5 mental health challenges of living abroad (and the fix for each)

What are the mental health challenges of living abroad?

The biggest mental health challenges of living abroad are loneliness, culture shock, language barriers, distance from your support network, and a quieter one that doesn’t get talked about enough: a shift in who you feel like you are. None of these mean something’s gone wrong with the move. They mean you’re a person adjusting to a genuinely big change, and that takes more out of you than the brochure suggests.

I’m Joelle, an integrative counsellor at High Tide Counselling, and I’ve lived this from the other side of the desk. Madagascar, the Philippines, Greece, India, Cuba- at various points in my life I’ve been the one googling “why do I feel like this” at 2am in a country where I didn’t speak the language. My parents are also foreign, so I know what it’s like to feel “between cultures”. So this isn’t theory. It’s what I’ve lived, plus what the research backs up.

Key takeaways

• Loneliness abroad isn’t just “missing home,” it measures higher than people expect: one 2025 study found 77.3% of long-term expatriates scored above the threshold for loneliness, compared with 46.9% of people who hadn’t relocated.
• Culture shock has a well-documented shape, honeymoon, frustration, adjustment, adaptation, and knowing which stage you’re in takes some of the panic out of it.
• Language friction is one of the strongest predictors of how isolated someone feels abroad, according to InterNations’ 2025 survey of over 10,000 expats.
• Video calls help, but they don’t fully replace the nervous-system effect of having someone physically nearby when things go wrong.
• A shift in identity, feeling like a different version of yourself in a new culture, is common and rarely discussed, which can make it feel more alarming than it needs to be.
• None of this means you made the wrong choice. It usually means the adjustment is real, and support helps it move faster.

Book a free 20-minute consultation if any of this is landing a bit close to home. No pressure, just a conversation.

Why does loneliness hit so much harder abroad?

Loneliness abroad hits harder because you’ve usually lost your default social infrastructure overnight: the people you’d normally text without thinking, the neighbour who waves, the colleague who gets your sense of humour. A 2025 study of long-term expatriates found 77.3% scored above the clinical threshold for loneliness on a standard scale, against 46.9% of people living in their home country. It was a small sample, so treat the exact numbers as indicative rather than gospel, but the direction matches what I hear constantly from clients: it’s not that you’re being dramatic; the gap really is that big.

InterNations’ Expat Insider 2025 survey, which polled over 10,000 expats across 46 countries, found that ease of settling in varies enormously by destination, and that finding local friends is one of the hardest parts almost everywhere. Where the local language is hard to get by without, expats reported more isolation and slower integration. Where English travels further, or locals were patient with mistakes, people settled faster. This tracks with my own experience; life in a country with a language I could stumble through felt entirely different to one where every interaction was a translation exercise.

The bit that surprises people is that this loneliness isn’t really about being surrounded by people. You can be at a work dinner, at a language exchange, at your kid’s school gate, and still feel completely unseen, because nobody around you has any shared history with you. That’s a specific kind of lonely, and it deserves to be named as such rather than brushed off as homesickness.

Is culture shock a mental health issue, or is it just normal?

Culture shock is a normal, well-documented process, not a sign that something’s wrong with you, though it can absolutely tip into something that needs support if it doesn’t shift. Researchers generally describe four stages: honeymoon, frustration, adjustment, and adaptation. You don’t move through them in a straight line, and you can loop back to frustration months or years in, often triggered by something ordinary like a visa renewal, a hard winter, or a visit home that stirs things up.

The table above is a guide, not a diagnosis of your timeline. Some people move through frustration in a matter of weeks. Others sit in it for a long stretch, especially if the move coincided with other stress, a job change, a breakup, becoming a parent somewhere unfamiliar. If you want more on what’s actually happening in your brain and body during a stress response like this, our neurobiology psychoeducation page breaks it down without the jargon.

How does the language barrier affect mental health?

The language barrier affects mental health by turning small daily tasks into effortful ones and by cutting you off from the subtlety of connection: the joke that doesn’t translate, the tone you can’t quite read, the doctor’s appointment where you’re not sure you’ve understood the whole thing. It’s exhausting in a way that’s hard to explain to someone who hasn’t lived it, because each moment seems small. It’s the accumulation that wears you down.

There’s also a quieter cost. A lot of who we are comes through in humour, in the exact phrase we reach for, in sarcasm, in the way we tell a story. When you’re operating in a second or third language, you often can’t be fully yourself, and that mismatch between who you are and who you’re able to show up as day to day is its own kind of grief. I don’t think this gets said often enough, so I’m saying it here: if you feel like a flatter, less funny, less quick version of yourself abroad, that’s not you losing your personality; that’s the language gap doing exactly what a language gap does.

Does distance from family and friends make it worse, even with video calls?

Distance from your support network does make things harder, and video calls, while genuinely useful, don’t fully replace what in-person support offers. A phone call is brilliant for staying connected and for feeling less alone in the moment. What it can’t do is put a hand on your shoulder, sit with you in silence, or show up unannounced with food when you’ve had a terrible week. Your nervous system responds differently to physical presence than it does to a screen, and that’s not a character flaw; it’s just how humans are built.

This is often the piece that catches people off guard. You expect to miss people. What you don’t always expect is how much heavier an ordinary bad day feels when there’s nobody nearby who already knows the backstory. A cancelled meeting, a small argument, a health scare- things that would normally get absorbed by your usual people can suddenly feel enormous, because you’re holding it alone. If that’s resonating, my page on trauma-informed therapy covers why the nervous system reacts more intensely when we feel unsupported, even when nothing catastrophic has happened.

Why do some people feel like a different person abroad?

Some people feel like a different person abroad because identity is partly shaped by context, and when the context changes completely, the version of you that shows up can shift too. This isn’t usually talked about as a mental health challenge, but I’d argue it’s one of the biggest. You might find you’re quieter in a culture that values reserve, or louder in one that rewards directness, or that traits you were praised for at home read as rude or strange somewhere else. For anyone already working through identity, whether that’s sexuality, neurodivergence, or simply who you are outside of family expectations, an added layer of “which version of me is the real one” can be genuinely disorienting.

From my own time living across very different countries, this was the challenge that took me the longest to name. It wasn’t loneliness exactly, and it wasn’t quite homesickness. It was a low hum of not knowing which parts of myself were personality and which were just what my old environment had asked of me. If that sounds familiar, it’s worth exploring with someone rather than trying to think your way out of it alone, because this kind of identity work rarely resolves through logic. It resolves through being seen and reflected back to yourself, which is a lot of what integrative counselling is actually for.

When should you get support for mental health challenges abroad?

Get support if the low mood, anxiety, or isolation has stuck around longer than a few months, if it’s affecting your sleep, appetite, or ability to function day to day, or if you find yourself avoiding the very connections that might help. You don’t need to be in crisis to reach out. In fact, most people I see aren’t in crisis; they’re in that flat, stuck, “not quite myself” middle ground, which is exactly where counselling tends to make the biggest difference.

If you’re not near a therapist who understands the specifics of expat life, or you’re simply not ready for in-person sessions, online counselling can be genuinely effective for exactly this kind of situation. It also means you’re not limited to whoever happens to practise in your city. Ask yourself the question I ask clients constantly: what would you say to a friend going through this? You’d probably tell them it’s understandable, that it doesn’t need to be sorted out alone, and that reaching out isn’t a failure. Worth applying that to yourself too.

Frequently asked questions

Is it normal to feel depressed after moving abroad?

Yes, low mood is a common part of adjusting to a major life change, particularly during the frustration stage of culture shock. If it’s persistent, affecting your daily functioning, or not lifting as things settle, it’s worth talking to a professional rather than waiting it out alone.

How long does culture shock usually last?

There’s no fixed timeline. Some people move through the main stages within a year, others take longer, and it’s common to dip back into frustration during stressful periods like visa renewals or visits home. My page on how long counselling takes covers a similar “there’s no single right answer” question if that’s useful context.

Can therapy help with expat loneliness specifically?

Yes. Counselling won’t replace your old support network, but it gives you a consistent, understanding relationship while you rebuild abroad, and it can help you unpick whether what you’re feeling is loneliness, culture shock, identity shift, or a combination. Have a look at is expat counselling worth it for more on this.

Does the language barrier really affect mental health, or is it just an inconvenience?

It’s more than an inconvenience. Research on expat wellbeing consistently links language friction to higher isolation and slower social integration, and the daily effort of operating in a second language is genuinely tiring in a way that adds up over time.

What if I don’t want to leave but I’m still struggling?

That’s really common, and it doesn’t mean you’ve made the wrong decision. Loving your life abroad and finding parts of it hard aren’t mutually exclusive. A free meditation download can be a useful starting point for the day-to-day overwhelm, alongside talking it through with someone.