Mental health and living abroad: New data reveals the most common pitfalls

Studying or working abroad is a fantastic experience for many, offering new experiences and perspectives. However, it can also provide significant challenges, especially with regards to wellbeing and mental health.

Mental health and living abroad: New data reveals the most common pitfalls
Living in a new country can be exciting but also daunting. Photo: Getty Images

Many people experience significant challenges to their general wellbeing and mental health when moving to – and living in – another country. This can take many forms, such as:

  • Difficulty accessing medication, particularly medication prescribed in the previous country of residence.
  • Not being able to navigate the local health system to book an appointment.
  • Not being able to find the right ingredients for a vegan or vegetarian diet.

In partnership with AXA Global Healthcare, we take a look at some of the major issues facing international professionals, as well as what can be done to look after health and general wellbeing as an expat.

Difficulties faced

Having moved to Berlin from Saudi Arabia to study and work in HR, Hanan Asgar was excited about the opportunities Germany offered. As she says: “I wanted freedom, respect and equality for myself and my generation.”

However, the combination of being completely new in a foreign country, together with an unfortunate incident in her first few days in her new homeland – about which Hanan had no one to speak to – meant that Hanan began to feel isolated and anxious.

She tells us: “My anxiety grew and I actually ended up locking myself in my dorm room and questioning my choice of moving to Germany. But after some reflection, I realised that it was me who was missing out on the lectures I was avoiding. So I took the courage to step out again and face what was to come.”

Living and working abroad, far from home, can present a number of obstacles. Learn more about how AXA provides mental health and wellbeing healthcare as part of its global health plans 

Hanan subsequently underwent treatment for anxiety and depression with a therapist, and has now been living happily in Berlin for the past six years.

Hanan’s experience with initial culture shock and mental health challenges, while living and working abroad, is shared by many expats. A social listening study conducted by AXA* in 2021, across six popular nations or regions for those living abroad, discovered:

  • Anxiety was the most common difficulty faced by expats in France, the Scandinavian countries and the United Kingdom – 24%, 27% and 32% respectively.
  • Depression was the second most commonly experienced challenge.
  • Those in France were most likely to experience anxiety and depression regarding the consequences of Brexit.
  • Other issues that those in France, Scandinavia and the United Kingdom identified as obstacles associated with living abroad, included dealing with chronic illness (such as living with a condition like diabetes), safety concerns (for example, crime) and stress related to the workplace.  

Exercise can help deal with stress. Photo: Getty Images

Strategies that work 

Fortunately, the AXA study also shows that there are a number of strategies that work when dealing with health and general wellbeing issues. Their study found the following:

  • Building strong support networks and healthy relationships with friends and co-workers was seen as important by expats in all countries.
  • Building strong support networks, as well as spending time on entertainment and hobbies, were particularly important to those living in the United Kingdom
  • Exercise – outdoor, or in a gym – was particularly helpful to those in Scandinavia and France, while those in France reported that they had also had specific success with mindfulness practice and good nutrition.
  • The most effective and useful strategy that AXA discovered, however, was proactive and preventative healthcare, such as accessing a GP or qualified psychologist. 

Discover more ways to look after mind and body while living abroad with AXA and their Mind Health Service 

Seeking out the right health professionals for both body and mind can significantly reduce the levels of anxiety and depression experienced by those living abroad. Regular check-ups can prevent conditions becoming chronic, while discussing mental health and wellbeing can substantially reduce the pressure that many feel. Prevention, as the saying goes, is better than cure.

Hanan Asgar moved from Saudia Arabia to Berlin. Photo: Supplied

Ensuring you have the right healthcare

Finding the right health professionals abroad can be difficult due to language differences, cultural attitudes and varying levels of healthcare. As Hanan reports of her own experience: “I sought professional help and it was quite challenging to find a therapist who spoke English. It took months just for an initial appointment. In the meantime, I would go to an emergency psychological help centre or ask a friend to be around. It all worked out in the end, but it did take a mental toll on me”. 

This is why finding a health insurance provider that offers fast and effective links with health professionals is key. When looking for an insurance plan, consider what AXA has to offer, and the Mind Health Service1 they provide for their customers.

Included with all individual and small business coverage plans, the Mind Health Service provides up to six telephone-based sessions for those covered, in addition to their Virtual Doctor Service2. It’s easy and fast to connect to a qualified psychologist who speaks your language, wherever you are in the world, whenever you need it. There is no extra charge for this service for individual, family or SME customers, it has no impact on your excess and outpatient or policy allowances, and can also be used by anybody who is covered by your plan. 

Living abroad is, for many, the experience of a lifetime. The memories and friendships created can endure long after we’ve returned home. That’s why it’s so important to ensure that the care and support is there to ensure you can keep enjoying your new country.

Ensure that your time overseas is happy and healthy.  Access up to six telephone sessions with a qualified psychologist through AXA’s Mind Health Service, available at no extra charge as part of all individual coverage plans

*Social media listening, commissioned by AXA – Global Healthcare, conducted by Listen + Learn from 2018-21, across six regions: Canada, Dubai, France, Hong Kong, Scandinavia and UK

¹The Mind Health Service is provided by Teladoc Health
²The Virtual Doctor Service is provided by Teledoc Health

AXA Global Healthcare (EU) Limited. Registered in Ireland number 630468. Registered Office: Wolfe Tone House, Wolfe Tone Street, Dublin 1. AXA Global Healthcare (EU) Limited is regulated by the Central Bank of Ireland.

AXA Global Healthcare (UK) Limited. Registered in England (No. 03039521). Registered Office: 20 Gracechurch Street, London, EC3V 0BG, United Kingdom. AXA Global Healthcare (UK) Limited is authorised and regulated in the UK by the Financial Conduct Authority.

Member comments

  1. disappointed of the use of the word “expats” that word is just creating a classist differentiation that shouldn’t exist, and using our privilege to create a gap doesn’t help, we all are migrants, that’s it.

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More than prescriptions: 10 things you can do at a French pharmacy

From getting first aid and medical advice to taking tests, buying cosmetics and getting your mushrooms checked - there's a surprising amount you can do in a French pharmacy.

More than prescriptions: 10 things you can do at a French pharmacy

Pharmacies are common place in France, with their bright green signs that illuminate many of country’s street corners, but you might not have realised how multi-functional they are.

While you won’t be able to buy snacks or sandwiches at the pharmacy (French pharmacies are not akin to corner shops as some are in the US and UK), they are not just for picking up your latest prescription or buying a box of bandaids.

There are several different things you can do at French pharmacies, and luckily for you, there are a lot of them.

In fact, France is home to about 21,000 pharmacies, according to data from 2017, with about 33 pharmacies per 100,000 people.

The pharmacists who run these establishments are also highly-qualified people, who are able to provide a wide range of services besides simply giving you your medicine. Most have done around six to seven years worth of schooling, and they are generally the best place to start if you are looking for some routine medical assistance. By law, all French pharmacies must have at least one fully qualified pharmacist on the premises.  

Here are all the things you can do there;

Get your wild mushrooms checked

If you are out foraging for mushrooms, and you want to err on the side of caution, then simply take your haul to the pharmacy. All pharmacists in France receive training in mycology – or the study of fungi – so they are qualified to tell you whether a mushroom is toxic or not. This will certainly help prevent any unforeseen disasters when cooking your next “gratin de champignons.”

Get your latest vaccination (not just a flu or Covid shot)

Previously, getting a regularly scheduled vaccination in France – like one for tetanus or Hepatitis – could be time consuming as you needed to visit your doctor for a prescription, get the prescription from the pharmacy and then take it back to the doctor who would actually administer the injection. Only vaccines for seasonal flu, Covid-19 and monkeypox could be administered by pharmacists, but as of November 7th that changed.

Pharmacists became authorised to administer vaccines and boosters, as required, for the “human papillomavirus, diphtheria, tetanus, pertussis, polio, invasive pneumococcal infections, hepatitis A and B viruses, meningococcal serogroups A, B, C, Y and W and rabies.”

Nevertheless – all of the newly authorised vaccines still require a prescription, which patients (who must be over the age of 16) will need to show proof of prior to vaccination.

READ MORE: EXPLAINED: Why does France have so many pharmacies?

Receive medical advice 

Picked up a stomach bug while visiting France? Got a cough that just won’t go away? Or cut your hand and unsure whether you need stitches? The pharmacy might be the best place to visit first. French pharmacists are all trained professionals, and they are qualified enough to let you know whether you are suffering from something that will require further medical attention, or whether your treatment can be found in the pharmacy itself. 

So, if you have any confusion around whether you should see a doctor, go to a hospital, or simply take some paracetamol and rest, the French pharmacist is a great person to ask. 

While pharmacy hours vary, there will always be at least one “pharmacie de garde” open all day and night near you. Simply google pharmacie de garde along with your location to see where it can be found.

Get over-the-counter medicines

In France over-the-counter medications such as indigestion medicines, cold and flu remedies and general painkillers like Tylenol or Nurofen (usually sold under the brand name Doliprane in France) are only available in pharmacies.

Supermarkets and other general stores are banned from selling them. 

Buy cosmetics

When walking into the pharmacy, you might also notice a giant wall of skincare items. From face washes to lotions and serums, you will be able to pick through many different hygiene items. Next you might turn to the perfume section, where several fancy-looking glass bottles line the shelves. If you are out of mascara or eye-liner, you can find that at the pharmacy too. 

Don’t be afraid to ask the pharmacist’s advice too – if you are worried a certain face wash would be bad for dry skin, the pharmacist will likely be able to point you in the right direction.

Receive care

Many pharmacists across France are able to carry out basic first aid. If you need help bandaging a cut or scrape, have a nasty burn that needs dressing or assistance with your blood pressure monitoring, then you can always walk into a pharmacy and ask for help.

Additionally, if you are looking for help with how to take the medication prescribed – for instance with administering your own insulin injection – pharmacists are trained to help.

If it’s beyond their level of expertise, they will also be able to direct you to the best place to go. 

Buy homeopathic medicines

French pharmacies do not only contain conventional medicines – most have a wide variety of vitamins and homeopathic remedies as well. From vitamins and supplements like cod liver oil to essential oils to neti pots to help clear your nose, French pharmacies carry plenty of alternative, natural treatments too. 

You could also find a remedy for the distinctly French malady of ‘heavy legs’

Prescribe (some) medications

In France, pharmacists are able to prescribe medications for a few specific conditions. First, pharmacists are permitted to issue renewals for medication against seasonal allergies, in patients aged 15 to 50 years old.

Next, they can perform short consultations and prescribe medicine for cold sores, eczema, and conjunctivitis.

If you are a woman aged 16 to 65 and you are experiencing a urinary tract infection, then the pharmacist can also prescribe treatment for you, under certain conditions. As long as the UTI is not recurrent and you do not have a fever or lumbar pain, then the pharmacist may be able to provide you with an antibiotic treatment.

READ MORE: Why do the French love medication so much?

Finally, depending on a patient’s pain and how well they are recovering to an illness or procedure, pharmacists are also authorised to adjust the dosage of some treatments, such as anti-inflammatory drugs.

Perform certain tests

As of January 1st, 2022, pharmacists in France have been able to perform strep throat (angine in French) tests. This consists of a small swab of the throat to verify whether the illness is viral or bacterial, in an effort to avoid the over-prescription of antibiotics. However, you will want to ask your pharmacist if they have the materials to perform the test, because not all pharmacies keep them on hand. 

You can also get a Covid-19 test at French pharmacies, usually without having to make an appointment.

Return extra medications you have lying around

Expired or unused medicines can be returned to your nearest pharmacy – all pharmacies in France are required to take back this medication. You can either give the medicine directly to your pharmacist, or in some cases you can drop them in the dedicated box for these purposes. 

This is actually a recommended practice, as most medicines should be disposed of in a specific manner.

You don’t need to bring back the packaging or instructions along with the medication – simply take the treatment itself.

Keep in mind you won’t be able to return used syringes and needs, or aerosols and sprays, or cosmetic products.