A Series on Expat Depression #3: When and Why does it happen?

In my post last week I looked at the concept of “expat” depression and whether it could be classified in a division of its own (in the same way as, for example, postnatal depression). Whilst the jury is still out on this, I did find it a useful exercise to help me reflect on why we expats are more susceptible to these feelings than many others. Certainly what I have found through my research for these posts is that sometimes the depression experienced by expats is a one-off, caused basically by the change in circumstances and the associated issues that go with the relocation; other times these changes reignite underlying problems so that those who have suffered in the past find their symptoms return when they first move abroad.

Whichever one though, my discussions on the issue with counsellor Anita Colombara has led me to conclude that depression is depression and it is always worthwhile trying to do something about it (whether by self-help methods or seeking professional help) sooner rather than later.

Today I want to move on and start to look at some real life examples of how depression has affected expats. I am going to start by looking at the when and the why. The where is in there too but it less relevant – after all, depression is something that can happen to expats wherever they are in the world.

I realised pretty quickly when I started breaking down the answers that there were a lot of common themes in responses to the survey I put together for this series. So taking each theme in turn, below is a list of some of the most common reasons given for triggering expat depression. Hopefully by recognising possible danger points in the expat cycle, I can help you be more prepared. In later posts I will look at some of the ways people have dealt with their depression in some of these situations.

Moving somewhere new

“People tend to underestimate how upsetting a move, and moreso an international move, can be. Some ex-pats chalk it up as normal culture shock. Yes, that could be so. But even seemingly small life changes can trigger  more profound depression or anxiety issues.” Anita Colombara

Of course, moving to a new place doesn’t only happen to expats. Many people have moved across town to a new house, to a neighbouring city with a new job, even to the other side of the country. But becoming an expat is something different altogether – you are not just letting go of the familiarity of your old home and neighbours, you are moving away from the cosiness of a complete culture. And very often you are stepping completely into the unknown.

Whilst the relocation is often just the start of things, many find that the early days in a new country is enough in itself to trigger their first bout of depression. Here are a couple of people talking about these changes:

“When I first moved over to the UK with my husband, it seemed like nothing was familiar. And why would it be? We were in a different country from my home country. I loved aspects of it…but then there were those certain times when I was feeling a bit vulnerable and needed something – anything – that felt familiar” Erin.

“I know….that depression can be triggered by lots of changes and their associated stressors or stresses. Moving to a foreign country, away from family and friends and any support system you might have is really exposing yourself….” Robyn.

But as difficult as it may be, the move alone isn’t usually what triggers the depression. Instead, it is usually a combination of those factors that so many of us recognise as being part and parcel of expat life – starting with that old chestnut:

Loneliness/isolation

The expat “bubble”?

I suspect many of us underestimate how isolated you can feel when you first move somewhere new. We probably think we can make it through the first few days/weeks/months (possibly even years) without close companions, but in fact as much as anything it is the daily interactions with familiar faces as much as the close friends and family that help us cope.

You often lose this interaction when you move – maybe you stop working, or you don’t go to the school gates every day, or you don’t shop in the same shops on a regular basis. It may take time to build these sort of regular meetings up, you may never be able to do it. And although social media is a godsend to many of us, it is never truly a substitute for proper, human, face-to-face contact.

People mentioned loneliness because they weren’t working, they didn’t have children, they did have children, they couldn’t find ways to meet people….loneliness affects people in so many different ways and for so many different reasons, which is why it is hard to say exactly when and why it happens. Here are a couple of examples, starting with more from Erin:

“With my husband working long and crazy shifts, I felt isolated and alone. And because we had moved two months before the twins were born, I didn’t really have a good local friend to lean on. I was able to Skype home but if anything, it just made me feel more depressed. I wanted to physically hang out with those people. I wanted those people to go out with me or look after the twins while I took a break. Skype can do many things – but it can’t do that”.

And, from Amanda:

“…my partner was working and I wasn’t so I was spending a lot of time alone. Living in a small town made it hard to meet people, as most people were working during the day. The lack of daylight in the winter didn’t help as it made it difficult to get out of the house much”.

Living in a difficult place/cultural issues
Not all expat assignments are equal – some, without a doubt, are going to be more challenging than others. Although I should add that what one person finds hard is another’s easy ride. A lot of people think a Caribbean island would be a dream posting. I would tell them otherwise!

But even so, there are some places and some situations which undoubtedly do put extra pressure on. Alyson told me about the “cultural differences” that made running a business in Kenya quite a “challenge”; Sarah described living somewhere that she couldn’t drive (by law) or walk alone (which attracted negative attention). Talking about her time in India, Robyn told me:

“I was in an overcrowded, noisy, hot, dusty, culturally shocking place, trying to find my feet without any safety net and it wasn’t long before I felt some of the symptoms of depression start to take hold”.

India streelife – can be quite a culture shock to many.

Lack of job/role/purpose and boredom

“It started because I was a trailing spouse – I had a successful career of my own, but I gave it up to come abroad….” – Susanna

“After both my move to Africa and my move to Asia, I experienced feelings close to depression. My entire four years in Africa were an emotional roller coaster. The first three I was a stay-at-home mom with full-time staff, which left virtually “nothing” for me to do”- Mary.

“On my last island there was little to do. Seriously little to do. It’s beautiful for a holiday but to live there it’s difficult. Most of the wives ended up leaving to return back to the UK. We did two years but I felt like I was going mad from boredom” – “Princess Banana Hammock”.

Closely related to isolation, many people stated that one of their main problems was having no purpose in their new life. This is particularly common for the non-working “trailing” partner, who gets left at home when their spouse walks out the door to work. I think it is also a lot harder for those who don’t have children or whose children have left home. No job, no social life, often not even a real role in the house – domestic staff being such a common part of expat life for many.

I have often likened life abroad to that of being a 1950’s housewife – certainly, this is how it feels on the days when my main mission is to sit at home and wait for the electrician to turn up. And whilst there is nothing wrong with this type of life, you can see how demoralising it can become for those of us used to, well, a bit “more”.

While finding a job (paid or unpaid) is high on the list of many new expat partners, this can often be impossible due to lack of opportunity, visa restrictions, language difficulties…any of a number of things can impede your path to greater fulfilment and lead to a new sense of failure when you find you not only can’t find a role for yourself in yournew country, but you also can’t earn an independent income.

Loss of control
Another common reason for finding life abroad hard is a feeling that you have lost control. Again, this is probably more common to the partners of those who are working – the ones who have to call their spouse’s office if they need something done in the house or whose visa relies on their partner’s job or who can’t open a bank account in their own name. You may not get to choose your house, your furniture, even the school your children go to. Another major reason for this feeling of losing control is that their very being in that country relies on their partner’s job – and often on the plans of their partner’s employer. It’s hard to plan a life when you don’t know if you will still be living in your current location a year, even six months from now.

Life event
Of course not all depression that that develops among expats is based solely on their actual expat experience. Often it is triggered by the sort of thing that could happen to anyone, anywhere. But it is the fact that you are not in your home surroundings with familiar faces around you that can turn a distressing situation into one that plunges you very low. Anything from a major traumatic occurrence (a car crash, being robbed, an illness or death of a close relative) to something basically joyful but stressful like the birth of a new baby can set you off. This is especially true if you are already susceptible to low moods or have suffered from depression in the past. And of course, what is potentially a difficult situation is made harder by being a long way from your usual support networks.

Even something like a minor car crash can have a traumatic effect when you are living far from your usual support networks

Mary gave an example of how a series of events can really spiral out of control. After describing how her daughter basically shut down following a move to China, she:

“developed health issues….then the vet here literally killed our beloved cat that we’d brought with us and then the company stopped paying us for three months so we were living on savings. That’s when I hit bottom….”

Whilst most of these things (bar her daughter’s reaction to their move) could have happened anywhere, it was the fact that these events were combined with their move to a new environment, and the accompanying culture shock of the move, that caused the downward spiral. Shockingly, Mary admitted in her response to the survey that she had seriously considered suicide at this point; luckily, just giving herself this control over her own destiny helped her to “refocus” and she now says she is feeling a lot “better”.

I urge anyone who feels like this to seek professional help as soon as possible.

Repatriation
Finally, I wanted to mention something that comes up over and over again in any discussion on expat depression, and that is going home again.

Many people underestimate quite how hard this can be – and I suspect that it is often this underestimation that partially at least leads to these feelings. Why would it be hard – you’re just going back to that place where you were happy and had friends and family around you, right? Well, sadly, not – what often happens is that whilst your home and those who live there hasn’t changed, you have. And this disconnect between what you think will be waiting for you when you return and the reality can often be what causes the problem.

Reasons for moving home varied, with some people having more control over it than others. But even those that chose to return often found their lives a lot harder than they realised it would be –

This from someone identifying themselves simply as “a trailing spouse”:

“When I moved back to my home country employment was difficult and, although highly skilled, I was unable to find work. My resume, which showed frequent moves, “outed” me immediately as “someone not worth investing time in”….my oldest child had a very bad mismatch with his teacher at school, my spouse’s job was long hours….I hated it. HATED it.”

So from first moving overseas to moving back home again, there are many flashpoints in the expat cycle that we need to be aware of in tackling the issue of depression. I am sure there are many, many more reasons for why someone might be affected but these are the most common ones given to me.

Next week I want to look at how depression manifests itself, the reaction people had – hopefully all things that can help you recognise these symptoms in yourself.

Can you relate to any of these? Or do you have other circumstances to share? Please add your comments below – I want this series to be a starting point for further discussion as much as anything. I am not the expert – but I am giving you the space and the place to bring your experience to share with others who might be going through the same thing.

Photo credits: The Expat Bubble – David Ingram;  India street life: David Sanchini;  Car crash – Pat Joyce