikes. Read on to learn how to identify and deal with expat depression.
Expat Repatriation Depression and Social Isolation
Depression from moving to a new country can be hard to recognize. People think working internationally must be the thrilling opportunity of a lifetime. That means an expat might feel like they have “no right” to be depressed, and that family and friends at home won’t understand if they are. But while an international move is exciting and the introduction to a new country can be wonderful, it could come with feelings of isolation and you may need to learn some coping skills to deal with expat depression.
For one thing, an expat often leaves behind family and friends and has to build a new support network from scratch. If you have close ties to people in your home country, it can be hard to suddenly be separated from them. A strong support network is a major resiliency factor—something that promotes good mental health. Making new friends can be tough any time someone moves to a new place, but it’s especially hard in a whole new country.
Part of this difficulty can come from a language barrier. Often, expats don’t share a language with the residents of the new country, which can make it harder to get close to people. Even if you can speak the language of your host country, there’s no substitute for the comfort of your native tongue. When everyone around you is speaking a different language, you can feel like a stranger in a strange land.
Also Read: Caring for Your Mental Health Overseas
Not Just Culture Shock
Speaking of which, feeling disconnected from the culture you’re in—sometimes called “culture shock”—is common for expats. Even if the main language is the same as yours, everyday things like shopping, driving, and dining will probably be different from what you’re used to. It may be hard to find activities, social gatherings, or places of worship that feel comfortable and familiar.
But expat depression is more than culture shock. Expats usually get over culture shock after a few weeks or months in a new place. Depression sticks around, and can make it difficult to work, play, and take care of yourself.
Many expats are silent about their suffering, or have trouble identifying it as depression at all. Expats may feel ashamed or ungrateful if their experience of moving abroad doesn’t match the glamorous image of international life that their friends and family have. They may not want to talk to people back home about their unhappiness, which makes it hard for their feelings to be validated and seen. After a while, the isolation, the cultural alienation, and guilt about not appreciating their new life can tip over into depression.
All of the challenges mentioned above can be “normal” features of expatriating, which can bring on culture shock and homesickness. Most expats will probably miss their home country, or feel emotional fatigue from how different everything is. But when these feelings make you miserable and don’t get better after a few weeks, that’s expat depression.
Also Read: Coping With Culture Shock When Living Abroad
Expat Depression Symptoms
Expat depression isn’t so different from regular depression except in what causes it. People with depression often feel hopeless, fatigued, and uninterested in things they used to enjoy. It doesn’t necessarily mean you feel sad. A lot of times, depression makes it hard to feel much of anything. When depression is mild, it might just feel like everything is gray, but you can still go to work and take care of yourself. But more moderate or severe depression may look like:
- Having trouble getting out of bed, or doing everyday tasks like washing, getting dressed, and leaving the house
- Having trouble sleeping, or sleeping too much
- No appetite, or binge eating
- Overusing substances like alcohol or drugs
- Having thoughts of suicide
Addictive behaviors, like heavy alcohol use (another common problem for expats), can start as ways of connecting to new people, finding something to do, fitting in with a more hard-partying lifestyle, or just keeping up with your workplace’s cultural norms. But alcohol use can become a way to escape painful thoughts and feelings, and can tip into addiction.
When expat depression becomes severe enough, it can seriously diminish your quality of life, even making you doubt the wisdom of expatriating in the first place!
Expat Spouse Depression
While expat depression can affect anyone who moves overseas, it’s possibly even more common for it to affect the spouses of expats. While a person who relocates internationally for a job or school often has a specific goal in mind for being in a foreign land, spouses are often there with only their partners for connection. A wife or husband may also have left a strong social support network behind, and is now reliant only on their spouse for emotional needs.
Sometimes the expat develops social groups within their workplace culture or related expat community, while the spouse along for the ride is left out. These factors can make all of the above problems develop even more quickly, especially if the spouse feels like they lack direction.
How to Treat Expat Depression
Once a person becomes depressed, it can be hard to find the motivation to do things that would help, like exercising, calling a friend, or taking a shower. Depression can make all of these things feel pointless, and a depressed person may feel that they aren’t worth it, anyway. In severe cases, depression can make someone think that it would be better for everyone if they died.
Luckily, just as the characteristics of expat depression are similar to those of other types of depression, the ways of dealing with expat depression are similar, too. The main differences are about access to mental health care, which differs country by country. Many insurers have a mental health line you can contact to get started, and some have special assistance just for expats. Here are some basic ways to ward off depression, or to start to feel better.
Get Enough Sleep (But Not Too Much!)
Once you’ve adjusted to whatever time change exists between your home country and your new home, try a sleep schedule that gets you 7-9 hours every night. Depression can cause sleep disturbances, including insomnia, hypersomnia (sleeping too much), and nightmares. Limiting screen time before bed, keeping your room dark and quiet, and using relaxation techniques can help you get more restful sleep.
Watch What You Eat
While dealing with expat depression, or any feelings of depression, it’s not uncommon to experience a change in appetite. Some experience loss of appetite, or its opposite—binge eating or emotional eating. Eating a more balanced diet, and getting enough nutrition, can help your body even out its emotional cycles. Be careful to avoid foods you’re allergic or sensitive to. This can be tricky in a foreign country, where rules about labeling can be very different and names for things can be unfamiliar. When in doubt, eat things that are as close to their natural state as possible.
The social pressures of drinking in the expat community are very real. But consuming alcohol while trying to deal with expat depression can worsen your symptoms. Alcohol can easily become a coping mechanism for depression, but it also makes its symptoms worse. If it’s too difficult to stop completely, see if you can stick to two in a sitting.
Get Some Exercise
When you’re depressed, often the last thing you want to do is get on the treadmill. Yet exercise is the most consistently helpful thing for depression. Just a brief walk around the block can raise your spirits. If you can’t manage that, see if you can put on some music you like and dance to one song. (Even dancing in your chair can help!)
Have Some Fun
If you’re depressed, the idea that you could just “have fun” may seem ridiculous. Depression makes it hard to predict pleasure, so you don’t feel good and don’t even know what would feel good. You may be afraid to try it, worried that doing things that used to be fun but aren’t fun now will mean you don’t have those things anymore. But if you can manage to try something you used to enjoy, it can sometimes be a pick-me-up, and remind you that your depression isn’t permanent. Pick something low-stress: play a card game, pet a dog or cat, look at some art, or read a beloved book. Sometimes, just doing something that used to reliably make you feel better will still make you feel better, even if you can’t see how it will.
Call a Friend
Those who are dealing with expat depression often find that it has to do with isolation and the loss of friendly support. If you can stay in touch with people who supported you at home, do so! Find a time to call them when you’re both awake, or get a group chat going with your faraway friends. If you’ve made new connections in your host country, don’t be afraid to get closer with them a little more quickly than you might at home. Fellow expats—or natives who deal with expats a lot—will understand the need for a shoulder to cry on or a friendly ear.
Moving to a new country involves a lot of stressors. If you’re struggling, see if there are stressors you can reduce or eliminate—most likely those that don’t have directly to do with your move. Can you make your living conditions more comfortable and welcoming? Can you afford to hire someone to do some of your tasks (take the laundry out, cleaning, shopping, etc.)? Are there better boundaries you can safely set at work? Sleep, food, exercise and support will also all help reduce the stress load on your body and mind.
Seek Professional Help
Finally, if any of this feels too overwhelming to handle on your own—and it’s okay if it does!—look into talking to a professional. If you have international health insurance or a local insurance plan, your insurer can help with a list of recommended providers. If you are with the local health care system, you may need to go through your general practitioner or family doctor to get recommendations. There are also therapists who specialize in expat issues and provide Telehealth visits. There’s no shame in needing help and having someone to talk to who understands the issues can sometimes be the biggest help of all.
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