Feeling lost since you moved abroad? What actually helps

Therapy helps expats by giving you somewhere to put the specific, hard-to-explain weight of building a life somewhere your history doesn’t exist yet, with a counsellor who understands that homesickness, identity shifts and culture shock aren’t overreactions; they’re a real adjustment process with real effects on your mental health. If you’ve moved country and you’re now feeling flatter, more anxious or more alone than you expected, you are not imagining it, and you are not doing this wrong.

I’ve lived and worked abroad myself, across very different cultures, and I know the particular kind of loneliness that comes from being surrounded by people and still feeling like nobody actually knows you. That’s the gap this post is about.

Key takeaways

• Around 70% of expats globally say they’re happy with life abroad, according to InterNations’ Expat Insider 2026 survey — which also means roughly 3 in 10 aren’t, and the UK ranked among the worst-rated destinations that year.
• Culture shock is a recognised psychological pattern, not a personal failing: researcher Sverre Lysgaard mapped it as a U-shaped curve back in 1955, and the honeymoon-crisis-recovery-adjustment sequence still holds up.
• Among international students, one large US study found rates of anxiety, depression and suicidal ideation nearly doubled between 2015 and 2024, while use of counselling services grew far more slowly — the need is rising faster than the support.
• There’s no single “right” kind of therapist for expats — a home-country therapist, a host-country therapist and an online expat-aware counsellor each solve a different problem, and the right fit depends on your situation, not a default.
• Online therapy works as well as in-person for most people, and for expats it often solves the actual barrier, which is finding someone who gets your context, not finding someone nearby.
• You don’t need to be in crisis to start therapy. “Flat,” “not myself” and “stuck” are valid reasons on their own.

If any of that lands, book a free 20-minute consultation and we can talk through whether this is the right time and the right kind of support for you — no pressure, no obligation to continue afterwards.

Why does moving abroad hit your mental health harder than you expect?

Because the things that usually hold your sense of self steady, your friends, your routines, the version of you that people already recognise, all disappear at once, and your nervous system treats that as real instability, not an inconvenience. Every expat I’ve worked with describes some version of the same thing: it’s not one big crisis, it’s a hundred small daily disorientations stacking up, and to the outside world you look like you’re “having an adventure,” so nobody, including you, clocks it as something worth addressing.

This is worth naming plainly rather than softening: the InterNations Expat Insider 2026 survey, based on close to 8,000 respondents across 31 countries, found that while around 70% of expats globally report being happy with their life abroad, the UK sat among the lowest-ranked destinations that year, behind countries with far less obvious appeal on paper. Where you move to matters, and if you’ve landed somewhere that isn’t giving you back what you expected, that’s data, not a character flaw. You can read more about this pattern on my page about mental health challenges of living abroad.

Is what I’m feeling actually “culture shock,” or something more serious?

It can be both, and the distinction matters less than people think, because either way it deserves attention rather than a “give it time” shrug. Culture shock is a well-documented pattern first described by sociologist Sverre Lysgaard in 1955 after studying Norwegian scholars abroad, later expanded by anthropologist Kalervo Oberg: a honeymoon phase where everything feels novel and exciting, a crisis phase where irritability, low mood and homesickness build, a recovery phase where you start functioning again, and an adjustment phase where the new place starts to feel liveable rather than foreign.

Knowing the shape of it helps, because if you’re a few months in and hitting the crisis dip, that’s expected, not a sign you’ve made a mistake. But culture shock becoming persistent low mood, anxiety that doesn’t lift, or a sense of not belonging anywhere- not your old home, not your new one, is a different thing, and it’s worth talking to someone about rather than waiting to see if it passes on its own. My post on culture shock and mental health goes into this in more depth, and if the “belonging to nowhere” feeling is the loudest part of your experience, why don’t I belong anywhere? Speaks to that directly.

Why do so few expats actually get support for this?

Distance from your usual support system is the obvious barrier, but it’s rarely the whole story; stigma and practical mismatch do more damage than people admit. A large US study tracking international students from 2015 to 2024 found that rates of anxiety, depression and suicidal ideation nearly doubled over that period, while use of campus counselling services grew far more slowly, leaving a widening gap between need and support. Expats outside of education face a version of the same problem: no easy referral pathway, uncertainty over whether a therapist “back home” or “out here” is even the right call, and often a quiet worry that struggling proves the move was a mistake.

I’d push back on one bit of common advice here, because I think it’s wrong for a lot of expats: the instinct to only look for a therapist from your own home country. It feels safer- someone who already gets your cultural references- but it can mean working with someone in the wrong time zone, disconnected from what your day-to-day actually looks like now, and unable to speak to what’s specifically hard about the place you’re living in. A host-country or online expat-aware counsellor who understands migration and identity, even without sharing your background, is often the better fit. More on this trade-off is in finding a home-country therapist while living abroad.

What does therapy actually look like for expats, and how is it different?

The mechanics aren’t different: weekly or fortnightly sessions, a space to think out loud without managing someone else’s reaction, but a counsellor who works with expats regularly won’t need you to explain the basics of what culture shock, third-culture identity, or “why can’t I just be grateful, I chose this” actually feel like from the inside. That saved explanation time is often what makes the difference between therapy that helps and therapy that feels like starting from zero every session.

Here’s how the main options compare, so you can see what’s actually solving your specific problem rather than picking the first name that comes up:

If online sessions make sense for you, is online therapy suitable for expats? and is online counselling effective? Both answer the practical questions people usually ask before starting.

Does online therapy actually work as well as in-person?

For most people, yes, and for expats specifically, it usually solves the actual problem rather than compromising on it. The evidence on video-based therapy consistently shows outcomes comparable to in-person work for common concerns like anxiety, low mood and adjustment difficulties, and for someone living abroad, the real question was never “online versus in-person,” it was “can I find someone who actually understands my situation,” and online access is usually what makes that possible at all. You’re not settling for a lesser option by working with someone over video, you’re removing a barrier that has nothing to do with quality of care.

How do you find a therapist you can actually talk to as an expat?

Look for someone who names expat, migration or identity work explicitly rather than someone who’ll take it on as a side note to their general practice, and don’t be afraid to ask directly in a first conversation whether they’ve worked with people in your situation before. A good fit matters more here than almost anywhere else in therapy, because you’re not just explaining a problem, you’re explaining a whole context, and a counsellor who already has some of that context will get you further, faster. If it helps to hear this from someone who’s actually navigated it, is expat counselling worth it? and finding a therapist as an expat cover what to ask and what to expect from that first conversation.

One reframe I come back to constantly with clients, wherever they’re calling in from: what would you say to a friend who described exactly what you’re going through? Most people would never tell a friend to just push through homesickness, disorientation and loneliness alone for another year and see if it passes. The same standard applies to you.

Frequently asked questions

Is it normal to feel worse after the first few months abroad, not better?

Yes, this fits the well-documented culture shock pattern, where an initial honeymoon phase is often followed by a crisis dip before things level out. If the low period is lasting well beyond a few months or getting worse rather than shifting, that’s worth talking to a counsellor about rather than waiting it out. See culture shock and mental health for more on the timeline.

Should I see a therapist from my home country or one where I live now?

Neither is automatically right. A home-country therapist offers cultural familiarity but may not understand your current context or work in your time zone; a local or online expat-aware counsellor understands migration and identity directly, even without sharing your specific background. It depends on what you actually need support with.

Can online counselling really replace face-to-face therapy for expats?

For most common concerns, yes, evidence shows comparable outcomes, and for expats it’s often what makes finding the right fit possible in the first place. Read is online counselling effective? for the full picture.

What if I don’t feel like I’m in crisis, just flat and unsettled?

That’s a completely valid reason to start therapy. You don’t need to hit a breaking point first, and most people who come to counselling as an expat describe exactly this, not acute crisis, just a persistent sense of not being themselves.

How do I know if it’s homesickness or something I need proper support for?

If homesickness is affecting your sleep, motivation, relationships or ability to function day to day, or if it’s been going on for months without easing, it’s worth a conversation with a counsellor. Coping with homesickness as an expat walks through the difference in more detail.

If you’re ready to talk this through properly, book a free 20-minute consultation with me, or read more about my approach first if you’d rather get a feel for how I work before reaching out.