Several weeks ago I posted an article about expat women and depression and got more responses from that article than from anything else I’ve ever posted. Several women asked what was normal and what was considered to be clinical depression. So I thought I’d speak to that here.
One of the best ways to self-evaluate for depression is to take the Goldberg Depression Questionnaire. It is readily available on many sites if you Google it.
This is a short test consisting of 18 questions designed to get at the frequency and extent of depression. This will give you an idea of whether or not to seek professional help. If you decide to seek help or treatment, you can bring the questionnaire with you when you visit your health care practioner.
When clinicians evaluate for depression we also look for how many incidents you’ve had of depression; is it recurring or a single occurrence? And we are also interested to know how frequently these incidents occur.
This topic relates to expat women in a significant way. We know that stress and depression can be triggered by changes in major life events. Most people make relatively few major life changes during a lifetime, and the changes they do make, don’t tend to happen all at once.
Major life events consist of death of a spouse, divorce, moving (even down the street) loss of community and support, loss of a child or family member, significant problems with a child or family member, and physical or emotional illness.
Expat women tend to make many moves in their adult lives, and not only to a new neighborhood, but to new countries, where they may not be familiar with the local language or customs. These moves almost always involve the loss of community and support networks, at least initially.
Moreover, they are frequently dealing with the loss of close family members. Though not by death, this loss is a significant contributor to depression and stress.
And if you’re an expat woman who is or is married to a career expat and if you have children, there can frequently be problems as children adapt to their new surroundings.
Yet even with the same triggers, not everybody reacts the same. What can seem like overwhelming loss to one person, another can experience as the excitement of a new situation.
New research into depression is suggesting that most of us come into the world with a predetermined set of characteristics, and that we are programmed to react in certain ways.
Research is also telling us that there is a far greater heredity component than previously thought. So if a parent or family member suffered from depression, there is a chance that you may too.
But the good news is that help is readily available and with “outcome based therapies” there is a really good prognosis. Cognitive Behavior Therapy and Mindfulness Based Therapy both offer relief from depression.
There are also many medications on the market, some with relatively few side effects. These medications need to be prescribed and supervised by a psychiatrist who is a medical doctor.
Many people don’t want to take meds, and may not have to if they’re in therapy. It’s an individual decision that needs to be evaluated by you and your clinician.
People often ask me where to start to find a therapist or doctor when overseas. Your embassy is a good place to start. They usually have a list of health practioners they are familiar with. If you’re from a smaller country, you can always contact the US Embassy in your host country and they may be able to provide you with names of doctors and clinicians they’ve used in the past.
Another option is to search for expat therapists online, particularly if you’re in a country where there may be few, if any, skilled English-speaking psychotherapists.
The point is that you don’t have to go through depression alone. Depression is readily treatable, so reach out if you feel you need help.
For more information on expats and depression visit www.expatcounselingandcoaching.com.