September 29

Top 10 Mental Health Challenges Expats Face

Expat Counselling


Travel, adventure, exotic locations, playing in the sea, and drinking martinis by the pool on a clear sunny day...

Is that how you pictured your time abroad?

On Facebook and Instagram, influencers portray expat life as a long holiday. One where the excitement of being in a new place doesn't fade, and you remain unburdened from home stresses throughout your stay.

But is that how it is?

Surely being an expat doesn't mean you escape all life’s problems? 

And are all those portrayals on social media really showing the full picture?

The truth is, expat life can be fun and rewarding, but it comes with challenges.

I know first-hand.

In my early twenties, I spent time living and working in China. It was a fantastic adventure and I enjoyed myself immensely at the start.

Yet when I returned to the UK three years later, I was stressed, tired, and wound tight as a drum. It took visits to the GP and my local community Mental Health programme to get me back on my feet. Something went wrong.

No doubt about it: mental health is a real issue for expats. I’m not the only one to have suffered.

Most studies show expats are at a high risk of mental health issues, such as depression and anxiety.

But it doesn't have to be that way.

Insight and understanding can go a long way to helping you avoid some of the problems that expats, including myself, frequently face.

With the proper support, expat life can be an exciting and fulfilling one. Armed with the appropriate knowledge, you can have the pros without the cons and make the most of the opportunities and challenges of living abroad.

Learning about the risks will leave you better prepared. You can protect yourself and maybe even enjoy those exotic locations you dream of, play in the sea, and drink cocktails on the beach.

Risk 1. Being an Alien

One of the biggest problems expats face is not having solid friendships and other support networks around them. Expat communities can be wonderful, but they are also often only small and limited.

They're nearly always transient, too, with people coming and going as visas expire, jobs relocate, or new shores beckon.

Old friends and family are distant too. They live in different time zones and are often unable to relate to expat concerns. Even if you call or facetime regularly, you may struggle with the distance and slowly drift apart.

If you can, try to stay in touch with friends and family back home and do your best to build up new friendships with locals and other expats. It may mean lots of extra effort on your behalf, but it'll be worth it.

Risk 2. Bureaucrats and Paperwork

Moving jobs and house are among life's most stressful events. And that's just within the same country.

Moving abroad is a whole different challenge! There are flights, visas, shipping, healthcare, housing, and schooling all to sort out. But you're not just opening and organizing things, you also need to close things like bank accounts and utility bills.

If you're not careful, you can arrive in your new country feeling exhausted and burnt out. And that's before you've even got around to arranging local healthcare and registering with the local police bureau.

Make sure you don't become overwhelmed by the stress of moving. Get support from friends or agencies and from people who've been through the process. Talk to a counsellor who specialises in supporting expats if need be.

Risk 3.Getting All Out of Sorts

You probably had a well-organised routine involving work, family, friends, and social activities or hobbies in your home country.

You won't have these routines when you move abroad and recreating them can be tricky.

You may feel unmoored and adrift, especially if you gave up your job as part of the move.

For this reason, often, the expat partner is more at risk of mental health problems.

Although moving abroad and having the chance to change routines can be exciting, these new routines can take a while to establish.

It may not seem important, and you may be glad to escape some routines that you didn't like or felt had become stale, but it's important to have structure to your days.

Make sure you don't drift through the weeks and months without having regular activities and order to your day. It’s the activities you do routinely, like novel hobbies, going out for local meals, and making new friends that will shape your expat experience.

Risk 4. Falling into a Trap

It's possible that you feel trapped living abroad. Perhaps you didn't feel you had any choice – you moved because of your work or your spouse's work. Or maybe you don't want to admit that expat life is not what you thought it would be.

Many expats say the feeling that they have no choice except to be where they are, even though they don't like it, adds to their sense of discomfort and contributes to poor mental health.

Part of the reason I became unwell in China was that I'd convinced myself – for various reasons – that I couldn't return to the UK.

Remember, you always have the choice to go home. Even if it means you need a temporary break from your relationship, to skip over a promotion, or to admit that expat life wasn't all you thought it would be. Your health is more important.

Risk 5. Green Bananas and Kissing the Same-Sex

Culture shock is the experience you may have when you arrive in a culture different from the one you're most familiar with.

It's everything from green bananas that you must cook before eating, villages without electricity and greetings that involve two, three or even four pecks on the cheeks regardless of sex.

You might be shocked by almost anything, the different weather, rules of etiquette, not knowing the language and feeling unable to communicate. Or not knowing what food you're eating or where to find the staples you like.

Remember that most expats experience some form of culture shock. It's not a sign that something is wrong. It's part of the experience. Keep an open mind and welcome surprising experiences as they happen.

Brace yourself for the fact that things will be different. Read travel books or books about your destination before arriving.

Risk 6. Lost Roles

Relocating abroad can mean an identity change. If you've moved for work, your role in the company might have changed, or you may feel different in your position without the colleagues and organisational structure you're used to.

If you've moved because of someone else's job, then perhaps you’ve given up your career and are now a stay-at-home parent and don't have the distraction and focus of work each day.

Sometimes sacrificing or changing a career can lead to a loss of identity and a loss of confidence. Resentment can build to breaking point.

Regardless of the change, you may struggle to adapt to your circumstances and lifestyle and may not receive the support you need and want from your partner or your partner's company.

Find out from your colleagues who've worked abroad what it's like. Prepare yourself for the fact that you may need to invest your identity into new activities, such as new hobbies, family roles and social activities.

Risk 7. No Services and Support

When you're in your home country, you have all sorts of resources at your fingertips that can help you during difficulties – not just friends and family, but state organisations and charities too.

There’s the doctor who has known you since childhood, the local counsellor who you've not met yet, but whom you know is always there should you need him, and the mental health support groups that you see on flyers from time to time.

When you stepped abroad, a lot of these support services melted away and became inaccessible. In a foreign country, they either don't have the same institutions or those resources are more difficult for foreigners to access.

Yet, in times of need, these services can be essential.

Investigate online forms of support before you leave. For example, forums for expats such as Internations and or counsellors, such as myself, who specialise in supporting expats.

Risk 8. Not Growing Roots

If you've moved from one foreign posting to another, or if you're a digital nomad constantly changing country every few months, then the lack of stability can have an effect over time.

For those who love travel and adventure, it can be hard to accept, but sometimes you need to stay in one place for a while. You'll have an opportunity to put down some roots. You’ll have an opportunity to deal with any mental health or relationship issues that frequent changes of place can mask. You'll be able to tap into local sources of support.

If you've been abroad for an extended period and struggled to put down roots in your host country or if you've been moving around a lot, consider whether a stint in one place or a break in your home country would be helpful.

We all need to settle down for a while, even if it's just for a few years.

Risk 9. Running Away

Sometimes people move abroad because they are trying to leave issues behind at home. You may not necessarily be running away from your problems, but at the same time, being abroad gives you an excuse not to have to address them.

Being an expat can make it easier for you to avoid the long, hard work of confronting your faults and issues. On the surface, we may feel happier for not facing these problems, but underneath, turmoil could be roiling. Problems that remain undealt with are unlikely to go away. Instead, they'll lay deep within, festering, and they'll make themselves felt in other ways – through anxiety or anger, for example.

Don't use being abroad as an excuse not to work on any problems that you may have. Find a local counsellor in your host country or find one that works online.

Risk 10. Estrangement and Alienation

Alienation means feeling disconnected from others. This can occur when you’re isolated for long periods in a culture very different from your own.

During my time in China, I often lived in cities where there were only six foreigners and eight million Chinese. At other times I lived in smaller rural locations where I was the only foreigner.

And in China, I was always treated as a ‘guest.’ Although well-meaning, it contributed to the sense of being 'other', of being different from everyone else. I felt completely alienated from those around me, struggling to relate to them in the easy way I do those of more similar cultures.

If you feel uncomfortable in your living environment and estranged from the people around you – those you shop from, get your teeth checked by and see walking in your local park, consider talking to someone about it. Sometimes talking through how you feel can be enough to reduce your sense of alienation.

Don't Suffer Alone From Expat Mental Health Problems

You're worried about an upcoming move for yourself or someone else. Or you've been abroad for a bit and are not coping as well as you thought you would.

The reality of expat life is often very different from that portrayed in the media. It's not all glamour and glitz.

Sure, there’s excitement, challenge, and the chance to get out of your comfort zone, but there are also stresses and strains that you probably haven't thought about.

Living abroad doesn't mean you escape the everyday challenges that life throws at you. On top of that, there are added stresses that come from living abroad.

These can range from lack of structure and stability and a sense of isolation from friends and family to culture shock, alienation, and difficulties dealing with foreign bureaucracy.

And you may not have the support you need, whether that's mental health support from a professional or just someone to talk to who understands.

But you don't have to be alone.

If you need any help or support, reach out. I draw on my training as a psychotherapist and my experiences of living abroad and specialise in helping those living the expat or nomad life. You can book an introductory call here to find out if we're a good fit.

If you have any worries or concerns and feel you need support, then reach out.

Just because you're in a foreign country doesn't mean you're unsupported.

You can make expat life a success and enjoy those exotic locations, new adventures and opportunities to relax.

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