Moving Abroad by Choice, Struggling Anyway: Mental Health for Expats
People leave their birth country for different reasons. Some did not have a choice due to circumstances while some made that choice with meticulous and foolproof plan. Perhaps it was a good job offer, a partner’s career, a place you had always wanted to live, a lifelong adventurous dream, or a more enjoyable life. From the outside, everything looks like it should be fine. So when loneliness, sadness or a strange sense of not quite being yourself creeps in, many expats stay quiet. They assume they have no right to struggle, or that something must be wrong with them.
There is nothing wrong with you. This article looks at why life abroad can be hard even when the move was your own decision, and what can genuinely help.
Wanting the move and struggling with it can both be true
Living abroad is so often romanticised that people feel ashamed to admit they are finding it difficult. A better salary, a safer country or a successful career is supposed to cancel out everything else. It does not. Gratitude and grief can exist together. You can love your new life, still miss home and struggling, and you should not have to justify missing it just because your life looks good on paper.
It is also worth being gentle about the word “choice”. Choosing to go is not the same as choosing never to feel a loss. Even the most welcome move involves leaving behind people, places, routines and a version of yourself that was understood without explanation.
Giving it a name
One of the most helpful things for people living abroad is simply having the words for what they are going through. Too often there is no language for it, and people end up concluding something is wrong with them. A few of the experiences that do have names:
Ambiguous loss. Grieving people, places and a way of life that still exist but are out of everyday reach. Because nobody has died, the grief can feel unjustified, and others may not recognise it.
Acculturative stress. The steady strain of learning new unwritten rules, a new language and new ways of relating. It is tiring in a way that is hard to explain to people who have not done it.
Identity disruption. At home, people mirrored a consistent version of you. Abroad, you meet people who know only the person who arrived last year, and your old sense of self can feel hard to find. Finding and discovering a new version of yourself can be exciting and fun but also exhausting and scary to say the least. Some people later feel they belong fully neither at home nor in their new country.
Chronic loneliness. Friendships take years to build, and in international communities people come and go. It is possible to be surrounded by people and still feel unknown.
If you recognise yourself in any of these, you are not failing at expat life. You are having a very human response to a large change.
Why struggling expats stay silent
Many people learn to suffer quietly. Some fear they will seem ungrateful. Others do not want to burden a partner who moved for them, or family who thought the move was a wonderful thing.
This is especially hard for the partner and family member who followed. They may have given up work, routine, status and a social world all at once and acculturalise to a new environment. It is common for them to feel they have no right to complain because the move was also “for the family”.
When to ask for support
Most people feel unsettled, tearful, irritable or overwhelmed at times after a big move, and it often eases over the first months to a year. It may be time to seek support when:
low mood, anxiety or loneliness persist or are getting worse
sleep or appetite have changed significantly
you are withdrawing from people or things you used to enjoy
work, study, parenting or relationships are suffering
you are drinking or using other substances more to cope
you feel hopeless, or have had thoughts of harming yourself
You do not need to wait until things are unbearable. Early support usually makes the process shorter and gentler.
What tends to help
Let yourself feel both. Allow missing home and enjoying your new life to sit side by side. Feeling one does not cancel the other.
Invest in a few real relationships. Social support is among the strongest protective factors for people living abroad. Depth matters more than numbers: one or two people who know your story are worth more than a busy calendar. Where possible, include someone who is rooted locally as well as people who share your situation.
Keep a foot in both worlds. Studies of acculturation suggest people tend to do better when they hold on to their own culture while engaging with the new one, rather than cutting off one or retreating into an expat bubble. You do not have to choose between who you were and who you are becoming.
Become a regular somewhere. Belonging is built through repetition. A weekly class, a volunteer shift, a neighbourhood café or a sports team can help you stop feeling like the newcomer.
Say it out loud to someone. Breaking the silence, even with one trusted friend, often takes away much of the shame.
Check in with yourself over time. What helps in year one is not what you need in year ten. New jobs, visa decisions, bereavements or thoughts of returning are good moments to pause and ask how you are really doing.
How therapy can help
Therapy gives you a place where you do not have to explain or defend your situation. Together we can make sense of identity and belonging, work through the grief of leaving, understand patterns such as holding back from friendships that feel temporary, and recognise the strengths you have built along the way.
It matters that the person you see is curious about the world you have had to navigate, rather than assuming your difficulties are generic. Language and culture shape how distress is felt and expressed, and misunderstandings or blind spots can easily follow people into the therapy room, so it is worth finding a therapist who takes your background seriously. Where possible, working in the language in which you feel most yourself can make a real difference.
Why this work matters to me
I know this from the inside. I am an immigrant and an expat who has lived and worked across Thailand, the US and the UK, and I have felt the pull between gratitude and grief. I know the voice that says “this is what you chose, so you should appreciate it and shouldn’t complain”, and the fear of admitting that you’re struggle will make you look ungrateful. I also know how hard it can be to find someone who truly understands the internal monologue and the arguments you have with yourself, without needing you to explain everything first.
Intersectionality of identities also play a big part in the struggles of this big change. Living abroad can add another layer, because our identities do not sit separately. They intersect. Whether you are an immigrant, being gay or queer, and belonging to a particular culture, race or class can each shape how welcome and understood you feel, and together they can make loneliness and connection even more complicated. As a gay person of colour who have lived abroad, I understand this intersectionality hugely contribute to the struggle. You may be out in one country and more guarded in another, or feel you belong fully neither to your home community, the expat community nor the queer community around you. Finding people who are curious about you and understand the whole of you, not just one part, can take time, and in the meantime it is easy to feel unseen in one way or another. If that sounds familiar, you are not imagining it, and you do not have to carry it alone.
As a cultural-sensitive, trauma-informed and integrative psychotherapist, I offer a collaborative, non-judgemental space where both the gratitude and the grief are welcome, and where you do not have to navigate your dream of an expat or an immigrant life alone.
A final thought
Struggling abroad does not mean you made the wrong choice, and it does not mean you are ungrateful. Living abroad does not need more romanticising. It needs more understanding, and that begins with permission to say it is sometimes hard. You do not have to do it alone. If any of this resonates with you and would like to talk, you can get in touch here.
If you are in crisis, help is available. In the UK, you can contact Samaritans free anytime at 116 123, or text SHOUT to 85258; for urgent mental health support you can also call NHS 111 and select option 2, call 999, or go to your nearest A&E. In the US, call or text 988 (Suicide & Crisis Lifeline). In Thailand, Samaritans of Thailand can be reached at 02-113-6789 (press 2 for an English callback line), daily 12:00–22:00; in an emergency you can also call 191 or go to your nearest hospital. If you are elsewhere, a local crisis line or emergency services can help you find immediate support.