Living abroad is often portrayed as exciting and liberating. New places mean new people and new opportunities. But for many expats, the reality of moving abroad is complicated. Behind the adventure, there can be loneliness, perceived pressure to “make it work”, and a constant sense of being out of place.
It is therefore not surprising that expats are at higher risk for depression. Loss of familiar routines, distance from support systems, language barriers, cultural misunderstandings, and uncertainty about the future can quietly take a toll on mental health.
Below are six common signs of depression that many expats experience, often without realising what is happening. These signs are based on ICD-10 diagnostic criteria.
1. Persistent Low Mood or Emotional Numbness
Feeling sad, empty, or irritable most of the day is one of the core signs of depression. When living abroad, this shift in mood is often attributed to temporary stress or the challenge of adjusting to a new environment. Many expats tell themselves they simply need more time to settle in, which can delay recognising that something deeper might be going on. Some have also had to convince family and friends that moving abroad was the right decision, and now feel pressure to hide their low mood from their loved ones. This can quickly feel draining and isolating.
2. Loss of Interest or Pleasure in Daily Life
Activities that once felt enjoyable, such as exploring the city, meeting new people, or learning about a new culture, may start to feel pointless or exhausting. As a result, expats might begin staying at home and withdrawing from local communities. This isolation can be particularly problematic when there are not yet close local friends who might notice changes, check in, or encourage them to get out of the house.
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3. Difficulty Concentrating or Making Decisions
Depression often affects cognitive functioning. You might notice that it is harder to focus on work, follow conversations in a foreign language, or make decisions. This can be especially stressful when navigating daily life in a different culture. At the same time, bigger questions, such as “What long-term career is right for me?”, “Should I move back home?”, or “How can I improve my situation?”, can start to feel overwhelming and impossible to resolve.
4. Low Self-Esteem, Excessive Guilt, or Self-Blame
Thoughts like “I’m failing at this,” “Others manage just fine,” or “I made a mistake moving here” are very common among expats experiencing depression. Living abroad often removes familiar reference points that would normally help reality-check such thoughts. Without trusted people around who know your history and strengths, self-criticism can grow unchecked, reinforcing feelings of inadequacy and isolation.
5. Physical Symptoms: Fatigue, Sleep Problems, or Appetite Changes
Depression does not just affect the mind. Many people experience persistent fatigue, sleep problems (sleeping too much or too little), changes in appetite, or unexplained physical aches. Expats may overlook these symptoms while mentally occupied with navigating new cultures and social norms, and the pressure of making a new life work. Over time, this can contribute to a cycle of stress and physical exhaustion.
6. Recurrent Thoughts of Death or Feelings of Hopelessness
In some cases, people may experience recurrent thoughts about death, wishing they could disappear, or feeling that life is not worth continuing. Feeling deeply disillusioned with life abroad while simultaneously feeling unable or unwilling to return home can feel suffocating. Expats may also feel unsure about where to turn for help within an unfamiliar healthcare system.
Important: If you are experiencing suicidal thoughts or feel unsafe, please seek immediate help. Contact local emergency services or a crisis hotline in your country. You do not have to handle this alone.
How Therapy Can Help with Expat Depression
There are several effective psychological approaches for treating depression. Cognitive Behavioural Therapy (CBT) is one of the most well-researched options. It focuses on the connection between thoughts, emotions, and behaviour, and aims to interrupt the patterns that keep depression going.
However, there are multiple evidence-based schools of therapy, and no single approach is right for everyone. Different people benefit from different therapeutic styles, and a good therapist will adapt treatment to your individual situation, background, and needs.
If you recognise yourself in some of these signs, it does not mean you are weak, ungrateful, or not suited to life abroad. Depression is not a personal failure. It is a human response to prolonged stress, loss, and change. If you feel stuck or unsure how to cope, you can find an expat therapist on It’s Complicated who works online with internationally mobile clients.
Daniel Schurr is a clinical psychologist specialising in working with expats and internationally mobile individuals. His work focuses on relationship and identity challenges related to living abroad, supporting clients through emotional difficulties, identity shifts, and life transitions across cultures using evidence-based approaches including CBT. Daniel works virtually with expats around the world. Find Daniel on It’s Complicated.
