Mental Health Post #14: Expatriate Depression

When I was between my sophomore and junior year in college, I did a French-speaking study abroad in Belgium as an au pair (nanny).  I was SO excited to travel and to experience language-immersion.  I am pretty decent at languages, probably one of my only intellectual gifts.  I had started learning French in college and just loved the feel of it in my mouth as I spoke.  (Can a language have a mouth-feel like a drink?...)  Unfortunately, things did not go as planned right from the beginning.  To start with, I had started dating a guy immediately before I left (like in the couple weeks before!).  Then my planes were all delayed until I was like a half a day late to the Brussels airport.  Remember, this was back in the stone age when we didn't have cell phones, and I was totally clueless on how to make a phone call from a foreign payphone.  (Or how to pay for it, AND I didn't bring the host family's phone number.)  My host father was understandably upset at going to and from the airport looking for me and worrying.  Finally I got to the home I would be staying at for three months, absolutely exhausted and numb from the stress of the past couple of days of travel.  And I found out that the host mom was in the hospital with pre-term labor, and the toddler I was supposed to care for was with family in another country.  Kudos to my host father for working to get me set up with French classes in Brussels and teaching me how to shop at the local supermarket, how to take public transit to get to my French classes and church, and how to drive an actual VW Bug from the medieval times...  

Almost immediately after arriving, my host father made plans to go pick up his little one in the other country.  Road trip!  It was so cool to drive through the other Western European countries.  We also made a couple stops to see some beautiful sites.  We visited my host father's family and I made a crucial mistake: I brushed my teeth with the local water (they warned me not to drink it, but I guess I was too naive and dumb to think about brushing with it?).  And I got traveler's diarrhea.  Like so bad that I pooped my pants trying to get to a bathroom in a foreign country while my host father was visiting a loved one in hospital.  (Please pardon how vague this is, but I am taking out details to protect privacy.)  I was so sick the entire time we visited with his family and at the hotel on the way back.  Not an ideal way to make acquaintance with the child you are going to care for.  Finally I got back to normal and we settled into a routine at home where I would care for the little one while both parents were gone.  Somewhere in there, the host mother gave birth prematurely and things got even more stressful.  At some point, I realized that I was really struggling.  I had extremely long periods where I was alone and anxious all the time about navigating the foreign landscape and new routine.  I could never get the Bug to start (and I grew up driving a manual transmission), I was so isolated from any other adults, and I dreaded the times I had to myself more than the times I spent caring for the little one and with other family members.  I found myself pulling in, and weeping for hours at a stretch, while I wandered around the house aimlessly.  I became so numb that I tried to make myself feel by eating vast quantities of delicious Belgian Waffles (gaufres), and gained 20lbs in 2 months.  I tried to soothe myself by taking care of errands like shopping, going to my French class, playing piano, and hanging out with fellow au pairs from BYU.  Unfortunately, I fell deeper and deeper into depression and started getting darker and darker thoughts.  One of my lifelines at this time was my dad.  He listened to me and paid for what I'm sure was extraordinarily expensive transatlantic phone calls.  At some point, I confessed that I wasn't sure what what I was going to do next (aka I was suicidal), and things changed rapidly.  Plans were made for me to fly out of Heathrow, and the next things I knew was that I was on the Chunnel and running around London (literally, I walked everywhere in one day because I didn't even know what the Tube was at that point) to see the sites before heading home.

When I look back, I realize that the depression I felt was a combination of factors: obviously leaving my comfort zone, and having so many (what I now know is normal) snafus in traveling and circumstance, plus my own tendency toward mood disorder.  Plus the isolation and the realities of life in a foreign country which I was definitely not prepared for in anyway.  (I am laying no blame here to my host family or BYU--who could've known what was to come or how I had a predisposition to struggle?  There were some issues with oversight that I won't go into which I believe is why my group was the last group to do foreign language study abroad in the same manner at BYU.)  This was my first major depressive episode, and still my longest by far.  Even my first experience with post-partum depression was not as long or as severe (by this I meant, I never truly got to suicidal ideation with the PPD).  Here's the craziest part of it: almost by magic, it was immediately lessened by my arrival in San Fransisco (I literally kissed the ground in the terminal when I disembarked).  I was still cautious and broken inside, but returning to the familiarity of America and my normal routine (I enrolled in summer school at university immediately) dispelled the deep gloom and desire for self-harm within a couple of weeks.  I never needed to go on medication and I actually had a renewed purpose in life and motivation.  I made a couple of big religious decisions (for my LDS friends: I took out my endowments and began weekly time in the temple) and was a star pupil who really attacked my studies with more determination than before.  

The thing about it was that I never truly "got over it".  While I found myself functional and moving forward in life afterwards, I felt deep guilt for my shortcomings as an au pair and a person for decades afterwards.  Even now I have tears welling up as I think about the incredible burden of psychiatric pain that I went through at that time.  I'm pretty sure this qualifies as true PTSD (as more than one psychiatrist has told me), and it's ramifications still affect me today.  This experience is why we did a sabbatical in England: I wanted to start preparing my kids now for culture shock and situational anxiety/depression.  I asked that it be England because then there would at least be a shared language (I mean, at least we share the same root language, right?...).  And it was still hard for me because those feelings from over twenty years ago flared up the minute we set foot on English soil.  Some of my kids struggled too, but overall I feel like we all made progress because we had each other, and we had our support group (including my beloved mother in law who came and stayed with us in a brutal heat wave of July).

Coming back to the purpose of me posting about this experience: I believe it is waaaay more common than is talked about.  I've seen it referred to as expatriate depression on the internet, tho I believe it is commonly referred to as situational anxiety/depression or just plain old anxiety/depression among mental health professionals.  I have felt pangs of it as I've traveled this ginormous country of ours, or the brief trip I took to Toronto with Derek, or Hawaii.  Just pangs, but still echoes of what scarred me so deeply  can be difficult to deal with.  (The irony of this is how much I adore traveling.  Just so much.)  And I don't believe I'm the only one by half.  As a member of the Church of Jesus Christ of Latter-day Saints (aka the Mormons), I have seen many people who go to serve missions, even domestically who struggle greatly with what seems to be this same phenomenon.  

What can be done?  For me, there was no choice but to leave the situation and seek healing over time.  For some people it can mean extra support until they become adjusted to their new situation.  Some people will discover that it is the tip of the iceberg and that they need medication and/or therapy perhaps lifelong to maintain good emotional health.  Either way, it requires patience and compassion from a support group as the person attempts to deal with both internal and external stressors.

 One last thing: I found this blog online that has some really thoughtful write-ups on this very topic.  I encourage you to look through it if it's something you want to know more about.  Like me, the writer is not a mental health provider, but someone who has dealt with expatriate depression.

https://lifeinmerida.com/what-is-expat-depression/

Photo note: A close up of the creepiest part of my Halloween displays, the baby dolls.  Please also note the skeleton on the door that is supposed to be putting her hands on her hips, but instead has a rather unsavory position.  Don't worry, I changed it...  :\