This article is not meant to diagnose or provide medical advice—that responsibility lies with physicians. The author is not a licensed medical professional.
Your flights are booked. Your camera, journal and passport are packed. You’ve received all the recommended vaccines. You think you’re ready for your gap year abroad or tropical vacation. But did you remember to pack a mental health management plan?
It may sound like a downer, but thinking ahead about how your trip can affect your mental health can help prevent complications while traveling.
“Psychological problems figure very high in reasons for emergency repatriation,” Michael Jones, MB, ChB, FRCP, FFTM RCPS, an infectious disease consultant in Scotland, says. Dr. Jones chairs the Psychological Health of Travellers Interest Group, a committee operating under the Atlanta-based International Society of Travel Medicine, which has been promoting healthy and safe travel through research and educational programs since 1991. Dr. Jones worked in Tanzania in the 1980s and was witness to expats being evacuated back home. “In fact the day I arrived, a Scandinavian colleague was flown home who had not been able to cope with the realities of working in an African environment.”
Travel poses unexpected emotional challenges, regardless of where you are on the mental health spectrum.
“Something could happen at home and even if you don’t have a mental health disorder, that stuff is hard to deal with,” Ross Szabo, a mental health advocate and former Peace Corps volunteer, says. He recalls how a fellow volunteer sought counseling during his Peace Corps service when he learned that a family member back home had died.
The United Nations World Tourism Organization reports that 561 million people traveled somewhere during the first six months of 2016. Depression alone affects roughly 350 million people worldwide, according to the World Health Organization. While estimates of the number of travelers with a mental disorder are hard to come by, a 2011 study by The Journal of the World Psychiatric Association reported that over 11 percent of travelers experience “some kind of psychiatric problem.”
Given those numbers, you might assume that information and resources abound about how to manage psychological well-being while traveling. Ironically, mental health and travel is a nascent topic among travel health professionals. Dr. Jones and fellow ISTM members seek to change that. While the Psychological Health of Travellers Interest Group’s main focus is on providing resources for expats working abroad, it hopes to expand its scope so that at the clinical level, advice about travelers’ mental health becomes as routine as giving information about travel vaccines.
If you want to explore the world but feel limited by your mental health, here are some tips on how to maintain your psychological well-being while out there.
Since mental health and travel isn’t yet a salient topic to travel health clinicians, travelers should proactively approach their providers about it.
“Patients with mental health issues should check with their mental health professional that they are in a fit state to travel and are resilient enough to cope with cross-cultural movement,” Dr. Jones suggests. He points out that having such a conversation isn’t about “stigmatizing individuals who have those kind of issues, but is about making sure that they’re not going to be harmed or unnecessarily disturbed and that they do the wise thing rather than things which are going to put them at risk.”
Coordinating a communication system with your therapist while abroad should also be part of your mental health management plan. Skype, Facetime and good old-fashioned email make it easy to connect so long as you have an Internet connection.
Sticking to a routine while traveling, especially in remote places for short periods of time, can be a challenge, but finding a rhythm will help you feel grounded.
After his service with the Peace Corps, Szabo started his own company to spread positive and informational messages about mental health. He now travels extensively, giving presentations to student groups and organizations. Following a schedule helps him navigate anxiety and depression while on the road. He says that keeping a routine “allows you to have that safety, that security where you feel like you have some control over what’s going on.”
A combination of activities comprises a type of routine that helps Blythe Utz align all of her senses—including the sixth sense—and stay balanced. She identifies as a highly sensitive person. “For me, HSP means that my five senses—touch, taste, sight, hearing and smell—are hyperactive.” She has also been navigating depression since her teens. Recently, she and her husband left behind their lives in Portland, Oregon to travel throughout South America and Asia. “It behooves me to meditate, pray, journal, blog, dance, play and commune with nature as often as I can. When I do these things, all is well no matter how chaotic a scene.”
Speaking of meditation, taking a moment to close your eyes and breathe can help if you’re feeling overwhelmed by your surroundings. Meditation has been shown to decrease stress and anxiety, triggers that can set off a relapse. Luckily, travelers can practice meditation anywhere and anytime. And you don’t have to be a meditating master to benefit from it—just simple in-and-out breathing is meditation enough, and can work wonders.
“Meditation is critical,” Utz says. “Through meditation, I not only find balance and calm easily, I recognize my resilience and personal power, which can be lost in my mind when feeling triggered by the senses.” She recommends downloading guided meditations when you have a reliable Internet connection so that you can turn to them when you’re off the grid.
Szabo seconds meditation. He was sick—“like digestive sick”—and lost a lot of weight during the entire time he lived in Botswana. Tests by doctors there revealed nothing out of the ordinary. When he returned home, he continued to shed pounds and wound up in the emergency room. Eventually, he saw a gastrointestinal professional who helped him recognize that anxiety was the source of his illness.
“Looking back,” he says, “I realized that I was burying my anxiety in my body, and that would never show up in any tests. I got so good at the cognitive piece of balancing anxiety and depression that I never thought about what I was doing to my body. Since I’ve gotten back, I’ve started doing a lot more yoga and focusing on meditation and mindfulness. It really changed my life.”
Kathy Eow is a freelance journalist whose health, travel and culture writing has been published in Curve magazine and local news network Seacoast Media Group.