What is expat blues? Understanding mental health abroad

Also known as expat depression (or moving abroad blues), depression is a common experience among those living abroad. However, a thrilling and enriching experience, living abroad comes with its own challenges, which may trigger low mood and feelings of depression. 

If you are curious and want to learn more, I recorded an episode on my podcast We are here, too, and I have included a detailed blog post below about depression when living abroad.

If you are concerned about your mental health, I wrote a blog post on how you can find support where you live:I need help with my mental health: what do I do? 

Common causes of depression when living abroad

There are various reasons why someone is struggling with their mental health, and we cannot attribute sole responsibility to our time abroad. That said, there may be elements of it that can exacerbate certain feelings. Following, there is a list of common causes of depression that we may encounter specifically for living abroad (or choosing a life of travelling).

Being in a new and unfamiliar culture can be overwhelming and lead to disorientation, isolation and confusion (culture shock). It also involves a loss of cultural values and systems that can lead to feelings of sadness and a longing for home (homesickness). If you couple this with difficulties adapting and uncertainties when it comes to navigating new social norms and expectations), frustration and a sense of helplessness can be triggered and fuel our low moods, hence the depression. 

Other factors that can exacerbate the situation may be stress related to a new working culture and language barriers. 

Read more Exploring the emotional toll of moving abroad: what does it look like?

Read more Culture shock is real

Recognising the signs of depression when moving abroad: a disclaimer

Before delving into the signs of depression when living abroad, it is essential to clarify a few points.

Firstly, those who migrated may experience symptoms of depression just like anyone else. However, the unique stressors and challenges of life abroad can exacerbate these symptoms.

Secondly, symptoms of depression may be due to other factors as well, such as culture shock, homesickness, or adjustment to a new environment. What makes depression difficult is the persistence of symptoms and interference with everyday life. 

Last, depression can manifest differently in different cultures, and cultural factors can influence how people experience, express, and cope with depression.

Cultural differences in the expression of depression

Expression of emotions

Cultural norms and expectations (together with family attitudes) play an important role in the way individuals express their emotions. When I first moved to Scotland, I soon realised that the locals would be more reserved and contained in the way they expressed emotions compared to those of us who come from the Mediterranean region.

Symptoms

Depression can manifest differently across cultures for various reasons, including differences in cultural values, beliefs, and attitudes towards mental health and emotions. 

So, for example, in some cultures, depression may be expressed through somatic complaints, such as fatigue, sleep problems, or changes in appetite. In contrast, it may be expressed through irritability, anger, or substance abuse in other cultures.

Attitudes towards mental and emotional health

Attitudes towards mental and emotional health and seeking help can also vary across cultures. Stigma, cultural attitudes towards gender roles, family and social status, plays an important role in the way people make sense of and talk about what is going on for them emotionally. A culturally-appropriate support would be aware of these differences and support people to talk through their struggles by staying in their frame of reference, without imposing the dominant culture’s way of assessing and treating depression (or any other type of psychological distress).

Cultural-sensitive coping strategies

There is no one-size-fits-all approach to coping with depression, and what may be effective for one person may not work for another. This is especially true when it comes to coping with depression when living abroad.  

You could connect with cultural support networks in order to feel less isolated and engage with a more familiar environment. Many cultures have established support systems, such as religious communities, cultural organisations, or extended families in the new country, that can provide a sense of belonging and comfort. 

Going through depression is hard, and you don’t have to do this in isolation. If engaging in activities feels hard, there are ways you can still look after yourself that are soothing and less energy-consuming.

You could focus on self-care in different ways. For example, if you struggle with your personal hygiene, you could start a step at a time by first washing your face if showers are out of the question. 

Practising cultural rituals and traditions in the comfort and intimacy of your home or through activities, such as engaging in traditional dance, music, or prayer, can also help you feel more connected to your cultural identity and provide a sense of comfort.

Last but not least, you can search for a culturally sensitive therapist, someone who understands and is sensitive to your cultural background and can help you explore and cope with your depression in a way that is meaningful to you.

I’m a cultural-sensitive counsellor, work with me

Hindsight observations on depression when living abroad

This is an extract from my podcast episode S1E5: What I learnt from my depression when living abroad (you can listen to the episode from the link above or major music platforms).

• You embody possibilities: remember that no matter what you are going through, you are an inspiration for someone. It may not feel like it even if in that moment, you may have lost a sense of wonder and curiosity that once encouraged you to move abroad. Those possibilities are still within you. 
• Migrating is not an answer: moving abroad is not the answer to all of your struggles, although it may provide an opportunity to start afresh in a place where some of your challenges are removed. What worked for me was to remember my whys: why I moved and why I decided to stay.
• Coping strategies for the here and now: your present is what matters and dictates what you can do. Find ways to move you forward that are respectful of the energies you have at the time. 
• Give yourself grace: life is hard, and you are doing your best to go through life in more challenging circumstances.
• Remember your why: focus on the reasons why you moved in the first place and what excited you to do so. Whatever way you feel towards your why may be an indication to what step you need to take next.
• Reach out and lean on: at a time when individualism is praised over collectivism, we must remember that we strive when we connect, share and support. There is no moving forward if we don’t do it collectively. And if you need more structured support, you can access health services (GP or counsellors) and take it from there.