The Expat Experience and Mental Health

Moving to another country is unlikely to cure any mental health issues. It may, in fact, make them worse. You are experiencing big changes and probably have lost some of your usual support systems.

Blaise Dismer is a mental health professional specializing in anxiety and depressive disorders, and I asked him to write a few words on the subject. Anxiety and depression cause very real suffering and I hope any of you, wherever you are, reach out for help to Blaise or any resources you choose so you can feel better. His website is HERE.

And now.. from  Blaise…

Change is unsettling. Adapting to a novel environment, language and culture arouse a certain amount of “normal anxiety”. Often, anxious people think,” If only I could get rid of all this anxiety!” but our minds and bodies were engineered to benefit from stress when conditions warrant it. For example, when we hear an unexpected noise or we approach the edge of a cliff, our natural anxiety alerts us of possible danger. Our adrenal glands and central nervous systems prepare us for “fight or flight” responses (incidentally, it’s now called “Fight/flight/freeze response”). Only when we are experiencing anxious symptoms frequently without any signs of danger, is it maladaptive. Yuck!

Depression can be seen from a similar view. We all get sad at times. Being away from family and old friends is reason enough for expats to experience homesickness or the occasional blues. However, when one experiences the majority of the following symptoms, it’s time to seek professional help: sleep disturbance, change in appetite, difficulty concentrating, low energy, low libido, feeling hopeless or helpless, poor self-esteem, slow mental/physical responses, thoughts of death and dying. Should one have thoughts about harming oneself or another, a trip to the hospital emergency department is imperative.

Being a newbie in Panama, you may not yet know the mental health resources available. A good place to start is your expat community; another is your GP. Check out the Anxiety and Depression Association of America at Another great source of help is It’s really, really important to know that one can get demonstrably better, perhaps completely past, worrisome anxiety and depression. Don’t allow hopelessness to cloud your vision. Try instead, walking, socializing (even though it may be THE last thing you feel like doing) and talk to a friend or neighbor about what’s going on.

Keep keeping on,



About Kris Cunningham

We live in David, Chiriqui Provence, Republic of Panama! This blog is about some of our experiences in our new country.
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2 Responses to The Expat Experience and Mental Health

  1. jim and nena says:

    Hola Kris,
    Sad is OK. Sad for days and days is melancholy. Melancholy for days without sunshine is Boquete.
    OK, that could be an exaggeration but for many it is true. The rainy season at its worse is hard on anyone. Those with a tendency toward depression can find it tough to conquer. I have suffered through periods of melancholy and I have found what works for me. I watch the movie, Apocalypse Now. By the time I have watched the scene of Captain Willard swinging that bolo knife, I feel great. I don’t know what the analysis to that means, but for me it works.

    When Nena gets to feeling sad for no reason (rare), she starts a sewing project. A few hours later, the look of calm on her face says it all. Everything is OK again.
    Everyone must find what works for them.


    • I think everyone has days, and hopefully things that work for them. When it’s more serious though and interferes with living life, that’s another thing and proper treatment can definitely help many people.


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