rsz_out_of_the_darkIt’s normal to experience both positive and negative emotions as appropriate responses to life events, but your ups and downs should balance each other and you should have the resilience to come back to your center. You should not get emotionally stuck. Nor should your moods undermine your physical health, interfere with your sleep or work, damage your relationships, or limit you from engaging fully with life. If you feel you are low in happiness, know that you can make changes to let more of it in.

Depression is a multifactorial health problem, rooted in complex interactions of biological, psychological, and social variables. Loneliness, for example, is a powerful predictor for depression. Numerous studies show that people with few intimate social contacts are more likely to be depressed than those who enjoy a rich network of friends and family. Obviously, depression is one of the major problems of expats. For a multitude of expats, making new friends is not easy. The more isolated and lonely we feel, the harder it is to get out and meet new people and consequently we become even more isolated and lonely – creating a vicious circle.  The worst part about being depressed abroad is you feel totally isolated and misunderstood within your new country, but also nobody at home gets it either. It was your own choice to live abroad! How can you be depressed!? The absence of close friends also diminishes the ability to deal effectively with other problems.

There are three types of depression. Expats tend to suffer from situational depression, a reactive depression that is triggered by stressful events (death, unemployment and moving to another country) and has a temporary nature. All types of depression share symptoms: feeling the blues, loss of appetite or increased appetite, change in sex drive, trouble sleeping, lack of energy, apathy, problems concentrating, feelings of guilt, physical pain, agitation, feelings of hopelessness. Distinguishing symptoms that are more closely associated with severe ‘clinical’ depression are suicidal thoughts, symptoms occurring for no apparent cause, symptoms that are not an appropriate response to the stress and a family history of depression.

These past decades, drug manufacturers launched a worldwide campaign promoting serotonin as the biochemical essence of happiness. Serotonin reuptake inhibitors (SSRIs) were said to end depression. But there is a growing body of evidence against SSRIs. Most people with depression don’t need an active drug. They do as well on regular exercise or a conversation with a good friend as on medication It doesn’t matter what you do; it’s just that you’re doing something.

Are you experiencing a depressed mood for most of the day? Please stop hiding your depression, thinking that it is a ‘weakness’.  I understand you prefer to curl up in front of the tv with a good glass of wine, but in the end this is going to worsen your situation. Get up and sign up for this program, talk to a professional or to an unbiased friend. Don’t suffer in silence. You are too precious to stay in the dark.

Out of the darkness
In this program will first assess your present situation and health, review your lifestyle and set goals. We’ll develop an individual program considering physical health, emotional health, lifestyle, diet, exercise patterns, sleep habits, hopes, fears, socialization, isolation, culture shock, jobs, hobbies, family and friends.  After identifying your most pressing needs, we can look for changes and strategies that work for you: positive psychology, meditation, change of assumptions, breathing technique. Below an example.

Week 1. Assessment of your present health, situation and lifestyle. Identify pressing needs. Set long term goals.
Week 2. Depression in the expat context. Socialization. Vulnerability. Acceptance. Contentment.
Week 2. Health problems, diet, exercise, caffeine, drugs, vitamins, breathing technique.
Week 3. Management of negative thoughts. Anxiety and depression. Sleep and dreams. Information overload.
Week 4. Music. Influence of others. Positive psychology exercises.
Week 5. Evaluation of progress.
Week 6. Choosing long-lasting strategies. Information overload. Explore your creativity.
Week 7. Limiting yourself. Meditation and yoga. Problem areas. Anger and forgiveness.
Week 8. Caring for your spirit. Volunteer work. Re-assesment. Week 9 and beyond.

This program is not for people with severe depression associated with psychosis, manic episodes, psychoactive drugs.