The 4 Most Common Mental Health Concerns While Living Abroad

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The 4 Most Common Mental Health Concerns While Living Abroad

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Are you looking for the most common mental health concerns while living abroad? Then you came to the right place. Below, are the four of the most common mental health concerns experienced by expats. You’ll also learn what helps with each of the concerns. These tips are helpful for both expats and those considering a move abroad. 


Summary:
In this article, you will learn about common mental health concerns for expats. We will discuss loneliness, burnout, culture shock, and prior mental health concerns. 


We will explore causes of loneliness and coping strategies for loneliness. You’ll be able to differentiate expat burnout and work-related burnout. We’ll discuss strategies for burnout. 


You’ll learn about culture shock and the stages of culture shock. Lastly, pre-existing mental health conditions will be discussed. We will talk about how to prepare for a move if you have a pre-existing mental health condition. 


1. Loneliness
2. Burnout 
3. Culture Shock 
4. Pre-existing Mental Health Conditions

1. Loneliness

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Loneliness is a common concern for expats around the world. In my experience, loneliness can feel multi-layered. It can crop up from not knowing anyone when you first move to a new country. But, it might also arise from feeling disconnected from the new culture.


Personally, I experienced lonliness after moving to Zambia. Feelings of missing my home country, my friends, my family bubble up. I can’t count the number of times I’ve reached for the phone to call my mom. Only to stop mid-reach, realizing that it is the middle of the night for her. This causes waves of homesickness to roll over me.


Homesickness
A 2020 research article lists homesickness as an overlooked concern for expats, (1). You may think that homesickness only applies to kids who are away from home at summer camp. In reality, the concept goes much deeper. Oxford Languages define homesickness as “a feeling of longing for one’s home during a period of absence from it,” (2). 


The sense of longing is real. You find yourself thinking, “If only, I had Amazon…” “If only, dried cranberries were available…” “If only the gas station was not out of fuel….again….”


Because of the connotations of the word, “homesick,” we are afraid to admit that we miss our home country. We don’t want others to think less of us because of homesickness. This is especially true if people already questioned your decision to move overseas. You don’t bring up the fact that you miss home for fear that you’ll hear “I told you so” responses.


Relationships 
Living overseas can bring about feelings of loneliness in relationships. This can pertain to both romantic relationships and friendships.

Friendships
You don’t know anyone in your new country at the beginning and it feels like you are starting from scratch. You undergo a big stressor (the move) and may have little social support in your new home. We never learn in school the best ways to make new friends. In reality, it takes time to form new relationships. 


I once met a fellow expat who had a very hard time getting close to other expats because “expats always leave.” Building friendships takes a lot of time and effort. It is frustrating when after all that effort the people you love, move away. 


But, remember that it is always worth having a relationship. None of us can guarantee how long we will be around. If we wanted to have zero chance of getting hurt, then we would never let anyone into our lives. It takes courage to be open to friendships. 


Romantic Relationships 
If you have a spouse/partner, you may find moving hard on your relationship. You have to adapt to new jobs, routines, and/or living spaces. Your family has to develop a “new normal.” 
If you are single, then you may have to adapt to a new dating culture. It may be difficult to continue romantic relationships because of frequent moves. For example, if you decide to move on to another country, your partner may not want to move with you. 


What Helps: 

1. Build a Community of Support-
Make a conscious effort to make friends in your new country. Is there an activity or hobby that you could try? Join a club or organization and try to meet others with similar interests. 


I made friends in a variety of ways after moving. I joined language classes, yoga classes, and a church after the move. These settings allowed for many friendships to materialize organically. I’ve also met people through Facebook. There was a women’s expat Facebook group that met in person at a coffee shop nearby. The first time I went I was really nervous, but I ended up meeting 3-4 women that I still hang out with today. The important thing is to not be afraid to try something new. 


If you get stuck, ask others how they made friends when they first moved. You can’t have friendships without putting in the effort. Be the first one to invite someone to your house or out to dinner. Keep in mind that you may not click with each person that you meet. Don’t give up if you don’t find a friend group right away.


2. Stay in Touch With Friends/Family Back Home-

Don’t neglect connections in your home country. Platforms such as Zoom, Facetime, and WhatsApp make it easy to connect with people far away for free. Find a time that works for both of you even with the time change. 


3. Be Honest About How You Feel-

Be open and vulnerable with others. Tell your friends and family members when you are feeling lonely. Change only begins when we are vulnerable about how we are feeling. 2. Burnout

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Burnout is “physical or mental collapse caused by overwork or stress,” (3). Expats can experience both work-related burnout and expat burnout. 


Work-Related Burnout 


It is easy for work-related burnout to happen overseas. This is especially true if you moved for your job. It can be tempting to put everything into your job in your new country. You may put in long hours and take more projects while neglecting rest. 


You don’t build a life outside work. As the stress increases, you experience a new level of exhaustion. You begin to dread going into work before the day even begins. When you accomplish something, you feel that you don’t care. Your levels of criticalness and cynicism rise. These are the signs of work-related burnout. 


Expat Burnout 
For more information on “expat burnout,” read this article. Expat burnout is burnout that arises from challenges related to moving /living overseas. Over time the stressors related to living in a foreign country begin to build. This chronic buildup can lead to a state of burnout. 


What helps: 

    • Take Breaks

Taking breaks from work betters mental health. Set definitive time periods where you aren’t working and/or that you aren’t available to others. You can also set an automated email reply, (ex. I respond to emails at 8 am and 4 pm daily to set boundaries). 

    • Develop Hobbies

Grow a life outside of work. It can be easy to slide into the “work is life” mentality, but this misses out on the fuller picture. You won’t enjoy life more if you don’t take the time to enjoy life.  


Engage in your interests or hobbies. If you find that your hobbies keep getting pushed to the side, set a reminder on your calendar. Set aside specific time for the hobbies.


If there isn’t a specific hobby or interest that you love, try new things. Start by googling hobbies and pick out one or two that interest you. Notice how you feel after engaging in the hobbies. 

    • Get Help

If you are feeling burnt out and it does not get better with rest, seek professional help. Make it a priority to see a mental health professional and/or a doctor. Work on changing your lifestyle to form a healthier balance. 

3. Culture Shock 
Culture Shock tops the list of mental health concerns for many expats. Culture Shock is “The feeling of disorientation experienced by someone when they are suddenly subjected to an unfamiliar culture, way of life, or set of attitudes,” (4). When you move to a distant place with a different culture, it is a jolt.

There is not a particular way to avoid culture shock. Rather, it is important to recognize it. 
There are four stages of culture shock: honeymoon stage, frustration stage, adjustment stage, and acceptance stage, (5). The honeymoon stage is where everything is still fresh. You find yourself loving and appreciating all the cultural differences. You try new foods, begin to learn a new language and make new friends. It may seem that moving was the best decision you have ever made at this point. 
Slowly, you move into the frustration stage. At this point, small things begin to annoy you. It becomes tiring not to know the language. The public transport system that was once felt endearing suddenly feels overwhelming. You begin to want to return home. 


You move next into the adjustment stage. Slowly, you make adjustments to the new culture. You are driving one day and realize that you haven’t checked your GPS once. You begin conversing in the local language without thinking. You move to the next stage: acceptance. 
The final stage of culture shock is acceptance. Over time, you gain an appreciation of and understanding of the culture. You begin to think in less black and white terms about the new country. You realize that things are not right or wrong, but rather different, (5). 


What helps: 

    • Expect Culture Shock 

If possible, gain an awareness of culture shock before you move. Read books and articles about culture shock. Have a plan ready for what you should do when you begin to experience culture shock. 

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    • Make a List of Things You Love About the New Culture 

When you are in the middle of a struggle, it is difficult to remember things you enjoy about the culture. In Zanzibar, I got dengue fever. For more details on this story, read this article. 
In the midst of being sick, I began to find everything about the culture annoying. After I recovered, it took a while to rediscover my love of the country. Doing the things that I initially loved, such as going to the beach and drinking spiced coffee, helped. 

    • Avoid Comparisons and Practice Radical Acceptance 

Things are not necessarily right or wrong when it comes to culture, (there are of course some notable exceptions). Generally, things are just different. Avoid comparing everything to your home country. 
Radical acceptance means that you accept how things are instead of how you wish they would be. Often, we spend a lot of time and energy trying to change reality. Instead, accepting things we can’t change is also a healthy part of life. 4. Pre-existing Mental Health Conditions 

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Mental health concerns will not disappear with a move. None of us can move away from our problems. Moving to another country will not “fix” any of the mental health issues that you were/are having. 
Depending on where you moved, there may be fewer mental health resources than before. It’s important to research options prior to moving. Consider using online counseling resources.


What helps: 

    • Prepare Ahead of Time

Make a plan for addressing mental health with mental health professionals before moving. Decide what you will do if the current plan does not work or if you need to make adjustments. Find mental health resources in the country that you are moving to. If possible, call and learn more information about the resources. 

    • Admit When You Need More Help 

If your plan does not work, then admit that you need more help. If you need more mental health resources than are available, be honest with yourself. Consider moving back home for at least a limited period to get the necessary treatment. 


Conclusion
There are special considerations to make when moving abroad. Maybe you are considering a move abroad and want to consider how it may affect your mental health. Or perhaps, you are already abroad and mental health concerns have cropped up that you did not expect. 


Loneliness, burnout, culture shock, and pre-existing mental health issues are four common expat mental health concerns. Make a plan that puts your mental health first. What have I missed? What helps you with mental health as an expat? Be sure to comment below. 

    1. https://journals.sagepub.com/doi/full/10.1177/2397002220952735
    2. https://www.lexico.com/definition/homesickness
    3. https://www.lexico.com/definition/burnout
    4. https://www.lexico.com/definition/culture_shock
    5. https://medium.com/global-perspectives/the-4-stages-of-culture-shock-a79957726164

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I write about expatriate mental health and provide resources to those living outside of their home country. I share candid accounts of mental health experiences from brave individuals. My vision is to lower the stigma of mental health and to provide helpful, evidence-based information to others.

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