Contributed by Krista Creel

Let’s make one thing clear. Mental health is health. But for centuries it has been either minimized or stigmatized, rarely normalized.  

Whereas today it is socially acceptable and even encouraged to go to the doctor for any type of physical ailment, we can’t say the same for our mental health. Yet, mental health greatly affects physical health and the ability to function.  

When traveling for extended periods or moving overseas for remote work—away from connections, friends, family, familiarity—mental health illnesses can fester without treatment. They don’t go away. They grow.  

The Minimization of Mental Health

It is just culture shock. It will pass. Get over it. Smile more. Don’t worry, you’re just a little blue. Relax, you’re just a little stressed. These are statements that minimize the importance of addressing mental health, and not only do others try to tell us these things, but we also tell ourselves.  

The expression, feeling blue, especially sweeps the underlying issues under a decorative but useless rug. Ever wonder where that expression originated? There are a few theories: 

Some theories point to the 1300’s when Geoffrey Chaucer, in his poem "Complaint of Mars. Converted", connected the word blue to sadness.

Wyth teres blewe and with a wounded herte...” 

Converted from Olde English, it means "with tears of blue and a wounded heart."

Other theories point to the physical changes that occur in our bodies when we are injured. We bruise black and blue. And when we lose oxygen, our face and lips turn blue. So, you could be on the verge of death during a mental health crisis, and some may still say you’re just feeling blue.

A Personal Experience with the So-Called Blues

When I was going through my divorce, my anxiety was so high that my body didn’t know what to do with it all. I broke out in whelps all over. My entire face swelled, and not uniformly. It became so distorted it looked like a burl on an old tree.  

So, I went to my primary care doctor for help. He wrote me two paper prescriptions that day: one for steroids and another for “Find your happy place.”  

I still have that prescription to this day as a reminder to myself of just how far I’ve come.

And while I know he meant well, I didn’t find that happy place, not then. In fact, soon after I saw him, I found myself in rehab, diagnosed with alcoholism, battered women syndrome, PTSD, and depression. I was only 31.  

That place and the people within it saved my life, and today, I can say I have found my happy place. I still have trouble talking about my experiences, but I wish I didn’t. I’m not ashamed, not anymore, but I don’t know how to talk about it or even when. Obviously, I’m still not immune to the stigma of mental illness. So, let’s talk about that.

The Stigmatization of Mental Health Illness

For millennia, mental health issues were considered by many cultures and countries as punishment for displeasing God, or a form of demonic possession. People suffering from depression, autism, schizophrenia, and “hysteria” were treated as criminals. They were shunned, imprisoned, tortured, or killed.  

Just Google images of “old psych wards” and you’ll have nightmares.

It’s certainly better in many countries around the world today, but we’re not there yet. In the US, over half of adults suffering from mental illness do not receive treatment, according to the Mental Health America 2022 State of Mental Health in America report. Over 4.5% have had serious thoughts of suicide, and this number is only increasing year over year.  

It’s difficult to understand what you can’t see. You can’t see past traumas, chemical imbalances, malfunctioning synapses, etc. So, when you only see the symptoms, such as addictions or compulsive behaviors or grandiose expressions (or a misshapen, anxiety-ridden face), it can be frightening. The tools to help those suffering took a long time to develop and are still developing today.

The Facts about Expats and Mental Illness

A study published in the International Journal of Health & Productivity found that expats had “a higher overall risk for mental health problems, including risk for internalizing problems, externalizing problems, and substance use disorders.”  

According to an article in InterNations, factors for this can include the following:

  • Facing unrealistic or unmet expectations
  • Feeling isolated and homesick
  • Having an unreasonably full agenda
  • Having a preexisting mental health condition
  • Trying to make long-distance relationships work
  • Sorting out all the paperwork

Others include financial worries, medical and insurance concerns, and disasters abroad.

When and How to Seek Mental Health Help

The signs are there. Don’t ignore them.

  • Are you chronically sad?  
  • Withdrawing from others?
  • Unable to cope with life’s tasks or coping by way of substance use?  
  • Are you having suicidal thoughts?

Those are a few of the red flags to consider for yourself or someone you love. According to Eutelmed, “Every three seconds a person in the world attempts suicide, and unfortunately every forty seconds a person succeeds.”

That number represents one million suicides per year.

How You Can Help Yourself and Others with Mental Illness and Suicidal Thoughts

Don’t wait

If you need help, don’t wait. Find out your local hotline number to call or reach out to someone you trust. In the U.S, dial 988 to be connected to immediate assistance. You can learn more about it at www.988lifeline.org.

Reach out

If you know someone who is showing signs of distress or changes in behavior, reach out and encourage the person to talk to you, someone they trust, or a mental health professional.  

Here are a few steps you can follow:  

  • ask questions (including about suicidal thoughts),  
  • be there for them,  
  • help them connect to others,
  • propose support from a mental health professional, and  
  • follow up to show that you care and that they matter.

Talk, talk, talk about mental health  

The more we talk about it, the more we normalize it. The more we normalize it, the more help people will receive. Encourage others. Let them know that they are never alone, no matter how much it feels that way. If they are coping by way of substances, Alcoholics Anonymous and Narcotics Anonymous are life changers, and there are thousands of free meetings everyday around the world. September is Suicide Prevention Month. You can show your support of this observance by promoting it through walks, posting social badges, sharing stories, and especially by being there for those suffering. Learn more.

Get informed

National Institute of Mental Health (NIH)

Substance Abuse and Mental Health Services Administration (SAMHSA)

National Alliance on Mental Illness (NAMI)

World Health Organization (WHO)

Anxiety and Depression Association of America (ADAA)  

Here are some informative podcasts covering some mental health topics specifically around expats and digital nomads.  

Participate in a community support walk  

Locate a NAMI walk near you. The American Foundation for Suicide Prevention also hosts community walks, shares stories, and provides ways to make a difference.

About Krista Creel

Krista has served in marketing roles in a variety of industries, including service, construction, retail, industrial, insurance, and non-profit healthcare. Her passion is merging creative concepts with strategic execution to build bold brands and the marketing departments that pave the way. Krista earned her masters at the University of Memphis and digital marketing certification from the American Marketing Association. She currently resides with family in the Quachita Mountains of Arkansas where she works remotely as Director of Marketing & Communications for Insured Nomads. She’s an avid gardener, professional writer, and eager student of life.