Mental Wellness Abroad

I’ve been in Madrid, Spain for the past week, beginning my semester of study abroad at the Middlebury School in Spain. Though Madrid has been amazing thus far, there are times of homesickness, stress, exhaustion and culture shock.

Though these experiences are normal and common amongst those who study abroad, they are often glossed over when recounting experiences abroad. Though it is usually good to focus on the positive parts of study abroad, it’s also useful to be realistic and prepared for the some of the low points.

Being abroad is not going to be 100 per cent comfortable all the time. It can be frustrating and hard to adapt to a new culture and new language. These difficulties can have an impact on mental health and wellness, which makes it of paramount importance to be prepared mentally to study abroad.

If you struggle with mental health, there are many useful steps to take prior to going abroad that can ease the transition and reduce chances of serious problems arising. With a little preparation, studying abroad with a mental health condition is certainly possible and may even help you manage your condition.

If you take medication, it’s important to have a plan for how to access medication while abroad. In some cases, doctors can prescribe enough medication in the United States to last your entire time abroad, but you should still get educated on how to properly carry medications while travelling internationally (check out the State Department’s website for useful information on traveling with medication: http://travel.state.gov/content/studentsabroad/en/health/prescriptions.html).

Those going abroad for longer periods may need to get prescriptions filled while abroad. Working with your psychiatrist or doctor and the staff in the study abroad office can help sort out prescription issues prior to going abroad – make sure you know the names (including generics) and dosage of your prescriptions, and, if you’re going to a country that operates in another language, learn the vocabulary words for your condition and medication. Make sure your doctor knows you’re going abroad and discuss possible challenges beforehand.

Doing research online and talking to the counseling center about mental health resources in various cities can be a great start to a healthy semester abroad. Some larger cities will have mental health resources in English – for example, Madrid has a variety of psychiatrists and psychologists who operate in English. Smaller cities or less-developed countries may have limited resources or no resources in English.

If weekly therapy is a part of managing your condition, it may be wise to choose a study abroad site with mental health resources available. You can also talk to your psychiatrist or psychologist about the possibility of Skype sessions or strategies for self-management while abroad.

Another factor is international insurance and mental health. In Madrid, for example, we received a list during orientation of health and mental health resources that accept HTH Worldwide Insurance, the standard Middlebury Schools Abroad insurance. You may want to check in advance whether the place you plan on studying has mental health resources that accept this insurance, and if not, plan accordingly.

Take time to consider how housing options, university options and program size will affect your time abroad and impact management of mental health issues. It may be that a smaller program with more individualized attention and housing with other students you already know may be a better fit for you. If you feel comfortable, you can discuss mental health resources abroad with the study abroad office or students who have studied abroad before. This may give you a better idea of what to expect and how to approach any issues that arise while abroad.

It’s important to have realistic expectations. Studying abroad can be overwhelming. Don’t expect everything to go perfectly, but don’t expect to be miserable all the time (that’s a sign that something may be wrong). Reading other student’s blogs can help prepare you for possible cultural differences and give you an idea of the typical range of reactions to studying abroad.

Once abroad, it’s important to maintain contact with others – don’t isolate yourself just because you feel overwhelmed and out of place. Chances are other students feel the same way.

Do your best to make connections to people in the host country and explore your surroundings, but don’t feel bad if you need time to indulge in American comforts, like favorite TV shows or peanut butter.

Finding ways to get outside of your apartment or house to get some exercise and stimulation is vital.

Researching beforehand can help make it easier to find your favorite activities abroad – in large cities, there are likely to be sports teams and gyms you can join, dance classes to take and free walking tours of the city.

Make a list beforehand of things you’d like to do and see in the place you’re going; pre-made lists can provide extra motivation to get out of the house and experience the culture of an unfamiliar place.

Journaling can be helpful to reflect on your experiences abroad and your feelings toward various aspects of the semester or year.

This sort of reflection may help you identify healthy and unhealthy patterns of coping in a new setting and can better prepare you for future mental health issues that might arise.

Keeping in contact with those at home is important but can become a problem as well: make sure you aren’t spending too much time in contact with those back home, even at the beginning. This can lead to more extreme homesickness and dependence and can start an unhealthy pattern for the rest of the semester.

Nutrition, adequate sleep and moderation in use of alcohol and drugs are important as well. Make sure to eat enough and eat well; branch out and try new foods, but don’t use that as an excuse to eat unhealthily (e.g. do not go to France and eat only croissants and Nutella).

It can be hard to get adequate amounts of sleep while abroad, especially with the different eating and sleeping schedules of many cultures. Putting in the extra effort to get enough sleep can have a huge impact on how you handle being abroad; fatigue combined with the unfamiliarity of a different culture can make small problems seem like crises.

Alcohol and drugs can also make small problems more severe. Though being abroad is a great time to try wine in Italy and beer in Germany, moderation and control are important, especially at first, when you may not know the layout of the place you’re studying, sketchy areas and how to avoid being mugged, or who to contact in emergency situations.

It is important to be realistic in your expectations for how you’ll feel abroad. It’s normal to feel sad, frustrated and angry while abroad, perhaps even more frequently than at home.

A new culture can be challenging to adapt to. That said, it is not typical to be sad, depressed or miserable all the time. If you’re having trouble getting out of bed every day or find yourself crying all the time, you should talk to someone and find out what resources are available to get help.

If you’re in a place with limited resources, there is lots of helpful information online for ways to cope with feelings of depression, anxiety and more while abroad.

Many universities have guides for mental health condition management while abroad; one example is Northwestern University’s “Mental Health Abroad” (found here: http://www.northwestern.edu/studyabroad/guide/health-and-safety/health/mental-health-abroad.html).

Studying abroad is an invaluable experience for many students; having a mental health condition does not mean you can’t take part in it. Like physical health issues, mental health conditions require extra consideration when deciding whether to study abroad and extra preparation when getting ready to go abroad; with a little preparation, study abroad can still be a success!