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Expat depression: 7 tips for how to cope

Living abroad can be an exciting and enriching experience, but it can make coping with life’s challenges more difficult, which can lead to depression.

Expat depression: 7 tips for how to cope
Photo: ikurucan/Depositphotos
Of course, depression can affect just about anyone for any number of reasons; the World Health Organization (WHO) estimates about 300 million people around the world suffer from the disease.
 
And a 2015 report from the US National Institute of Mental Health (NIMH) found that an estimated 17.9 percent of US adults have suffered from some sort of mental illness in the last year.
 
“Depression can feel like it hits you from nowhere,” says Sean Truman, a US-based clinical psychologist who also runs a practice providing mental health care to English-speakers living overseas.
 
“The ways people get to depression is varied – there’s no one pathway there,” he adds.
 
“It’s sort of like dominos – there is a cascading effect and the trick is figuring out how to interrupt them.”
 
Having grown up in Nairobi himself, Truman has first-hand experience with some of the difficulties associated with life abroad. He’s since co-authored a study looking at how likely expats are to develop depression and other disorders compared to US-based workers.
 
“There has always been anecdotal evidence that people who live their live overseas struggle,” he explains. “But there wasn’t much research into the topic.”
 
The study revealed that US expats were 2.5 times more at risk of internalizing problems and developing substance abuse compared to their counterparts who stayed home – increasing their risk for anxiety and depression.
 
“There really is a need for mental health support in the international expat community,” says Truman.
 
Some expats lack the proper coverage for mental health care abroad. Some locations may simply lack access to mental health professionals. And even if you end up in a place where counselling is available, it’s usually only available in a different language or culture.
 
But regardless of how great or how rough your situation is abroad, there are other steps you can take to help prevent and cope with expat depression.
 
1. Get enough sleep
 
Most adults need seven to nine hours of sleep per night – and staying well-rested can help give you the energy you need to keep the blues at bay. But the exact relationship between sleep and depression is complex – some people may develop depression after not getting enough sleep; others may have trouble sleeping – or sleep too much – after becoming depressed.
 
“It’s important to have stability and rhythm,” says Truman. “Safeguard your sleep. It can help you stay on track.”
 
2. Get out and exercise
 
With all the new demands and routines that come with life abroad, it’s easy to feel you’ve lost control of your own life. But carving out some “me time” for exercise can help.
 
“Being active can help you regulate your own experience in a new environment,” says Truman. And numerous studies show that regular exercise can help give a boost to people suffering from depression.
 
3. Keep alcohol intake in check
 
Living outside the community we know best can sometimes bring about a more relaxed attitude to alcohol or drug use.
 
“Being connected to a community helps bracket our behaviours. People know who you are,” Truman explains.
 
Losing that structure can make it easier to feel like we can break other norms and rules. Indeed, Truman’s study found that expats had a higher risk for substance abuse problems compared to US- based workers. Bottom line: think twice before opening that next bottle of wine.
 
4. Join groups to connect
 
When depression starts to set in, it becomes even harder to find the motivation to get out and engage with others.
 
“Things become smaller, you’re unhappy. You basically lose your mojo,” Truman explains.
 
Back home, we have existing social network that help us activate, but expats need to put in extra effort to create new ones. Join a sports club, find a new hobby, or if you have kids, get engaged in club for them – all of which can be mechanisms to help you connect with other people and help pull you out of the doldrums.
 
5. Don’t overdo it on social media
 
Social media has radically changed the way expats can relate to friends and family back home or networks from other phases of in life.
 
“It does provide a connection,” says Truman. “The problem is that it’s a connection with very low bandwidth based on an idealized version of our lives that fails to capture the reality.”
 
Thus, spending too much time scrolling through your Facebook means less time making real-life connections in your new country. While cutting social media out completely may be extreme, it’s good to exercise some moderation.
 
6. Let people know they can help you
 
While there may be less of a stigma associated with depression that there was 20 years ago, that doesn’t necessarily make it easier to talk about – especially for expats who don’t have access to their normal support networks or face other pressures.
 
“Often, an overseas assignment is a chance for rising star to prove themselves on the way to a C-suite. They have to exemplify stability and confidence.”
 
Regardless, Truman says it’s important to open up and invite people to help you. Many of them will.
 
7. Seek professional help
 
Therapists exist for a reason, and can be a huge help in aiding expats with the mental and emotional toll of living abroad. And expats who sign up for any level of Cigna Global International Health Insurance gain access to coverage for mental health treatment – and on the Platinum level, mental health care is paid in full. That means you have one less thing to have to worry about when struggling with depression – after all, no expat is an island, even if you might live on one.
 
 
This article was produced by The Local Client Studio and sponsored by Cigna Global.
 
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Emergency room visits to cost 50 francs in Switzerland

People who visit the emergency room for non-urgent treatment will now need to pay 50 francs after the Swiss government issued final approval for a rule change.

An ambulance approaches Geneva University Hospital. Emergency room visits will now cost 50 francs in Switzerland. Photo: Fabrice COFFRINI / AFP
An ambulance approaches Geneva University Hospital. Emergency room visits will now cost 50 francs in Switzerland. Photo: Fabrice COFFRINI / AFP

The proposal was originally developed by Zurich National Council member Thomas Weibel and received approval by the National Council in 2019. 

The Council of States on Wednesday accepted the parliamentary initiative, meaning that people who seek treatment in the emergency room for non-urgent health issues a fee of 50 francs. 

This will be introduced as a co-pay, meaning that the patients would have to pay out of their own pockets (i.e. it will not be covered by insurance). 

READ MORE: Switzerland to introduce 50 franc fee for emergency room visits

MPs argued that this measure may dissuade those who are not seriously ill from going to the emergency room and overloading the system, while also taking medical staff away from patients who need urgent help.

Opponents countered that this may discourage people from visiting hospital who actually need treatment, however the measure passed with a narrow majority. 

EXPLAINED: Everything you need to know about health insurance in Switzerland

No concrete indications were given as to what amounts to ’non-urgent’ treatment in the eyes of the law.

This is expected to be laid out by the National Council who are now charged with the responsibility of drafting the rules. 

Exemptions could apply to children and adolescents under the age of 16, patients referred to the emergency room by a doctor, and those whose treatment subsequently requires hospitalisation.

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