Living Abroad and Red Flags: When to seek professional help

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Studying and living in a different country can be an exciting, fulfilling and life-changing experience. It can be an opportunity to explore and grow at different levels: personally, academically, professionally and socially. However, most people don’t think about the trials and tribulations that come with this experience. They don’t anticipate the red flags. When we think about studying and living abroad what usually comes to our mind is the excitement of learning a new language, living on our own, immersing ourselves in a different culture, meeting new people, touring around the city, traveling to other cities or countries nearby, trying new foods.

Sometimes, we may hold high expectations about how our life is going to be in a different country, for example, having the expectation of being someone new, a better version of ourselves, or being in a place where we would easily overcome our previous difficulties and problems. A change of scenery may help, but usually, if we were experiencing difficulties back home, it is likely that we would experience similar difficulties in a different country, in addition to having to face the typical challenges of living abroad: adjusting to a new culture, new friends, different language, different educational system, different foods and meal schedule, etc.

It is important to be careful with our expectations; if there is a significant discrepancy between our expectations and reality, mental health related difficulties are likely to appear. Living abroad can, indeed, be a place where we can grow and flourish, but we should have realistic expectations and keep in mind that personal growth stems from stepping out of our comfort zone, which is not absent of challenges, especially if this is the first time we are living in another country.

Here are some red flags that may indicate it is time to ask for professional help:

Anxiety symptoms: worrying about minor things, feeling easily overwhelmed, feeling dizzy or lightheaded, having palpitations, shortness of breath, or hot flashes. Having anxiety in new stressful situations can be common, but if the intensity and frequency of the symptoms are interfering with your daily functioning and you have difficulty enjoying your experience abroad, you might consider seeing a mental health professional.

Changes in your mood: if you experience mood swings, feel like you are on edge, feel upset or irritable and not really knowing why, feel unable to cope with daily frustrations. Also, if you experience low mood, low energy, low motivation, feel like you do not enjoy hanging out with friends or doing your hobbies as much as you used to, prefer to spend more time on your own, feel apathetic, sad, lonely, feel like crying or cry more than usual, have difficulty getting out of bed in the morning, all these symptoms are signs that something is not going well, and outside help might be beneficial to face the difficulties you are going through.

Sleeping difficulties: if you have trouble sleeping or getting to sleep, sleep just for a few hours a night (less than the recommended amount), feel tired and unrested when you wake up, and this situation persists for several days in a row or for weeks, it very important that you seek professional help. If left untreated, the lack of proper sleep could worsen your psychological and emotional state and could lead to cognitive impairments (difficulties in attention, concentration, decision-making, studying, etc.).

Tendency to isolate: if you are a friendly, sociable and outgoing person and you start feeling like you want to spend much more time alone, do not want to socialize as much, spend more time in your room by yourself, do not enjoy other people’s company as much as you used to, you are not as interested in the cultural/entertainment activities the city has to offer you, be careful and try to make an effort to socialize, it will be key to your wellbeing. If you isolate yourself, it could lead to mood related difficulties.

Homesick with an excessive intensity: missing home, your loved ones, your city and country, your previous routines, can be quite common when spending some time abroad. But if this happens too often and makes you feel really sad, apathetic, nostalgic, and you cannot wait until the day you go back home, this might be an indicator that you are experiencing some difficulties that are interfering with your daily life.

Poor academic performance: if you are having difficulties concentrating, getting organized when studying, have lower grades than you use to have back home, part of this could be attributed to the fact that you are studying in a different educational system and/or in a different language. But if your academic performance has suffered an important decline, that might be related to anxiety or mood related difficulties, consulting with a professional would be recommended. It is also important to be aware that being a perfectionist and self-demanding to the same level as you were back home could be detrimental to your performance and mental health; keep in mind that you are in a different environment under different stressors and so your performance could be affected.

Tendency to bottle things up: if you are one of those people who tend to keep to yourself and do not share with others the difficulties or challenges you are facing, doing so when living abroad could potentially be a bit problematic. Keep in mind that living abroad could be a stressful experience and takes time to adjust to a new environment, social support is key to success on this journey. Your peers might be experiencing the same difficulties as you are and sharing with them what you are going through might give you a chance to feel understood and supported. This is also an opportunity to potentially acquire knowledge on different coping strategies. If you don’t feel comfortable sharing your thoughts and feelings with your peers or family members, consider sharing them with a mental health professional, who would help you process what you are going through.

Unhealthy coping strategies: if you find yourself using coping strategies that might not be healthy for you, such as engaging in risky behaviors (i.e., using alcohol/drugs, gambling, unprotected sex, self-harming behaviors, unhealthy restriction of calorie intake) to cope with negative emotions (i.e., sadness, loneliness, anger, fear, feeling of being inadequate, etc.) I highly recommend seeking professional help. You may have used these strategies in the past to deal with difficulties, distress or discomfort, which probably helped temporarily to numb or reduce the intensity of negative emotions and evade problems or difficulties you were experiencing in your life, however these strategies never tackle the problem, help in finding a solution nor help to adaptively regulate your emotions. Also, these strategies, in the medium/long term usually generate more problems (at school, at work, with family/friends). If you keep using these strategies your chances of enjoying your time abroad and making the most of this experience will probably be hindered or limited to some extent.

Other situations in which you may need to seek professional help while living abroad:

• If you are currently taking medication for mental health related difficulties it is advisable to have a psychiatrist in mind who you can go to. Depending on the type of medication, it could be beneficial to have an appointment with a psychiatrist so he/she can monitor your progress while living abroad. You might have enough medication for the time you are going to spend abroad, but something unexpected could happen and you might end up running out of medication. Prescribing medication may work differently in your home country, some medications might have a different name and it could take several days to schedule an appointment with a psychiatrist, so be prepared and do not wait until you run out of medication to ask for an appointment, do it in advance.

• If you have been diagnosed with a chronic/episodic mental health problem, have a history of stress related difficulties, or have experienced recent stressful life events (i.e., break-up, illness or death of a loved one, etc.). Keep in mind that living abroad can be a stressful experience, which could add to any other stressful events in your life. Therefore, especially in those cases, it would be highly advisable to be on alert for potential red flags.

If you experience any of the red flags, difficulties, or unhealthy coping strategies mentioned above, my advice to you is to not hesitate to ask for professional help as soon as you detect any of those symptoms. Do not put it off until the point at which you are so distressed that things feel unbearable or you are so sad that you do not have energy to get out of bed, do not enjoy hanging out with friends and cannot wait to go back home. Living and studying abroad could be a wonderful opportunity to grow and flourish, personally and academically, but challenges and difficulties are an integral part of this experience.


You do not need to have a serious mental health problem or crisis to consider seeing a professional, sometimes you just need some help because you do not have enough/appropriate resources to adequately face new challenges or difficulties. With professional help you can acquire new skills, resources and strategies to successfully adjust to a new environment. A mental health professional can help you navigate these difficulties, deal with culture shock and adjust to the new environment and make the most of your experience.

At Sinews every member of our team has spent time living in another country, if not in several countries. This means we may have had a similar experience to what you might be going through. We have experienced first-hand the challenges and difficulties of living abroad and know that asking for professional advice when needed could be crucial for a person’s physical and psychological well-being. If you think you can benefit from seeing a psychologist/psychiatrist, at Sinews we will be happy to guide you through this process of overcoming the difficulties you have encountered in your journey and we will help you develop better strategies to transform this experience in a positive, nurturing, and life-changing one.

Amanda Blanco Carranza

Leah has been living in and exploring Madrid since 2013 when she moved to the city for a simple summer abroad. After falling in love with Madrid, she started the Citylife Blog in 2014 with the goal to share everything there is to know about her favourite place on earth! In her spare time you will find Leah at some of Madrid's many museums and cultural exhibitions.

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