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Mental health and living abroad: New data reveals the most common pitfalls

Studying or working abroad is a fantastic experience for many, offering new experiences and perspectives. However, it can also provide significant challenges, especially with regards to wellbeing and mental health.

Mental health and living abroad: New data reveals the most common pitfalls
Living in a new country can be exciting but also daunting. Photo: Getty Images

Many people experience significant challenges to their general wellbeing and mental health when moving to – and living in – another country. This can take many forms, such as:

  • Difficulty accessing medication, particularly medication prescribed in the previous country of residence.
  • Not being able to navigate the local health system to book an appointment.
  • Not being able to find the right ingredients for a vegan or vegetarian diet.

In partnership with AXA Global Healthcare, we take a look at some of the major issues facing international professionals, as well as what can be done to look after health and general wellbeing as an expat.

Difficulties faced

Having moved to Berlin from Saudi Arabia to study and work in HR, Hanan Asgar was excited about the opportunities Germany offered. As she says: “I wanted freedom, respect and equality for myself and my generation.”

However, the combination of being completely new in a foreign country, together with an unfortunate incident in her first few days in her new homeland – about which Hanan had no one to speak to – meant that Hanan began to feel isolated and anxious.

She tells us: “My anxiety grew and I actually ended up locking myself in my dorm room and questioning my choice of moving to Germany. But after some reflection, I realised that it was me who was missing out on the lectures I was avoiding. So I took the courage to step out again and face what was to come.”

Living and working abroad, far from home, can present a number of obstacles. Learn more about how AXA provides mental health and wellbeing healthcare as part of its global health plans 

Hanan subsequently underwent treatment for anxiety and depression with a therapist, and has now been living happily in Berlin for the past six years.

Hanan’s experience with initial culture shock and mental health challenges, while living and working abroad, is shared by many expats. A social listening study conducted by AXA* in 2021, across six popular nations or regions for those living abroad, discovered:

  • Anxiety was the most common difficulty faced by expats in France, the Scandinavian countries and the United Kingdom – 24%, 27% and 32% respectively.
  • Depression was the second most commonly experienced challenge.
  • Those in France were most likely to experience anxiety and depression regarding the consequences of Brexit.
  • Other issues that those in France, Scandinavia and the United Kingdom identified as obstacles associated with living abroad, included dealing with chronic illness (such as living with a condition like diabetes), safety concerns (for example, crime) and stress related to the workplace.  
Exercise can help deal with stress. Photo: Getty Images

Strategies that work 

Fortunately, the AXA study also shows that there are a number of strategies that work when dealing with health and general wellbeing issues. Their study found the following:

  • Building strong support networks and healthy relationships with friends and co-workers was seen as important by expats in all countries.
  • Building strong support networks, as well as spending time on entertainment and hobbies, were particularly important to those living in the United Kingdom
  • Exercise – outdoor, or in a gym – was particularly helpful to those in Scandinavia and France, while those in France reported that they had also had specific success with mindfulness practice and good nutrition.
  • The most effective and useful strategy that AXA discovered, however, was proactive and preventative healthcare, such as accessing a GP or qualified psychologist. 

Discover more ways to look after mind and body while living abroad with AXA and their Mind Health Service 

Hanan Asgar moved from Saudia Arabia to Berlin. Photo: Supplied

Seeking out the right health professionals for both body and mind can significantly reduce the levels of anxiety and depression experienced by those living abroad. Regular check-ups can prevent conditions becoming chronic, while discussing mental health and wellbeing can substantially reduce the pressure that many feel. Prevention, as the saying goes, is better than cure.

Ensuring you have the right healthcare

Finding the right health professionals abroad can be difficult due to language differences, cultural attitudes and varying levels of healthcare. As Hanan reports of her own experience: “I sought professional help and it was quite challenging to find a therapist who spoke English. It took months just for an initial appointment. In the meantime, I would go to an emergency psychological help centre or ask a friend to be around. It all worked out in the end, but it did take a mental toll on me”. 

This is why finding a health insurance provider that offers fast and effective links with health professionals is key. When looking for an insurance plan, consider what AXA has to offer, and the Mind Health Service1 they provide for their customers.

Included with all individual and small business coverage plans, the Mind Health Service provides up to six telephone-based sessions for those covered, in addition to their Virtual Doctor Service2. It’s easy and fast to connect to a qualified psychologist who speaks your language, wherever you are in the world, whenever you need it. There is no extra charge for this service for individual, family or SME customers, it has no impact on your excess and outpatient or policy allowances, and can also be used by anybody who is covered by your plan. 

Living abroad is, for many, the experience of a lifetime. The memories and friendships created can endure long after we’ve returned home. That’s why it’s so important to ensure that the care and support is there to ensure you can keep enjoying your new country.

Ensure that your time overseas is happy and healthy.  Access up to six telephone sessions with a qualified psychologist through AXA’s Mind Health Service, available at no extra charge as part of all individual coverage plans

*Social media listening, commissioned by AXA – Global Healthcare, conducted by Listen + Learn from 2018-21, across six regions: Canada, Dubai, France, Hong Kong, Scandinavia and UK

¹The Mind Health Service is provided by Teladoc Health
²The Virtual Doctor Service is provided by Teledoc Health

AXA Global Healthcare (EU) Limited. Registered in Ireland number 630468. Registered Office: Wolfe Tone House, Wolfe Tone Street, Dublin 1. AXA Global Healthcare (EU) Limited is regulated by the Central Bank of Ireland.

AXA Global Healthcare (UK) Limited. Registered in England (No. 03039521). Registered Office: 20 Gracechurch Street, London, EC3V 0BG, United Kingdom. AXA Global Healthcare (UK) Limited is authorised and regulated in the UK by the Financial Conduct Authority.

Member comments

  1. disappointed of the use of the word “expats” that word is just creating a classist differentiation that shouldn’t exist, and using our privilege to create a gap doesn’t help, we all are migrants, that’s it.

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LIVING IN GERMANY

How to make the most of Germany’s long summer days

In Germany the sun sets late and rises early in the summer months. The Local's reporters share their favourite activities for taking advantage of the long hours of daylight.

How to make the most of Germany's long summer days

Germany doesn’t quite get to see the “midnight sun” – how’s it going up there Norway? – but it is located far enough north to enjoy rather long days during the late spring and summer seasons.

The summer solstice, called Sommersonnenwende in German, marks the longest day and also the beginning of the summer season in the Northern Hemisphere.

In the town of Flensburg, which is near Germany’s northern border with Denmark, the sun sets at 10:06 pm and rises at 4:41 on the summer solstice, amounting to approximately 17 hours and 24 minutes of daylight.

Central and southern German cities get a little less daylight, but still enjoy late night sunsets and early morning sun rises. Berlin, for example, gets 16 hours and 50 minutes of daylight on the solstice. Munich gets just over 16 hours of light on the longest day.

Especially for people who moved to Germany from more southerly latitudes, watching the sunset at 10 pm or noticing the sky lighten at four in the morning can be a surreal experience.

But of course the flip side of long days in the summer are long nights in the winter, giving you all the more reason to take advantage of all the light while you can.

Here’s a few things to do with your extra daylight hours during the German summer:

Add outdoor sports to your ‘Feierabend’ routine

Germans place a high value on work-life balance, and this is perhaps best seen in the importance placed on the Feierabend, or your after-work time.

READ ALSO: Why every country should get on board with the German Feierabend

During the winter having a dinner date, or more simply a Feierabendbierchen, are the main after-work activities that come to mind. But during Germany’s long summer days, you still have plenty of daylight left to go skating in the park, or enjoy a bicycle tour of the city, even if you work until 6 pm or later.

sunset jog

Jogging, biking and other sports are all possible after work during Germany’s long summer days. Photo: picture alliance/dpa | Peter Kneffel

Some people really take advantage of the extended light – using that extra time for physical activities that they might not otherwise get to do during work days. It’s not uncommon to see people stand-up paddle boarding on the river, or rock climbing, late into the evening in the summer.

Go for an early morning stroll

Germany’s early morning sunrises can be a bit of a controversial topic.

For the early birds, they offer an opportunity to get ahead of the day before your work day or other obligations begin. For the night owls who currently lack shutters, they can be an unwelcome wake-up call.

But with the sky lightening as early as 4:30 am, whether you’ve freshly woken up, or are heading home after a long night out, you may want to consider taking advantage of a unique opportunity for a morning walk. 

Especially for those who tend to sleep in, an early stroll can allow you to see the world anew – complete with birdsongs in the air and the smell of freshly baked bread wafting out of local bakeries.

Enjoy some of Germany’s summer events and festivals

The summer season is a good one for outdoor events and festivals in Germany, and especially in June and July, attendees can add a catching a late evening sunset to a fest day’s itinerary.

There are a number of festivals worth checking out in June in Germany, including some events scheduled for the longest day itself, such as this solstice celebration in Conneforde or Fête de la Musique in Berlin.

A couple others worth mentioning are the Tollwood Summer Festival in Munich or the Rose and Light performance night in Frankfurt’s Palm Garden.

Stay tuned for a list of July events we’ll be sharing soon.

Catch a film at an open air cinema

Germany loves open air cinemas – it’s home to hundreds of them – and a mid-summer eve is really the best time to experience one.

To find an outdoor theatre near you, try searching for ‘Freiluftkino’ + your city name. 

But be sure to keep languages in mind while looking over screening programs. If you don’t yet have the German skills to enjoy a movie auf Deutsche, you’ll want to look out for films marked OV (original version), OmU (original version with German subtitles) or OmeU (orginal version with English subtitles). 

an open air cinema

Spectators watch a film at the open-air cinema in Oranienburg Castle Park at dusk. Photo: picture alliance/dpa | Jens Kalaene

Watch (or play) some football

This year, you have the added option of watching Euro 2024 football games – often late into the evening – until July 14th.

Of course watching football is something you can always enjoy in the comfort of your own home. But this year you can join in the real-world frenzy that is the UEFA Euros Championship outside at one of the official fan zones, or otherwise at your favourite beer garden, späti or sports bar with outdoor seating.

This has the added benefit of allowing you to watch the game, while also taking in a the summer breeze.

And if watching Die Mannschaft score a couple goals is particularly inspiring, you might still have enough light to head to your local park and kick a ball around after.

Take a wild dip in refreshing waters

Summer in Germany is often accompanied by at least a few heatwaves: a string of hot, sticky days when temperatures soar and it’s tempting to just stay indoors.

In warm weather, though, there’s nothing quite like venturing out to a picturesque lake or a beach along Germany’s rugged coastline and taking a wild dip.

Though you can’t expect temperatures as warm as the Mediterranean sea, that’s part of the charm: bathing in cool, refreshing waters is the ideal medicine for lethargy during those sweltering summer afternoons. 

There are a range of studies that show that outdoor swimming is good for the soul – not to mention great for your health. From releasing mood-enhancing endorphins to boosting immunity and improving cardiovascular health, it’s no wonder wild swimming is known as one of the best natural highs around. 

READ ALSO: ‘Go early and stay late’ – Your tips for making the most of Germany’s lakes

With reporting by Imogen Goodman

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