International Boundaries by Jim Witkowski on Unsplash

The Hidden Cost on Mental Health of Living Abroad

It is World Mental Health Day. People are sharing valuable resources and personal stories on Twitter and Instagram. Usually, I miss these days, but it just so happens that I have a story or two when it comes to mental health.

When I finished my studies I found a job in the happiest (or so) country in the world: Denmark. I got a Ph.D. position here which gives me great opportunities, one of which was spending a year at Heriot-Watt University in Scotland, UK. Before this turns into too much of a humblebrag, back to the facts:

I’m a EU citizen, that means, Denmark provides universal health care without much hassle for me. However, it’s important to note, that you get assigned to a Doctor’s office. My first Doctor was a very nice older Dane. As it goes for most well-educated Danes, his English was flawless when I came to his office. I needed a refill for my prescription of anti-depressants. The pills that kept me alive ever since I experienced Burnout in university.

The doctor was very nice and renewed my prescription without a hassle. Nevertheless, he gave me some advice to eat well, stay hydrated and try working out. Advice I’m used to when general practitioners hear, I have depression. Good advice, which is why I followed it for years already by that point. Well-meaning advice is common when it comes to mental health.

Have you tried eating healthy and working out?

Scotland, in the UK, has a very similar system. You get assigned to a Doctor’s office and as an EU citizen (for now) you are insured. This is great, right? In the United States you’d already be in debt by this point. But this positive experience with the nice Dane stopped when I had to move. You get assigned to a new Doctor in a new place. The new Doctor suggested to work out and eat better, I don’t need the medication.

The only way to get a diagnosis would be to go to a specialist like a psychiatrist. Any country I have ever lived, psychiatrists and psychologists have waiting lists for months, sometimes years. Moreover, following the law of the market, they are in high demand. Psychiatrists don’t need a good website. The practice phone doesn’t even have to be in English. Would you like to ask your new native colleagues to translate the phone message of the psychiatrist’s office for you? I didn’t either.

Here are some of the possible side effects of quitting anti-depressants cold turkey because you’re at the whim of a new doctor:

  • anxiety
  • nightmares
  • trouble sleeping
  • depression and mood swings
  • nausea
  • abdominal cramping
  • flu-like symptoms
  • headache
  • sweating

The benefit of healthcare and insurance might not mean you will get mental health care abroad.

In a modern world, where you have to move to the job, you get to sample a lot of assigned doctors. This is not an isolated case, especially general practitioners can be reluctant renewing existing prescriptions, but are generous with their helpful advice. Both Denmark and Scotland have beautiful nature for leisurely walks after all.

Psychotherapy and Others

Does Psychotherapy work? Do pills help?

Unfortunately, it does not stop there. Nowadays, it is still very rare for therapy to be covered by any insurance. There may be alternatives, even if you’re “just down” for a couple of weeks. It doesn’t need to be the hospital or psych ward.

Is there hope?

Podcast that always makes me smile.

Sometimes universities may provide a psychological service, some therapists might cut you a deal if they can, but it is at a cost. While in theory, Betterhelp and Talkspace sound really good, they never worked for me. It was text-only expensive chatting with a therapist that had enough other clients to deal with. Maybe it’s a cultural problem, seeing that all therapists on those platforms are US-based.

These days, although possibly a cliché, support groups may help you. Sometimes having someone that goes through something similar, helps more than the seemingly all-knowing therapist with their helpful tips.

Personally, I have worked through many problems in therapy. Medication has helped me wade through the mess that is a Master’s thesis. And today, my friends, healthy habits, and making sure I’m in a positive environment, have made me weather any storm to date. In fact, I’m handing in my Ph.D. thesis soon.

My hope for us is to reduce the stigma. My hope for you is that you get the help you need, whether you moved abroad or not.

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... is a geophysicist by heart. He works at the intersection of machine learning and geoscience. He is the founder of The Way of the Geophysicist and a deep learning enthusiast. Writing mostly about computational geoscience and interesting bits and pieces relevant to post-grad life.
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