Expats, Depression, and Honesty

July 8, 2014 Kristance Harlow
Me Journaling on the beach

[dt_quote type=”pullquote” layout=”left” font_size=”big” animation=”none” size=”1″]Now it is 11am on the 16th. I barely slept. My anxiety is through the roof. My heart is racing, my head is in a nervous fog, my stomach is tied up in knots and I could throw up. I’m holding something in, but what? What is weighing so heavily that it’s making me toss and turn and cry? Nothing bad has happened in months, my career is taking off, I have a great apartment, my boyfriend is amazingly sweet and supportive, my relationship with my sister is good, my mom and I talk often and she is doing better than ever. It’s like I keep waiting for the other shoe to drop. I’m preempting the next bad thing. Disbelieving in all that is good so that when the next bad thing happens I’m prepared. Am I making a negative outcome a possibility through my insecurities and anxieties? Why can’t I relax? Why can’t I express myself clearly to others? Why can’t I stay calm? Where does my panic come from?[/dt_quote]

[dt_quote type=”pullquote” layout=”left” font_size=”big” animation=”none” size=”1″]I want to trust in life and the path I am on, but I keep looking down, afraid of tripping or taking the wrong turn. My emotional flip flops confuse even me. It isn’t a front, besides when I try to hold back an outburst, all my expressions are genuine. I believe in every smile, every laugh, every tear. Each injury and illness is what I’m going through, they aren’t exaggerated or purposely prolonged. I feel sick half of my waking hours. My left elbow experiences shooting pains at random intervals. When I stand up I am often so dizzy that I see in a hazy tunnel vision that quickly fades to black, and I have to hold onto something to steady myself. I feel a strong compulsion to pick at imperfections like dry peeling skin or zits. I stare at my back in the elevator because I worry about how fat my shoulders look. I push one arm out in photographs so no one can tell how flabby my large arms are. I think I am pretty and some days I can be beautiful and sometimes I am confident and fearless. Lately, I am meager and weak. I am afraid of my own shadow. My heart pounds too quickly in my chest and I can hear the throbbing in my ears of it working overtime.[/dt_quote]

Finding a way to move forward from Post-Traumatic Stress Disorder amplified by an already existing depression and circumstantial anxiety has been more than a little bit of a struggle. For half a day, or even a week, I may feel the energy of the world in such a positive way. I will see the future clearly with optimism and excitement. In those moments I feel successful, I feel that I’ve found my calling and am on the path to reaching more of my personal and professional goals. Then, a couple of hours can pass, and a crippling self-doubt will take hold. Maybe it’s a wire tripped by a depressing song with lyrics that latch onto my neurotransmitters and kill the sertraline that was bringing along the euphoric feelings. Or it’s re-watching a video I was working on and all I can see are flaws. Or I’ll reread an article I wrote and hate it beyond reason, instead deciding to scrap the whole thing than submit such a horrid piece of work for others to have to read.

Struggling with depression is a very real and often scary thing. For the sufferer and their family and friends. I find that personal anecdotes are extremely helpful in teaching others how to understand something that they have never personally experienced. Statistics and facts can prove to you that mental health issues exist but understanding what is like to live a life punctuated by mental health problems requires someone to bare their soul.

Perhaps I share too much about myself. What is too much? It’s a strange path to choose – to be a writer who writes about herself. It’s a path that relies on the acceptance of other people. My success requires other people to embrace me and my story. I’m a person who very much seeks approval, even though I hate to admit that. I like to pretend I don’t care. I like to pretend like rejection doesn’t faze me. Only those closest to me know these truths. Now the group whom I share these deep inner workings with has grown exponentially.

I am sick and tired of people being too afraid to talk about mental health openly. It is no different than any other illness and requires treatment and care. There is entirely too much stigma surrounding a problem that affects everyone. Either you or someone you know is dealing with a mental or neurological disorder. 1 in 4 people around the world will be affected in their lifetime. Many people suffer more than one disorder at a time. An estimated 450 million people around the world, today, have some sort of mental health disorder. It is one of the world’s main causes of ill-health/disability. It’s time to cut the stigma shit out and let our freak flags fly. We all have problems, this is one of mine. I also have an unhealthy love for reality TV and have become a compulsive Pinterest user.

By sharing my honesty, my darkness, my light, I hope that someone else will feel like they can do it too. I am not trying to break every social contract that exists. I know some secrets need guarding and that some stories are best left untold, but we still need to learn to be honest with ourselves. In this day of social media, we all make up too many falsehoods about ourselves. We post our happiest photos on Instagram, or perhaps we post our most passive aggressive thoughts on Facebook. You paint a picture of your life and other people feel like they know you through this vetted online presence.

Statistics show that expats experience a higher level of depression than their home-dwelling peers. “As described by the Center for Disease Control and Prevention, short-term travel causes the least amount of stress while expatriates and frequent travelers experience the highest levels of stress. Even people without known pre-existing conditions can have a mental health disorder emerge during travel.” What researchers don’t ask is: what kind of people choose to be expats and would they really be happier anywhere else? Living as an expat has its unique positive and negative aspects and it is certainly not like living in my own country. There are large communication gaps in terms of language and culture. Things simply work differently from country to country and living life in the same manner as your home country simply isn’t possible. It is harder to build a support system abroad, from finding the right doctor to making friends.

P1080870I wouldn’t go so far as to say it is the life of an expat that breeds depression or makes it harder to move forward from PTSD. If I lived in New York City I would probably be the same. I’ve lived in Oregon, Vermont, Massachusetts, India, England, Scotland, and now Argentina. I am me no matter where the wind takes me. It isn’t location that brings around content. It isn’t circumstance or the right job or the right clothes. I have had many of those things and lost those things. It is the mind, the heart, finding a way to quiet yourself in the midst of the chaos of life.

A natural introvert, moving is not so difficult for me. Even in my home town I generally socialize only every now and again because that’s what I like to do. I’m no hermit, I just am content doing my own thing away from the crowds and away from small talk. My best friends are extroverts who don’t take no for an answer when it comes to connecting and getting together. I can’t maintain friendships with people who can’t handle rejection, because I will inevitably reject them. Not on purpose, but because I have always gone through phases of extreme introversion and gone on plan-cancelling rampages.

What PTSD has granted me with is the unique ability to feel an irrational fear of anything and everything that could go wrong. I have always had a healthy dose of fear, but for the right things. Don’t leave that candle burning all night, drive carefully, hold your bag tight in a crowd. But now I’m afraid of nothing at all. No, I don’t mean I’m not afraid of anything. I am afraid of NOTHING, just of EVERYTHING. I’m terrified of failing.

In fact, the expectation that I should be doing certain things socially and that I should be reaching certain milestones can make the fear of failure that much more of a palpable panic. I am succeeding professionally and my love life is fantastic and I have a great relationship with my family even though they are so far away from me at the moment. I have close friends who live in the far flung corners of the world but because I feel the pressure to be something other than myself, I feel anxiety that I will be “found out.”

“Found out” as someone who hates big crowds, who isn’t as easy going as I think I should be. As someone who, even though I am living in a foreign land with a foreign speaking partner, cannot easily learn the language. As someone who likes having a few drinks to lessen the anxiety of taking on new experiences. As someone who will lie once in a while in order to do something that helps me relax because I am afraid other people don’t understand. Needing to just take an hour and compulsively watch reruns of my favorite TV show while eating chocolate and drinking a cocktail.

It isn’t a daily occurrence, but sometimes it comes around and lingers heavily for a few days before lifting away. I fight the fear and sometimes give into it. My heart races faster on these days when I escape into myself and I’m afraid someone will find out what I’m doing and what I’ve done. Tearing open my truth and showing the world my sins and my scars and show me as a fraud. A fraud of what? I don’t even know, but someone will see it and tell everyone about it.

“Found out” as someone who has reoccurring nightmares from which she awakes as if she never slept. Nightmares of fears I never knew I had. Of being grabbed by a stranger in the dark. Of trying to save children from a siege of gunfire at a school. Of having panic attacks in a dream. Of being chased down and being unable to find my shoes. Awaking not with the relief that it was a dream, but with negative fearful emotions surging through my body. As someone who is afraid, in many ways, of life because certain experiences have left very deep and painful scars that my mind refuses to let go of. I relive them in my dreams and then I vividly remember dreams as if they were real experiences.

“Found out” as someone who cannot always overcome their depressive emotions and “do something about it.” Happiness comes and goes, and emotional stability is illusive. Perhaps it is all in my head, but it is uncontrollable. It feels ridiculous to be so happy one moment and so unbelievably dejected and depressed the next. A memory, a rejection, a bad joke, a lonely feeling and I will be swallowing cries and tilting my head to stop the tears from dripping down my face.

IMG_8820So I put out a specific persona, the happy persona. It’s a very real part of me, and I feel that way every day. Not all day every day, but every day. I see everyone doing the same thing. Ashamed that they feel badly, ashamed that they are afraid, ashamed that maybe they feel like crying for no particular reason and can’t articulate why they feel lost in a storm even though the sky is blue and the breeze is pleasant.

Perhaps I am not always producing content on this blog that is exactly what you, my readers, were hoping for. Travel is not all glitz, glamour, and incredible backpacking adventures. The real adventures are those that change you. They require you to change in order to make it through the journey. I have had it all and lost it all many times before. Each time I’ve risen from the ashes. A phoenix reborn from the sorrow and horror of past pain. I’ve come out stronger, but pieces of myself have been damaged. I can’t fit it all back together. I’m a broken puzzle. Aren’t we all? I found parts of me I didn’t know existed but I lost others. I am missing important pillars to hold myself up with. I’ve lost my anchor and now sail with little control over my course. I have no way to stop. To rest. My journey is at the mercy of the winds and all I can do is adjust the sails.

What I am consistent about on this blog is that I am always honest. I wonder if reading these stories ever inspires your own introspection. Do I carry you along on my journey? Sometimes it is just a journey inside myself, although it is happening as I throw myself far from my comfort zone. Liberate yourself and tell the truth about your fears. Let’s have an open conversation about our weaknesses so that we can feel that much more powerful for all of our strengths. After all, what is strength without weakness?

Update 7:10PM Argentine time July 8: This post has been updated to include a link to research supporting the claim that expats experience higher levels of mental health issues.

More Reading
Finding Healing / Healing Journey

Am I Scared or Is It Grief? – Uncovering the Sad Feeling

June 18, 2022
Crisis Intervention / Intervention and Recovery / Research

Shame, Alcoholism, Stigma, and Suicide

Domestic Violence / Mental Illness Stigma / Politics

Stop Blaming Mental Illness for Gun-Related Violence

Addiction / Intervention and Recovery / Prevention / Traumatized Minds

Childhood Trauma, Body Dysmorphic Disorder, and Plastic Surgery Addiction

Human Rights / Social Justice / Traumatized Minds

How to Be Less of a Jerk – Part 2 – Admit Racism


  1. Shawn Cookson on July 13, 2014 at 6:23 pm

    Great open and honest article! I’m dealing with depression too, but on the flip side I’m hoping that hitting the open road will help get me out of the funk. I think getting out into the real world will alter my focus and start living again. Cheers! Blue Skies and Safe Travels

    • Kristance Harlow on July 14, 2014 at 7:12 pm

      Seeing the world can absolutely open your eyes and restart your system! Where are you planning on venturing to? I love to travel. When I get to explore a new place, I am in my element. There is something different and often difficult about living abroad, although that too can be amazing. I love living abroad and I love traveling, but there are definitely struggles that come along with it. I feel least comfortable when I stay in one place too long and being an expat is forcing me to deal with that instead of run from it. Good luck on your adventure!

  2. Marc d'Entremont on July 12, 2014 at 1:36 pm

    I’ve read the link Kristance in your updated blog and I believe you are misunderstanding the CDC results. In the last sentence of the introduction it says, “Given the stressors of travel, preexisting psychiatric disorders can recur, and latent, undiagnosed problems can become apparent for the first time.” That is significantly different wording than your first sentence in your sixth paragraph, “Statistics show that expats experience a higher level of depression than their home-dwelling peers.” The statistics in the study indicate that only travelers with “preexisting psychiatric disorders… and latent, undiagnosed problems” are at a higher risk. I can certainly see truth in that, but your blog title and the title of this discussion is misleading. It is not being an expat per se, its being an expat with preexisting or undiagnosed issues.

    • Kristance Harlow on July 13, 2014 at 6:03 am

      I appreciate your input, I’m going to write a new piece because of it. However, clear up my intentions, I didn’t say that being an expat causes depression. I was pointing out findings (more than just the CDC piece) which show that expatriates are at a higher risk of suffering from mental health issues including depression. This piece was just personal, but this upcoming week I will post a research blog post with more detailed information. Depression can hit anyone at anytime for any reason or for no reason at all and it can hit people with or without undiagnosed or preexisting conditions. The blog title is certainly not misleading. Expats (I am one), Depression (I have it), and Honesty (I’m being honest). Nothing misleading there at all. Also, it’s called having a hook 😉

  3. Rose L. on July 11, 2014 at 8:13 am

    I have always been an open person, sometimes maybe too open. I have had depression and know it is a struggle at times. I once developed a fear to leave my home and had to fight myself to seek the help I needed to rejoin the world. I had to do what I needed to take care of myself. Who would be my champion but myself. Yes, I had friends and family who were very supportive in action and words, but they could not heal me, only I could. My happiness and well being had to come from myself.

    • Kristance Harlow on July 13, 2014 at 5:57 am

      Absolutely, it ultimately comes from within. Thank you for sharing your experience, it echoes the story of so many others who suffer from depression.

Leave a Comment

Join the mailing list.

No spam and we will never share your information.

Something went wrong. Please check your entries and try again.

If you or someone you know is in immediate danger, call your local emergency number. The numbers listed here are the commonly used numbers for the stated region, the numbers can vary greatly depending on where you live. If you don't know your country's equivalent to 911, this wiki page and The Lifeline Foundation have comprehensive listings.



The Americas





112 & 999



112, 999, 110



112, 911, 999, 111, & 000


Find help for a crisis by texting, calling, or chatting online with these free crisis organizations. Looking for one outside of the USA? Check out our support listings.

Crisis Text Line
Text: “HOME” to 741741

Suicide Lifeline
Text: “ANSWER” to 839863
Call: 1-800-273-8255

Domestic Violence Hotline
1-800-787-3224 (TTY)

Child Abuse Hotline

The Trevor Project
Text “START” to 678678

These online and international resources may help you anywhere you are located. Looking for local support outside of the USA? Check out our support listings.

DV Support Abroad
Call toll-free worldwide

I'm Alive Virtual Crisis Center
Live chat with trained volunteers

Crisis Connections
24/7 crisis support with interpretation in 155+ languages