- Niesha Davis is a writer currently living in Thailand; you can keep up with her here.
- She’s been living outside of the US for five consecutive years now, but when she first moved abroad to South Korea, she found her mental health faltering.
- Her depression and anxiety were exacerbated, and this continued even after a move to a new job in Shanghai.
- She started engaging in more self-care, used online therapy services, created a medication plan, and actively sought out community.
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I was first bitten by the international travel bug at age 21, when I went to study abroad at The University of Amsterdam. I loved traveling around Europe, experiencing new-to-me cultures, and having the ability to soothe my depression and anxiety with legal, high-quality weed.
I loved the anonymity that life in Amsterdam provided me. Being immersed in a different culture gave me freedom and license to not only enjoy new experiences but life there gave me an opportunity to see life from other people’s perspective. As a person who is always striving to learn, I knew that if I wanted to gain as much knowledge as I can about the world, travel needed to play a big part in my life.
Nearly two years after graduating from undergrad, I decided it was time to leave America again. In the end I decided on a „gap year“ of sorts teaching English abroad. After a few months of applying, I landed a job teaching primary school kids at an English language camp in Daegu in South Korea.
Almost immediately things started to go south, and I felt totally overwhelmed. There was no real training for my job, which made me very anxious as a first-time teacher. I had also underestimated the stress of living on campus – in the mountains – surrounded by a revolving door of new Korean kids to get to know each week. Besides work and life issues, adjusting to a culture so different than the Western one I was used to was also daunting. I had always dealt with depression and anxiety, but being so far out of my element sent me into even more of a tailspin.
The following year I moved to Shanghai, thinking that a better job in a more metropolitan city would be the answer to my struggles. Spoiler alert: It wasn’t. It would take a few more years of crippling depression before I finally took control of my life and started making the changes I needed to thrive in the lifestyle I chose. Here’s what I do now to take care of my mental wellness while living outside of the US.
1. I became more mindful
Foto: Niesha Davis in Shanghai in 2016. Source: Courtesy of Niesha Davis
With my depression and anxiety, negative self-talk is a big issue for me. As I started to get serious about my mental wellness, I began engaging in more self-care practices. One of the things I did to combat the feelings of doom and gloom I felt many mornings was to create a morning routine for myself.
„Routines are crucial, especially when moving to a new country,“ said Christine Smith, MSW, a therapist and mental health coach who works with expats struggling with cultural adjustment in their new surroundings, life transitions, and stress management.
Smith suggests creating daily routines that include some combination of yoga, meditation, and exercise as a form of mindful self-care: „Mindfulness is one of the key components to almost all mental health treatments.“
My new morning routine included starting every morning with a bit of cardio, which not only keeps my body healthy but also naturally boosts my endorphins. I follow up my exercise with a guided meditation, which gives me the opportunity to quiet my mind and ruminate on a positive thought or intention for the day.
To combat my anxiety and negative self-talk, I also make a habit of jotting down a few things I am thankful for in a gratitude journal. Writing down things I am grateful for has given me a sense of hope, and a reminder that even in the middle of tough times, not everything is all bad.
„When people do not address negative feelings or thoughts, those thoughts become even stronger,“ Smith said.
2. I utilized online therapy services
Foto: Niesha Davis in Hanoi, Vietnam in 2017. Source: Courtesy of Niesha Davis
As a black queer woman, I move through life with a unique set of challenges and adversities. So, when I finally decided to seek out talk therapy, it was important to find a provider who could relate to me as a black woman of color. As such, I decided to go back stateside (at least virtually) and find a therapist to work with online.
Smith explains that teletherapy is just as effective as in-person talk therapy, and is an especially good option for people living in rural or remote areas, or – in the case of expats and travelers – abroad.
Things can get a bit tricky when it comes to not only finding a perfect fit but also making sure everything is on the up and up legally.
„In America, things are very strict. So, if you’re licensed in one state, you are only allowed to provide therapy to people who live in that same state,“ Smith said. „If you’re looking for somebody who has been trained as a psychologist or psychotherapist, check their site and see if they have education and experience in psychology or social work.“
Alternatively, there has been an uptick in online therapy services like Talkspace and Better Help, platforms that connect those looking for licensed therapists who can work with you online or even via text message.
3. I figured out a medication plan that worked for me
Foto: Niesha Davis. Source: Courtesy of Niesha Davis
Finding antidepressants while in China proved tricky, but not impossible. Information on the internet (and in person) was conflicting. While the general consensus was that psychiatric drugs were available in China, there was some confusion about where exactly to find them.
For example, during a routine checkup I decided to ask the OBGYN I was seeing at a local hospital if I could get antidepressants in Shanghai. She waved her hand dismissively, insisting that simply wasn’t a thing in China. Her reaction could have been due to a genuine lack of knowledge on the subject since she was not a mental health professional, or she could have been „saving face,“ as mental health is still highly stigmatized in China.
Thankfully, I continued to do my homework and ended up discovering the Shanghai Mental Health Center, a psychiatric hospital founded in 1958. The mental health clinic provides medication as well as psychotherapy, and it was here that I was able to get a prescription for antidepressants.
If you are currently taking anti-depressants and want to continue doing so while traveling, be sure to schedule an appointment with your primary mental health care provider and tell them about your plans.
„[Psychiatric medications] are very dangerous to just stop abruptly, especially if you’re using them to manage depression or anxiety,“ Smith said. „If you’re taking medication in your home country, it’s important to talk with your doctor to find out if that medication will be available to you where you’re going.“
Doing your homework and preparing beforehand if possible is essential to an uninterrupted medication schedule. Not only do medications have different legal standings all over the world, but your particular medication just might not be available in the country you are traveling to.
4. I found a community
Foto: Niesha Davis in Shanghai in 2017. Source: Courtesy of Niesha Davis
I did study abroad in the Netherlands, but finding friends and community as a college student is very different than trying to do so while navigating the workforce, learning a new culture and language, and dealing with other grown woman problems on the day to day.
Feelings of isolation and loneliness are common for expats moving to a new country or travelers who are visiting places they are unfamiliar with.
A study conducted by Brigham Young University found that isolation and loneliness yielded the same health risks as smoking 15 cigarettes per day, and are more likely to influence early death than air pollution and lack of physical activity.
If you’re trying to build community in your host country, Smith suggested volunteer work or engaging in activities you are passionate about.
„Volunteering not only allows you to connect with people who share a common interest in something you too feel strongly about, it’s also a great way to learn about your new culture and community,“ Smith said.
Smith, who currently lives and practices in Puerto Vallarta, Mexico, said one of the things she likes to do when visiting a new city is seek out online meet-up groups, introduce herself, and organize some sort of meet-up to get to know other people.
An introvert to the max, staying inside and secluding myself from the world comes naturally to me. In an effort to build more friends and have a better sense of community, I started taking different classes and workshops that I’ve always wanted to try, like pole dancing and burlesque. I also make it a habit to meet up at least once a week with a new or old friend.
As of now I’ve been living outside of the US for five consecutive years. There will always be travel-related stressors in my life that can’t always be avoided. Thankfully, I’ve put in the work to grow and utilize different tools to deal with my mental health issues while living abroad and experiencing the world.