Expats and depression: Interview with an expert

The post on my site which gets the most hits is one I wrote about depression back in February. It wasn’t a long post or a particularly informative one – but what it did say was that depression in expats is common, it’s not something to be ashamed of and it’s something that we should all acknowledge as a very real part of expat life. What the reaction to the post – both the immediate reaction at the time of writing, and the amount of hits that post has had since – told me is that this is a subject that needs a lot more attention.

So I extremely grateful when an expert in this area agreed to be interviewed for this blog, and not only to discuss some of the reasons why expats are so vulnerable to depression but also to help with some advice for those who think they may be affected. Anita Colombara is a mental health specialist with a particular interest in the International Community. Her own background and experience, as well as her training, has helped her set up her on-line counselling service and to be in a great position to offer advice to the globally mobile. I hope many people will read her advice – please share this post if you can because I know, from how many people find my blog by typing in the words expat and depression, that this is a topic more people need to be aware of.

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Anita, thank you for agreeing to this interview. First of all could you tell me a bit about yourself, your background.
I grew up in Washington D.C. with Asian parents. I enjoyed both the American and immigrant experience as I felt part of both and neither worlds at the same time. I also had friends who hailed from every corner of the globe. As an adult, I married an Italian/Ecuadorian who spent summers with family on two different continents. You could say that, since childhood, I’ve been embracing the world, determined to be a global nomad when I grow up.

I’ve had the privilege of visiting and living in over a dozen countries. For four years I lived in Cambodia, gave birth to my second child in Malaysia, and later, enrolled my children in public school in Beijing. Throughout these adventures, I’ve experienced both the joys and challenges of being an expat. I love acquiring new languages, assimilating to new cultures, and feasting on new cuisine. However, I have also struggled with adjustment issues – cultural shock, loneliness, and confusion; with mental health issues – post-partum depression, anxiety, and vicarious trauma; and with relational issues – misunderstandings with locals and colleagues, marital strain, and difficulties parenting my two young children. I’m guessing many of your readers can relate.

How did you come to be working in mental health and why do you think it’s important for the ex-pat community?
I started out as a social worker in the States about 20 years ago. I worked in a variety of settings focusing on issues related to domestic violence, sexual assault, human trafficking and refugee resettlement which I then implemented with my work in Cambodia.

However, during my years in Cambodia, and later in other settings, I saw that ex-pat and humanitarian worker’s needs were being severely neglected. As I mentioned, I’ve struggled living overseas. And I know I’m not alone. I’ve heard numerous accounts from those experiencing trauma, disillusionment, confusion, compassion fatigue, depression, anxiety, loneliness, etc. I’ve also seen too many marriages broken and families strained due to ignoring conflicts rather than addressing them in a healthy way. I saw the vital need for my peers, who live and work internationally, to have access to quality, professional counseling.

When I returned to the US in 2008, I enrolled in the University of Washington School of Social Work, focusing on trauma intervention and therapy.Since graduation, I’ve have been serving as a mental health therapist at a community based agency in Seattle, WA. However, my heart is still with the international community. That is why I founded Remote Access Mental Health. My vision is to see globally mobile people thrive no matter where they are. My mission is to provide on-line professional mental health counselling for this unique population.

Why remote counselling? How would the globally mobile benefit from it?
When I lived in Cambodia, there were few counselling services for ex-pats. The few professional therapists in town were often booked. Moreover, with the ex-pat community being so tight, there was a high probability that the potential client and therapist already knew one another. This made professional boundaries difficult and therapeutic relationships awkward. This is an issue in many locations, not just Cambodia.

Services offered by host or sending agencies have their own set of potential complications. A typical scenario is that of a field staff person being assigned an agency affiliated counselor when supervisors become concerned regarding mental health or other issues in that individual. Many times, since the counselor is employed by the agency, they give their assessment to the supervisor. This is not always a bad thing. However, more often than not, I’ve heard from field staff who have been hurt by their agencies when they felt that client-therapist confidentiality was violated. In some cases, this resulted in the sudden expulsion from the international arena in order to receive “treatment” for unresolved mental health issues, family conflict, moral failure, etc. Individuals and families are left feeling like they’ve failed, betrayed by their employer, further isolated, and sink deeper into disillusionment, depression, or resentment.

With that said, I know a lot of ex-pat individuals and families who would benefit from an unbiased professional who could provide support where they are. With high speed internet service becoming increasingly available, even in the most remote places, this is becoming a possibility. Although in-person counselling may be preferable, video conferencing is a viable alternative given the hectic travel schedules and lack of local services that many expats experience. Professional counselling is now within reach!

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What kind of mental health services do you provide specifically for the globally mobile?
First off, I realize the term “mental health” often turns people away. They automatically assume I’m talking about crazy people with paranoia or are detached from reality. On the contrary, most of the people I work with are completely normal.
In short, I apply the same evidence-based therapeutic approaches that I use with my clients in my in-person practice. I first perform a thorough assessment to determine what the client’s needs, goals, strengths and natural resources, and desired treatment modality are. I then work together with the client to flesh out a treatment plan accordingly. I provide tools to address struggles as well as help create a plan for long term self-care.

The difference with my remote access clients is that I tailor to the unique needs of those who travel or live internationally. I am particularly interested in supporting the globally mobile population, including TCKs and ATCKs, that want to address trauma, panic attacks, anxiety, depression, and stress due to unresolved issues or culture shock and re-entry (reverse culture-shock) adjustment.

What are the signs that expats need to look out for if they think they might be suffering from depression, PTSD or other mental health issues?
Depression is different than sadness and normal life’s lows. It involves intense feelings of despair with little or no relief. It interrupts one’s life, work, relationships, eating, sleeping, and ability to engage in once enjoyable activities. Typical signs of depression are:

  • Loss of interest in relationships or activities you once enjoyed
  • Loss of energy, feeling tired all the time
  • Sleeping more than normal or inability to sleep
  • Change of appetite, overeating or lack of eating
  • Difficultly concentrating or finishing tasks
  • Lack of motivation
  • Lack of personal hygiene
  • Ruminating on negative thoughts
  • Feelings of hopelessness, helplessness, emptiness, apathy, failure
  • Feeling more irritable, short-tempered, angry, aggressive
  • Loathing – overly critical or self and/or others
  • Consuming more alcohol than normal or increased drinking alone
  • Engaging in reckless or unhealthy behavior

PTSD, or Post-Traumatic Stress Disorder, is a condition following a traumatic event that leaves one with intense feelings of fear, anxiety, or loss of control. One may feel trapped in a constant state of danger or in a painful memory. Others may feel unable to “snap out of it” and feel disconnected from others and present reality.

Many of my colleagues engaged in aid and development work experience what is called vicarious or Secondary Traumatic Stress Disorder (STSD). Through repeated or long-term exposure to stories or observations of those suffering from traumatic events, one may develop symptoms similar to PTSD. These symptoms come in three main categories and can arise suddenly, gradually, or re-occur over time:

  1. Re-experiencing the traumatic event:
  • Intrusive, upsetting memories
  • Flashbacks (feeling like the event is happening again)
  • Nightmares
  • Feelings of intense distress
  • Intense physical reactions when reminded of the event (pounding heart, rapid breathing, nausea, vomiting, muscle tension, sweating)

2. Avoidance and numbing:

  • Avoiding activities, places, thoughts, or feelings that remind you of the trauma
  • Inability to remember important aspects of the trauma
  • Loss of interest in activities once enjoyed
  • Feeling detached from others
  • Feeling emotionally numb
  • Lack of motivation
  • Sense of a hopelessness or assuming premature death

3. Increased anxiety and emotional arousal

  • Difficulty falling or staying asleep
  • Irritability or angry outbursts
  • Difficulty concentrating
  • Hypervigilance (on constant “red alert”)
  • Feeling jumpy and easily startled

Before reaching the point of needing to seek help from a counsellor like yourself, what can we do to help ourselves if we do find we are in this situation?
Self-care, self-care, self-care! I know too many good hearted people who are constantly looking out for others but neglecting to take care of themselves. Development workers, missionaries, and those on the front end of disaster relief for sure! The most important thing is to develop healthy habits and a personal Wellness Action Plan (I call these WAP for short). The second most important thing is follow through with your plan.

Your WAP should be comprehensive, including all aspects of your wellbeing – physical, emotional, recreational, relational, financial, spiritual, etc.

Your WAP should also be specific. It’s not enough to say, “I will exercise regularly.” What kind of exercise? How often? What time of the day? Where? This is especially important for the globally mobile since settings change and new locations may not accommodate to previous routines.

Lastly, your WAP should be realistic. For example, there is no point making a plan to exercise everyday if you know you’ll be on a plane two days out of the week. Make your plan attainable. Otherwise, you will find yourself giving up in frustration for not sticking to it.

Oh, and be kind to yourself. I tend to work with a lot of driven folks who are hard on themselves. Give yourself a break once in a while.

At what point would you recommend we need to seek further help from a professional such as yourself?
Negative feelings such as sadness, frustration, or stress are normal. But when they become overwhelming and interrupt daily function or lead to relational problems, it is important to seek professional help.

With that said, many people wait too long. It doesn’t hurt to seek professional help sooner than later. After all, even the healthiest among us receive physical check-ups. That is why I love assisting people in their personal WAPs to promote long-term wellbeing.

How can we support others if we start to recognize some of the symptoms of depression in them? In particular, how can we help our partners?
Often times, when a loved one is struggling, we may feel distraught or frustrated ourselves. It’s easy to go into advice giving mode or to withdraw due to feeling at a loss regarding how to help. However, the most important thing is your presence – being with them even if it just means holding them, crying with them, or sitting beside them in silence. Validate feelings instead of try to reason with them. Watch out for minimizing their pain, blaming and shaming. Educate yourself on the disorder so that you can better understand your partner, but be careful not to lecture them.

If your partner is reluctant to seek professional help, that does not mean you cannot seek help for yourself. A good therapist will be able to guide you through the process of assisting a loved one struggling with mental health.

Do you have any particular advice for children who might be showing signs of depression? How would this manifest in them differently than in adults?
The answer to this important question deserves an article itself. In short, children often act out what they cannot put into words. Often times, symptoms of depression, anxiety or PTSD in children are misdiagnosed as ADHD. Children often manifest troubling behavior such as difficulty focusing, defiance, difficultly regulating their emotions, hyperactivity, inability to calm down when aroused, lack of boundaries or risky behavior. They may engage in violent or self-harming behavior such as cutting themselves or hitting their head against a wall. Other children, may retreat, fall silent, even becoming mute. This is often the case for someone with PTSD. Again, disturbing behavior is a sign of a more significant, underlying issue that needs to be addressed.

Anita Colombara MSW, LSWAIC
Anita is a licensed Mental Health Professional by the State of Washington. After spending many years in Asia, she currently resides in Seattle, WA where she lives with her husband and two children and enjoys the natural beauty of the Pacific Northwest. She is the founder of Remote Access Mental Health LCC, providing on-line counseling for the globally mobile. www.remoteaccessmentalhealth.com

If you are or think you may be suffering from depression, or are vulnerable to depression, then please do talk to someone close to you and/or consider seeking help. As well as counsellors like Anita, charities like MIND can also offer online support and advice. I list other forms of support in my book the Expat Partner’s Survival Guide.

Photo credits: woman with key: Mary Lock at https://www.flickr.com/photos/wijen/; woman at table: Adi Sujiwo at https://www.flickr.com/photos/wijen/

The Reality of Life as an Expat Partner

I don’t know if there is something in the water at the moment or whether I am just noticing more of these kind of posts the more blogs I follow, but I opened my lap-top to two very similar stories from very different “trailing spouses” this morning.

The first came from a relatively new expat, thesmult, an Australian living with her husband in Indonesia. Having arrived recently, thesmult has been struggling with her new identity and how to find her way in this unknown world. And by unknown I don’t mean Indonesia, rather the life of being the “trailing” partner. As she says in her post Who Am I Now?:

We had discussed the challenges faced when residing in another country and particularly a developing country such as Indonesia including language barriers, expectations of women in a Muslim country, security concerns and so on but we never discussed how life would change so significantly for me as the stay at home spouse.

It is for people such as thesmult that I initially wrote the Expat Partner’s Survival Guide. Living in St Lucia, I met a lot of women (and a very few men) in exactly the same place as thesmult. Women who had probably spent the six months prior to the posting worrying about houses and schools and packing and saying goodbye to people…but who had never really thought about what their life would be like for THEM when the dust settled at the other end. As thesmult also says in her post, the first few weeks (the “honeymoon” period) can certainly be exhilirating. But then reality hits and

you realise that this is real life and then I started dwelling on my frustrations. I was bored, lacked structure to my day, had no social outlets, felt stuck at home.

I urge you to visit thesmult’s website, follow her and comment. I feel really strongly that the more you realise others are going through the same thing, or have been through the same thing, the easier it can be. Virtual friends made over the internet through blogging or Facebook forums might not be quite as good as the real thing – but they can certainly make a huge difference.

The second post I read this morning that made me really stop and think was from a seasoned expat who blogs at the fantastically named Africa Expat Wives Club. Based in Kenya, this expat wife is at the other end of the expat partner scale from thesmult as she’s been overseas for 16 years. And yet, she still gets lonely – as her post Loneliness in Expat Life Sundays Suck – relays.

Again, I can totally relate to her when she says:

Sundays are the real bone of contention.  Sundays can drag and if your other half is away on business, then you can literally find yourself counting down the hours. As an expat, you are obviously nowhere near your home turf, so there’s no family member who might step forth from the breech and provide a safe haven for you and your bickering, antsy offspring for 12 or 24 hours. There are no close friends from way back to pick up the phone and chat to. It’s just you and the kids bouncing off the walls for 12 hours straight and honestly, that can be hell.  Sundays are when you feel most trapped.

Oh yes. Sunday’s (and to be honest, some Saturdays) were difficult in St Lucia. Everyone assumed we would be at the beach every weekend – and to be fair we often were, or at least at the pool of one of the local hotels. But doing the same thing EVERY weekend can get pretty tedious and there really wasn’t much else to do on that small island. We absolutely revelled in the parks and soft-play and museums and organised activities when we returned to the UK.

The Africa Expat Wives Club post also refers to the dreaded 9 (plus) week summer holiday – something which I know my own poor mother must have found impossible when we were growing up in the Philippines, and which I have now learnt to avoid by leaving the country where you are posted for as much of those 9 (plus) weeks as possible. I have also realised that one thing you DON’T do is move out to a new country at the start of, or even in the middle of, the summer. Things are made even worse when the children haven’t yet had the chance to make friends through school (or pre-school) and all their toys are still somewhere on the high seas….

So two very honest but I think realistic views of Expat life. Like some of my other posts about the reality of being an expat partner (including this one on depression and this one on relationships) I think these are important subjects that need to be shared.

However I do feel I have been writing too much about the bad side of expat life recently. I promise my next post will be a positive one 🙂

Facebook envy – or the self-perpetuating circle of how we present expat life to the world.

This morning I read a news story about a women in Dubai who never existed. Or rather, she did exist – but she wasn’t the woman in the photos. Leah Palmer was, according to her Facebook page and other social media outlets, a “fun-loving 20-something Briton currently living the high-life in Dubai”. Except she wasn’t, she was Ruth Palmer and her identity had been stolen.

We can only contemplate what made someone do this, but it led me to think about Facebook and expat life – and the story that we chose to present to the rest of the world when we move overseas. I realise we’re not all going to the lengths of actually stealing someone else’s identity, but how honest are we when we put up our photos and update our statuses? What version of the truth do we chose to show? Do we always portray the whole story?

Over the past few years, as Facebook has evolved, I have watched the lives of several expat friends as they moved from one country to another, settled in, started work or got the children off to school. I have seen photos of beaches and parties, cocktails and safaris. And before I go on I will admit that I, too, am guilty of presenting a certain image to the world of our lives abroad. Who wants to see me lugging shopping home when you could get a picture of sunset from our balcony?

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I realise that everyone does this to some extent, wherever they are in the world. But I do think it’s amplified when you move overseas, particularly to a either a renowned “exotic” location like Singapore, Dubai or the Caribbean, or to somewhere a lot of people think they would like to live like New York or Hong Kong. So why do expats tend to focus so much on the “good-side” of life? Is it because we’re trying to prove to our friends that the life we’re living is actually as good as everyone expects it to be? Are we trying to prove it to ourselves?

Having moved to another country several times in my life, I know life as an expat ISN’T one long beach. I explore culture shock, depression and unrealistic expectations in The Expat Partner’s Survival Guide – with the emphasis on being prepared for life not being as great as you think it might be. But perhaps part of the reason why we think life IS going to be all about the party is because that’s what we’re seeing on other people’s FB pages. And because that’s what we think others are going to expect, we do the same – posting the pictures of the days out, discussing the parties and the great restaurants but neglecting to mention the more mundane aspects of life such as the housework, the early mornings or the lack of decent shopping. Or even the downright horrible aspects of life such as the shocking poverty, the fear of crime or the awful loneliness. Is it a self-perpetuating circle? Are we all adding to it?

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One thing I have noticed is that there is a law of ever-diminishing returns at play here: the longer someone lives somewhere, the more mundane their lives appear to become. It’s impossible to keep up the image of an entirely glamourous life forever, no-one is going to believe that you don’t EVER have a bad-hair day or have to sit in a traffic jam. But the opposite to this is that early posts do tend to only be about how brilliant everything is, as if to prove to everyone (and themselves) that the decision to move is the right one. These early posts tend to co-incide with the “honeymoon” period of culture shock, when you probably do love everything about your new home and can’t wait to put up the photos to show everyone what an amazing place you have moved to.

The problems come when the initial period of excitement is over, when real-life starts to kick in and when you’ve probably bored everyone back home to tears with the pictures of you diving in the azure ocean or sipping cocktails with a beautiful setting sun behind you. This is the time to be more honest, to write about the not-so-great times as well as the fun. Of course you don’t have to tell everyone everything, I’m not advocating washing all of your dirty laundry in public. But be real, be truthful and make sure everyone whose only view of you is your “public” Facebook self realise that life overseas can be just as hard (and often harder) as life at home. Let’s break the circle and help our future selves prepare for their new life by understanding the reality.

Hopefully, this will stop people assuming that even though you’re moving to the Caribbean, life will not be one long holiday. Although, those watermelon daiquiris at sunset will still be welcome!

Do you agree? How honest are you in your portrayal of life overseas? And do you think this changes the longer you live somewhere?

For more on the reality of life overseas please also see my posts on expats and depression and expat relationships.

(Jakarta Slum photograph By Jonathan McIntosh (Own work) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)%5D, via Wikimedia Commons)

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Expat Relationships

The other day I asked for some last-minute help with information about relationships to go into the Survival Guide. I thought I had actually finished the book, I’d read it and re-read it, had it edited and even sent it to the proof-reader for a final going over. I’m still hoping to meet my self-set deadline of April for publication. But out of the blue, whilst out running (which is when most of my revelations come to me) I realised it wasn’t done. I needed more on how couples cope when they move abroad together.

I hadn’t totally ignored this important aspect of expat life. Or at least of expat life for those of you going as a couple or a family. When I talk about relationships in this context, I am really talking about the relationship with your partner – although I do touch on the family dynamic as another feature of life that shifts when you take on an overseas move. The interaction between you and your partner is interwoven right through the book, including making sure it IS a partnership right from the start (eg it should be a joint decision that you go), what happens if you are so bored you want to leave, and how important it is to talk to your partner if you think you are descending into depression.

But there still felt like there was a gap. I think  the affect an overseas move has on your relationship with your partner  is something that doesn’t get discussed enough. Just like a post I did about depression and the expat, this is a topic that can get a bit swept under the carpet. Why? Perhaps because it’s hard to admit that the exciting new life we’re all leading or planning to lead isn’t all sweetness and light. Or maybe because it’s hard to know who to talk to about it. Or perhaps we don’t even want to admit there is a problem to ourselves.

Of course, relationship problems can happen anywhere, to anyone – you don’t have to move half way around the world to start arguing with your husband. But just like with depression, there are things that happen when you do take the leap into expat life that are more likely to put pressure on your partnership. Not least your own loss of identity (if you are the non-working partner), the possible drop in income of only having one wage, the lack of a support network, the new need to be overly-reliant on your partner and just the day-to-day pressures (finding the shops, security fears, worrying about the children etc) that come with moving to another country.

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Luckily the very interesting responses to my survey showed me that it wasn’t by any means all bad news. In fact if anything there was a lot more positive responses than negative – and the clearest message that came out in the answers was that an expat move was likely to make your relationship stronger rather than push you apart. Sharing new experiences, spending more time together as a family, having to turn to each other because there is no-one else – many people told me these brought them closer and made their relationship a more robust one than the opposite. To directly quote one of my respondents: “All the moving around definitely brought us closer together. Even if there were occasional problems, by solving them we grew stronger. He’s my best friend now”. Another one even told me the move had saved her marriage – a planned split was put on hold when they found out he was being posted abroad and now they are not only still together but a lot happier than they had been.

But we can’t ignore the fact that whilst these positive stories are in the majority (or at least they were among those who responded to my request for your experiences), there are still others whose relationship does break down thanks to the particular pressures of moving and living in another place. I have seen first hand a number of couples split up for various reasons. Some I suspect wouldn’t have lasted wherever in the world they lived. But others were caused by bored partners whose spouses worked long hours in the office, affairs made easier due to the particular culture they were living in, the disparity between the two completely different lives being led or just simply an escalation in otherwise endurable problems caused by the massive changes.

So what happens in these circumstances? It’s always sad when a relationship breaks down, but being overseas can cause more complications than normal. What happens if one wants to return but the other doesn’t? Or if the working half of the partnership is tied into a contract which means they have to stay? What about if there are children involved? What are the legal considerations if you are not in your home jurisdiction? What about if one of the couple is from the country where you are living, but the other isn’t?

These are all issues that you might need to think through BEFORE you move, rather than when things start to go wrong. And if you think your relationship could be severely tested by the move, consider counselling either before you go or look for online help (Relate in the UK offers telephone, email and ‘live chat’ counselling) that you can carry on with from your new home.  I know it’s not a pleasant thing to have to plan for, but knowing what I do about the affect an overseas move can have on a couple I still think it’s worth at least considering what you would do if you and your partner did split up.  There is so much more I could say about this subject (and there’s now a whole chapter on it in the Survival Guide) but I don’t want to labour the point. Subjects like this are difficult to talk about and sometimes we just need to open it up as a discussion point just to make people aware of the issues. Hopefully this is not something you will ever need to worry about. But if you think it might be, or if you know it already is,do you know what you would do? It’s better to be prepared for something that may never happen than find yourself floundering when it’s too late.

How has moving abroad affected the relationship with your partner? What advice would you give to others, especially those that might be having problems?

 

photo credit: couple via photopin (license)

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Depression and expat life: something we don’t talk about enough

I wasn’t going to write a post today. I have a busy week with school assemblies and meetings and work to catch up on. I’m trying to do a final read-through of the Survival Guide before sending it to the proof-reader. The washing needs doing….there’s mouths to feed…you know the score.

But as I scrolled through my Facebook feed this morning, something caught my eye. One of my online ex-expat friends Nicola had posted something about today being “time to talk about mental health” with a supporting campaign called “Take 5“. As I read the post,  I wondered how many expats suffered from depression or other mental health issues – and how many of them (us) ever talk about it.

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According to the Take 5 campaign, one in four of us will suffer from some sort of mental health issue every year. Now, I am no expert on this but knowing what I do about moving and living overseas, I can’t believe that already fairly shocking figure isn’t even higher amongst expats. Some of the sort of things that can lead to depression or mental health issues – isolation, loneliness, change – are all part and parcel of life for many expats, especially those who are newly arrived. And for the partners, this is often magnified by their other half going to work and immediately finding a role, colleagues, friends – while their accompanying spouses stay at home and need to work all of this out for themselves.

But how many people ever admit they have a problem? Who would you admit it to, anyway? Your partner? Many of us don’t want to worry him or her, as they try and get their head around a new job. Or they’re so desperate for you to be happy that you don’t want to upset them.

Friends? You may be lucky and know one or two people when you first move overseas – but even then, they are unlikely to be someone you feel close enough to do talk about things like your mental health. At least not straight away.

Family? Once a week you have those Skype or Facetime discussions. Your mum wants to see the kids and she wants that tour of the house, loves looking at the tropical foliage in the garden or the city view from the upstairs window. How do you start a conversation with her about how down you’ve been feeling?

Professionals? In some countries this will be possible. In others, it will be a lot harder. It all depends on what is available locally.

This is a difficult subject to talk about – but sometimes that is all we need. Someone to discuss it with. I don’t have any magic answers here except to assure you, if you think you are depressed or do have other mental health issues, that this shouldn’t be something to feel ashamed of. And that you shouldn’t be afraid to seek help. DO talk to your partner – he or she needs to know and it’s better they hear about it early on rather than when it’s gone too far. If you don’t have any local friends you can trust enough to open up to, what about online forums? Mumsnet (as an example) will always have a sympathetic ear – whatever time of the day or night it is. There are also specialist expat coaches or counsellors who work over Skype or via email – often they will have been expats themselves and will have a really good idea about what you are going through.

Moving is said to be one of the most stressful things you can do. Moving overseas can be even harder. Being somewhere new, where you don’t know anything, can’t get around easily, have no routine to your day and possibly don’t even speak the local language, it’s not surprising if you don’t feel your normal self.  For most expats, things will get better as they settle in, get to know more people and start to get some routine back into their lives. For others, it make take a bit longer or they may need to get professional help. But for all of you, just remember to go easy on yourselves. This is a big life change – don’t expect it all to be sundowners and pool loungers. And don’t forget to talk!

 

Have you found it harder than your thought to settle in to expat life? What advice would you give to others, especially those who have just moved or are about to move overseas? Any tips for dealing with depression or low mood generally, even if you are not or have never been an expat?

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