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Expats and mental health
If you’re an expat, finding your feet in a new country can be difficult in ways that go beyond simply being homesick. Moving away from your support network to unfamiliar surroundings can result in high levels of stress.
Studies have revealed that expat depression is more common; this is attributed to the fact that people living abroad face a higher overall risk of mental health problems. So why does moving abroad lead to increased levels of anxiety, depression and stress? And how can you look after your mental health while overseas?
Expats face a higher overall risk of mental health problems
Recent research, entitled The Mental Health Status of Expatriate Versus US Domestic Workers, found that 50 per cent of US expats studied were at high risk of problems such as anxiety and depression, a figure two-and-a-half times higher than their US-based counterparts.
David Sharar, Ph.D, Managing Director of Chestnut Global Partners, the company that co-conducted the research, said: “Studies estimate that American expatriates have assignment failure rates as high as 40 per cent, which often results from stress caused by cultural difference and demanding workloads.”
The study also found that:
- Three times as many expatriates as US-based workers expressed feelings of being trapped or depressed
- Twice as many expats as US-based workers expressed feelings of anxiety or nervousness
What can cause mental illness in expats?
There are lots of reasons why expats may suffer from mental health issues. Cultural, climate, religious and language differences between the familiar home environment and the less familiar new country can be significant, and it is common to be concerned as to whether you will be accepted by the host country.
Other common factors that can lead to mental health problems include:
- Separation from family and friends
- The need to develop a high level of self-sufficiency
- Depending on the country, anxiety and stress can be caused by exposure to poverty, violence, suffering, death and the risk of disease
“Homesickness and social isolation are among these [problems],” says Madrid-based counsellor Kristin Ketelslegers. “There is a lack of support for expats, so it’s more difficult to cope with new circumstances because they don´t have family or friends nearby.”
Chris Neill, another Spain-based counsellor, agrees that rates of depression – or the feeling that life is meaningless – could be up to 50 per cent higher among expats. He also believes that anxiety is not unusual for people living abroad.
“People with anxiety stop enjoying activities that used to give them pleasure,” he says. “They don’t want to go out anymore and they start ruminating on the past or worrying about the future.”
Stress and anxiety that arise from moving to a new country are common, and a desire to seek a cure for mental health issues can sometimes make the situation worse. Not knowing how to cope with loneliness or how to deal with homesickness can lead to serious problems.
Dariusz Skowronski, a psychotherapist based in Japan, says: “Many expats seek a cure for stress, and [in Japan] many substitute it with alcohol, drugs or sex because they feel more liberated. This is why many of them try new things, especially if they are within reach.”
Lack of support and language can present challenges
If you are suffering with expat mental health issues such as stress and anxiety while living/working overseas then it can be tough to find the right help and support.
Skowronski says that people in less metropolitan areas may have trouble finding the appropriate, quality help in small towns and cities, which combined with their smaller size can make coping with loneliness harder. He also says that many people simply don’t know that there is support available in their host country and that there is lots of professional help at hand.
“There are three barriers – the language, the culture and the mental state – to overcome. Many people give up seeking help at the start, believing it is not available for foreigners or they won’t receive the treatment that would suit them,” he says.
Kristin Ketelslegers agrees that the language can be a problem. She says: “It’s very hard to find someone who can speak fluent English or German or French, for example. But it’s critical that therapists are able to do so. They are not there just to listen, but also to respond and give advice.
The truth is that many countries have mental health services available. Many major towns and cities offer counselling and mental health support, and treatment at these centres is often covered by insurance.
Dariusz Skowronski believes that expats need to be able to discuss their mental health issues. He says: “Providing education and information on mental health is necessary. But most of all, an environment for openly discussing stress-related issues and the risks of developing problems is what we need to enable expats to find help for their concerns.”