Expat depression is more common than you might think; according to a 2011 study, expats are more than twice as likely to suffer from anxiety and depression than the general population.
Sometimes the onset of symptoms of depression can be delayed. Laura, an expat living in Switzerland, experienced this. "Other than the normal culture shock, I was fine when I moved," she says. "It was a year later when the depression hit, and, in contrast to the low-grade depression I had before, this time it was a serious major depressive episode."
Being in a foreign place, especially when you don't speak the local language, can make it even more difficult to find help. Here are a few tips on how to handle expat depression.
Identifying expat depression
While only a qualified healthcare professional can diagnose clinical depression, here are a few warning signs to look out for:
Loss of interest and pleasure in previously enjoyable activities
Fatigue or lack of energy
Feelings of worthlessness or guilt
Insomnia (being unable to sleep) or hypersomnia (sleeping excessively)
However, it's important to remember that experiencing some or even all of the above symptoms does not necessarily confirm the presence of depression – these are merely signs that further investigation is called for.
Recovering from expat depression
Whether you’re in a state of chronic depression or you just have a bad case of the relocation blues, there are a few things you can do to pave the way for recovery.
Whether you opt to see a professional therapist or counsellor, or just have an honest chat with a trusted friend or family member, it's important to speak up about how you're feeling. There are also many useful online resources, including specialised expat counsellors who tailor their services to expats struggling to adjust. Many of these counsellors offer Skype sessions so they can speak with clients all over the world.
It's also a good idea to visit a doctor for an assessment, to establish whether you're suffering from a chronic condition or are just going through a period of feeling down.
Laura has some advice on how to access mental health care in a foreign country: "I understand that the ability to find a qualified mental health professional varies depending on the country you are in, but the best place to start is your regular doctor. The consulate or embassy of your home country may be able to point you in the right direction, too, particularly if you are having problems finding a therapist who can talk with you in your own language or at least one you speak well."
Be gentle with yourself
One of the biggest stumbling blocks when it comes to moving abroad is idealised expectations. Once you’re there, it can be hard to accept that problems you may have had back home will tend to follow you, and after settling in, the routine reality of day-to-day living that remains can be a downer. Expats should keep in mind that although moving to a new country is an adventure, it’s a tough path to walk down. You may feel angry, sad or frustrated, and that’s understandable. Rather than suppressing these feelings or scolding yourself for being 'ungrateful', allow yourself the time and space to adjust to your new surroundings.
Seek out familiarity
Sometimes even the simplest things can act as a balm when you’re feeling upset, distressed and homesick – your favourite mug from home, for example, or a familiar blanket that you’ve had for years. You can also try looking in the ‘imports’ aisles in local supermarkets for favourite products from your home country or, if that fails, order online or have someone from home put together a care package for you.
Take up a hobby, volunteer or join a club
Inactivity can be a breeding ground for feelings of depression, so instead of staying cocooned in your new house or apartment, force yourself to get out and integrate into your new surroundings – whether that’s through getting a job, volunteering, or joining a club. Laura says, "I think that the key is to combat feelings of loneliness, isolation, boredom, lack of purpose, and homesickness that an expat, especially an accompanying spouse/partner, might feel."
Lastly, and perhaps most importantly, look after yourself. It can be helpful to take note of how you’re feeling day-to-day in a mood journal – you can be as detailed or as brief as you like, and it can also serve as an emotional or even creative outlet. Moving is stressful, so take time out to relax with a good book, enjoy a bubble bath or take a walk.
The good news is that expat depression is often situational and therefore temporary. Once you’ve made a conscious effort to get help and to look after yourself, that grey cloud should soon begin to lift, leaving you to enjoy all that expat life has to offer.