In the spring of 2008, I was itching to get out of my school’s mandatory study abroad information session. I was sitting between a student going to Ireland and a student going to Michigan for a semester, reveling in the fact that I was the only person in the room who decided to study abroad in China for a whole year.
One of the school’s psychology professors was lecturing us about the various risks of studying abroad and I couldn’t help but laugh internally, “I’ve lived in the Netherlands as a child, flew to the UK at 18 on my own, and traveled China on my own for an entire month. I’m well aware of the consequences.”
Then that professor mentioned something that at the time I didn’t take seriously but to this day will never forget, “If you have any issues or problems here domestically, be sure to take care of them because they are only going to grow abroad.” I was confident that I didn’t have any problems at that time; two years later when I was preparing to live in China for two years to obtain my Master’s degree, I was still very much convinced I would be fine while studying abroad.
Unfortunately, the extreme nerves and crying sessions that started two weeks before flying to China didn’t stop two months after arriving. It took some time before I realized I had a serious problem and that I had to do something about it. To this day, I try to stay up to date with all research related to depression and I hope that my experiences and insight can help you to explore the world with one less consequence to consider.
What Causes Depression While Studying Abroad
Independent of studying abroad, depression is a complex condition that can strike for a number of reasons and can differ in severity depending on many factors that are sometimes out of our control.
As mentioned by the aforementioned professor, depression can arise from trying to escape your problems without truly addressing them. Preparing for and packing to relocate abroad can be intense and while anxiety is a completely natural human response, depression and anxiety can severely disrupt your life, especially when you are about to embark on a huge (even temporary) life change.
Depression frequently accompanies the unexpected or underestimated challenges of diving head first into a new language and/or culture. While my case was complex and lacked a proper diagnosis for many years, one of my least fond memories was eating lamb kabobs and pork dumplings for over a month because I didn’t know how to say any other food-related words in Chinese. Even though I had been to China before and taken two years of Chinese while in college, being in the country as a full-time resident presented itself as a whole new anxiety provoking challenge.
When studying abroad, it’s not uncommon to experience culture shock, mismatched (or even unmet) expectations about your new life, and depressed feelings as a result. Depression while studying abroad is surprisingly common, but often overlooked especially when students return home and answer the question “how was it?” with glowing remarks that skate over the dark chapters.
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How to Recognize Symptoms of Depression
While symptoms associated with depression can be easy to list, they can be difficult to distinguish from everyday ups and downs that you may experience, especially while adjusting to a completely new environment like studying abroad in a foreign country. Some of the more recognizable symptoms are:
- Inability to Get out of Bed/Motivate Yourself
- Lack of or Too Much of an Appetite
- Unavoidable Negative Thoughts
- Erratic Mood Swings
- Lack of Focus or Pervasive Forgetfulness
- Difficulty Sleeping or Sleeping Too Much
- Physical Pain
- Lack of Interest in Things You Once Loved
- Difficulty in Upholding Self Care
- Intense Anxiety (Anxiety and depression often coexist, so be sure to check that your concerns aren’t growing into constant fear or sadness.)
While these symptoms are highly recognizable by an outside party or even by yourself, in the thick of the moment, you may doubt yourself.
Despite experiencing most of these symptoms myself as well as more overt ones, such as constant crying, I truly thought that I was just “lesser” than my peers. I would watch my classmates gleefully down imported vodka by the bottle on a Friday night and wonder why I couldn’t enjoy the world like they could when really they were just coping in a different way.
The amount of shame I felt also prevented me from seeing that I needed help and that what I was feeling wasn’t my fault.
How to Manage Depression While Studying Abroad
As depression can be difficult to diagnose and treat, especially while abroad, it is important to not only check in with yourself regularly but also identify hobbies, people, and places that will be able to help you during your time of need. Some items to consider both before and during your time include the following:
Prepare in Advance by Facing Your Issues
Take the advice from that professor I didn’t listen to. If you know that you are prone to anxiety and/or depression, prepare ahead by speaking with a therapist or psychiatrist at home and start looking into preordering larger prescription amounts in case medication is not affordable or easily accessible within your destination abroad.
Participate in Creative Expression
Writing, drawing, singing, acting, and other creative hobbies are all excellent ways to reflect and make decisions with a calm and clear head.
Speak Honestly with Others
If you sense you are with someone you can trust and who is listening, be open about your issues. You never know when someone is able to help. For me, help came from a random referral from a not so close friend who ran into the first psychology Fulbright recipient ever to be allowed to practice in China.
Maintain Proper Diet & Exercise
While it can be difficult to get out of bed, it is the most important move you will make for the day. Staying in bed ensures that you will dwell on negative thoughts and do less and less to help yourself. Getting out of bed, if only out of habit, will help you to overcome those initial fearful steps and prevent you from losing precious time while exploring your new home.
A mental health specialist once told me that the brain cannot process practical and emotional information at the same time and then gave me two mind games to play with myself when I felt myself drifting into a sea of negativity. If you find yourself doing the same, try counting backwards by 7s starting with 100 or count the number of items around you of a certain color until you start to feel yourself calm down.
Find or Build A Community
Depending on your current position abroad (student, employee, or otherwise), you may start to experience a bubble effect that may not be a true reflection of daily life around you. Participating in local organizations enrichens your experience, improves your cultural awareness and language ability, and provides you with a completely new set of friends and community that can provide you with alternative perspectives and connections.
Seek Professional Help
Be sure to study up on your program or university’s insurance benefits and locate the nearest medical professionals for both everyday care as well as emergencies. Many countries are home to international hospitals that can provide care equal to or above standards of your home country and are usually fully covered by your school’s or work place’s benefits program.
Seeking Help: How to Find Mental Health Treatment Abroad
If you find yourself experiencing symptoms and are ready to find help there are quite a few options open to you.
First and foremost, your school, workplace, or study abroad program usually provides extensive international health care benefits, including coverage for mental health services. However, it is important to consider that these hospitals, while able to provide a high level of care, are subject to local laws and restrictions and are sometimes less able to provide the care or medication that you need.
If you are studying abroad at a local university, mental health centers can be found on campus for an affordable price with professionally trained visiting and/or local professors. Expatriate guides can also act as a great guide to find everyday and necessary English language resources, especially medical care. If you need to wait or are having trouble finding care, try to take care of yourself in the interim.
It’s important to give yourself extra time, without judgment or self-blame, to do things that may have been simpler to complete at home. Creating a routine, sometimes detailed to the point of having certain playlists for certain times of day can also help in building self-confidence and assurance until you gain the strength needed to embark on bigger adventures and projects.
Depression is a continuous and rocky battle that can be temporary or long-term. Today, I continue to build connections and a support system that will not only connect me to knowledgeable people but also enrich my knowledge of how best to take care of myself; especially when times get tough. To be forewarned is to be forearmed, and there are always opportunities to improve your overall armor, I’ve used my experiences to continuously improve myself personally and professionally and I hope that these bits of information help you to develop your own armor.
This post was originally published in June 2014, and was updated in July 2018.