Expat Depression: What it is and what you can do about it

With living abroad comes many challenges: homesickness, broken support networks and not to mention getting used to a new way of life and environment simultaneously. Expats are in a very unique situation in which they are faced with an experience of a lifetime, learning about a new culture and beginning a path of personal growth, but this equally places them in a vulnerable position.

The conflicting reality that is expat life may mean you’re feeling constantly exhausted, unmotivated and lacking confidence, and you may be thinking that this is something you’ll eventually overcome or that you’ll be able to shrug off in due course. But are these symptoms telling you something more and aren’t just down to you adapting to this new way of life?

Expats are at an increased risk of mental health problems according to recent research and report feelings of depression three times more than non-expats. So, it’s even more important for you, as an expat, to be able to identify the signs and symptoms of expat depression, what it is and what you can do about it. If you think your mental health is top priority, keep reading.

What is expat depression?

Expat depression is defined as feeling disheartened and feeling in low spirits in those living and or working abroad. Certain high stress situations have been shown to create or increase psychological distress amongst expats, situations like the COVID-19 pandemic for example. The fast-paced and intense decision of moving abroad comes with a lot of stressors – including language barriers and cultural adaptations. Even tasks that may have been menial in your home country, including a trip to the supermarket or post office, may become a challenge which might damage your mental and emotional state.

Other factors including a significant desire to return home or a low belief in one’s ability to succeed are two significant predictors of depressive symptoms in expats.

Recent studies have shown that as high as 41% of expats reported significant clinical depression levels. But the same research has highlighted the issue that governments around the world are not taking the mental health of the expat population seriously. So, it is up to you to know what you can do to help your expat depression. But how do you know if you have it?

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How do I know if I have expat depression?

How do you identify expat depression in any expat for that matter – it may not be yourself that you are concerned about, it may be your close friends and colleagues who are expats that may be concerning you. There are a number of signs and symptoms that you can look out for that might show you that you, or someone close to you, may be struggling with expat depression:

Poor concentration

If you’re struggling to remain focused or to pay attention to something, or feel like you’re not thinking clearly, this indicates you may have difficulty concentrating which is a common symptom of depression, and one that can often be very challenging. Research has highlighted that ‘trouble concentrating’ is a symptom often reported by migrants, and one that you shouldn’t ignore if you feel like you or someone close to you is struggling to remain focused in their daily life.

Feeling lonely

Defined as feeling like the levels of social contact that you want do not meet what you actually have, loneliness is a subjective feeling most likely to be experienced by everyone at some point in their lifetime. Loneliness is a symptom often reported by migrants, more so than natives. Reasons why this may be the case include that migrants may be less satisfied with their social relationships and may not participate in social activities as frequently as natives. Both loneliness and depression have shown to be linked in research, and in the case of migrants specifically.

Feeling sad

If you feel like you continuously have a low mood or feel sad or tearful, this may be a sign that you are suffering from depression. It’s common for people to often have low moods and feel down, but if this persists for weeks, or in some cases even months, this is when you should be aware of the possibility that you may be depressed.

Lack of energy and fatigue

Both lacking energy and feeling tired are major symptoms of depression. Depression can cause your energy levels to fluctuate, and often you’ll feel lacking in energy and tired – leaving you incapable of doing much. Migrants have often reported in research feelings of chronic fatigue.

Feeling anxious

Feeling worried or anxious is a psychological symptom of depression. Having anxiety or a diagnosed anxiety disorder already places you at an increased risk of having depression. Research has speculated that feeling anxious may be a symptom that most migrants experience until they become adjusted to their new lifestyle.

Loss of interest and enjoyment

Also known as anhedonia, feeling a loss of interest and enjoyment from things you would usually find pleasurable is a primary symptom of depression. One study showed that 85.7% of migrants reported symptoms of anhedonia and that overall, depressive symptoms were higher in migrants than controls.

Low self-esteem

If you ever feel like you’re lacking confidence, having negative opinions or being too hard on yourself, you may have low self-esteem. In a study of migrant females enrolled in primary education it was shown that the challenges faced with adapting to this new school environment can negatively impact their self-esteem. Both low self-esteem and depression are related, and so having a low self-esteem may put you at increased risk of poor mental health and therefore of depression.

Feeling guilty

Guilt is a symptom of depression. Research has highlighted that the process of migration can place you at an increased risk of feeling guilty, for reasons such as leaving family. Guilt is an enabler for depression and depressive symptoms and thus, it is important to be aware of guilt’s contributions to your mental wellbeing.

Remember, these feelings, signs and symptoms are completely subjective – no one person will ever experience depression the same as the next and not all symptoms are indicative that you have depression. If you are concerned that you may be depressed, the only person that can diagnose you with depression is a qualified psychologist or psychiatrist, so please seek help from a medical professional if you feel that you need it.

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What can I do about my expat depression?

Seek professional help

At the end of the day, depression is a mental health disorder, and one that has often been swept under the rug, misdiagnosed or not taken seriously. If you are concerned that you may have depression, you should seek professional advice from your local doctor and be referred to a psychologist or psychiatrist to be diagnosed accordingly. Depression is a spectrum, and has varying levels of severity, symptom manifestations and diagnostic criteria.

Once you seek professional help and if you receive a diagnosis, depression is typically treated in the following ways: by using medication to treat the biological basis and biological symptoms of depression or seeking therapy to treat the psychological aspect of the disorder. There are a whole host of medications and therapies available to treat depression (though this might vary based on your location) and you will receive the best advice from your doctor on the best treatment course that is suited for you and your needs.

Self-help

Get plenty of sleep

This will help relieve the feelings of fatigue and lack of energy you may be experiencing as a result of or alongside your depression. Good sleep habits and sleep hygiene are crucial to combat fatigue, especially when you may be experiencing depression. Habits including avoiding naps in the day, having a consistent sleep schedule, not consuming caffeine at least 6 hours prior to sleeping and staying off your mobile devices before bed are all important habits to ensure you avoid fatigue and have a good night’s sleep.

Exercise

For any anxiety symptoms related to depression, exercise has been shown to help ease these symptoms. It may be for reasons including exercise releasing feel-good chemicals such as serotonin and endocannabinoids which have also been shown to have anti-anxiety properties, but the reasons are not entirely clear in the medical field. Furthermore, exercise distracts you from the things that may be causing you to feel anxious. Research has even shown that those who report high levels of exercise were more protected from developing anxiety symptoms than their low exercising counterparts.

Eat well

Eating well is also a way in which you can combat fatigue you may be experiencing as a result of your depression. A healthy diet provides more energy: a diet high in carbohydrates being shown to increase alertness, but high fat can increase feelings of fatigue during the daytime. If you’re eating carbohydrates that are slowly digested by your body, such as vegetables, wholegrains and fruit, you’ll find that this provides you with even more energy during the day.

Improve your self-esteem

Be positive, research has shown that thinking positively actually helps ease depression. Another way in which you can improve your self-esteem is by targeting and challenging the negative opinions that you may have of yourself, a lot of them tend to be inaccurate, and upon reflection, you’ll realise just how silly they are.

Form positive relationships

A systematic review revealed that people who perceive themselves to have emotional support and larger social networks were protected from depression, and there is overwhelming evidence to show that social support positively influences mental health and is associated with a lack of psychological distress.

Find hobbies and activities that you enjoy

Research has shown that having leisure hobbies that you engage with can reduce the risk of poor mental well-being and depression. Research has even demonstrated how pleasant activity scheduling, a form of therapy technique, is a helpful way to treat depression, and involves scheduling participation in positive events to boost a person’s mood.

Speak out

Especially with regards to your concentration, it is worth communicating to those around you how this may be impacting your daily life, especially in the workplace. Speak to your manager and be open about your situation, especially if you have had depression long-term. According to the UK Equality Act 2010, anyone with a long-term mental health condition (a condition lasting or likely to last more than 12 months) is protected against discrimination in the workplace legally. Remember to be honest about your situation, people are more likely to be understanding if you’re open with them.

Give yourself plenty of breaks

In relation to your concentration and also to help relieve your anxiety, it is important to give yourself enough breaks, time and space to recover when you feel like you’re struggling mentally and or emotionally. Taking a break has been shown to increase productivity levels but also helps deal with mental health problems, including depression and anxiety.

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Living abroad is an incredible leap to make in life, and it’s ok that you may be struggling emotionally and mentally during and after your big move. But the most important aspect of facing your emotional and mental struggles is coming to terms with them and finding the help and support you need to overcome them – from a medical professional, from friends and family, and most importantly, from yourself.