Expats and Depression

An interesting article appeared in the Phnom Penh Post the other day. The Expat Blues, by Brent Crane, was about the prevalence of depression amongst expats in Cambodia. This was the teaser at the top of the page:

While foreigners generally enjoy a lifestyle in the Kingdom far better than they would at home – and far, far better than most Cambodians – loneliness, dislocation and culture shock still all take their toll

Crane went on to quote a 29 year old expat who said, “You lose interest in everything. You become less active – a lack of will to do anything or accomplish your goals. Basically, you just let life go by.” He went on to say how he filled in the gaps in his life with cigarettes, sex, online social networks and gaming, but they didn’t relieve the sense that his life lacked purpose.

The young expat, who asked to remain anonymous, was luckier than most. He was young and self-aware enough to know something was wrong and he sought help. Many other expats are in denial about their depression. Just recently, a young man died after drowning in his own vomit at the end of a drinking binge. Others get severe drug problems. Others just seem to be angry all the time. They may or may not be clinically depressed, but they share a common expat syndrome. Life in their adopted country didn’t turn out to be as great as they imagined it would be and they sink into a state of almost permanent negativity.

Expats and Depression

anti-depressantDepression isn’t limited to expats in Cambodia. There was another recent article about it it the Gulf News. Both the Phnom Penh Post and Gulf News articles recommended a combination of medication and “talking therapy.” That may be good advice, but many expats can’t afford either and many are in denial about their condition. They’re not hard to spot. They’re the ones that show up early in the bars and go home late. They’re the ones who start their day with a beer and/or a joint and go downhill from there. They’re the ones who spend inordinate amounts of time on Facebook and online forums complaining about life in their chosen country.

They’re also the ones who go through life with a permanent scowl on their face. They used to make me angry. Then I became indifferent to them. Now I feel kind of sorry for them, because I can see that behind that anger is fear, loneliness and, perhaps, creeping despair.

Scenes like this one are not uncommon in so-called Third-World countries. There are two possible scenarios here:

  1. The guy standing is trying to help his friend, who just passed out and fell off his bar stool.
  2. The guy who is standing just punched out the other guy after they got into an argument.

I don’t know much about bar culture, but a friend tells me expats choose their bars for the friendliness of the bartender and the company of those they keep in the bar. This is what passes for a social life for them. The added perks are alcohol and bar girls, who can be their girlfriend for a night or sometimes more permanently.

To some, that might sound like an ideal lifestyle, but the reality is that it only lasts for so long. In spite of its popularity and film depictions of alcohol as somehow therapeutic, alcohol is a depressant and can be addictive. Bar girls can be great company, but it’s not likely one of them is going to become a faithful partner. It happens, but rarely. So what you’re left with is the opposite of what you’re looking for.

I’m no shrink, but I think culture shock beats loneliness as a source of depression amongst expats. Many expats find a social network in the bars, but when everyone is suffering from culture shock and using the same “therapy” to deal with it, it’s not easy to get past culture shock.

So what’s the cure? One thing most expats who survive and thrive in a foreign culture share in common is a more positive outlook on their adopted culture. When viewing a sunset, you can either focus on the sunset or the trash that hasn’t been picked up off the beach. When viewing a culture like Cambodia, you can see the poverty or you can see the incredible resilience of the people. The young man interviewed by the Phnom Penh Post said: “In Cambodia, I don’t see much compassion. It’s like everyone is on his own. There’s no civic sense. There are no values really in general. That’s how I feel at least. I think that helps to strengthen my nihilist view of the world.” The most important words were, “That’s how I feel at least.”

There is compassion in Cambodia, but you don’t see it in the streets of Phnom Penh or the tourist traps of Sihanoukville or Siem Reap. You see it on the family and village level. Last week, a man fell off a roof and died in my neighborhood. His wife and baby were left with nothing because he was the sole bread winner. The neighbors pitched in to keep the family from starving. Just across the street from me, a woman raised her daughters on a cleaner’s salary. When the daughters grew up, they got jobs as nannies in Malaysia. After they returned home, they were able to find jobs in local restaurants. They still live with their mother and have been able to renovate the little one-room stilt house they grew up in. It now has a bricked-in first floor with a tiled floor.

What you think about becomes your reality. You can focus on the worst elements of a culture or you can focus on the best. I’ve learned so much about life here. Our Western culture seems artificial in comparison. We look to our government for support. We find jobs in large corporations. Cambodians have more traditional support networks. Poor Cambodians set up little shops or businesses to support their families. Those shops would be illegal in our “advanced” cultures, as would the cows that cross the roads to feed on the grass in vacant lots.

Yes, there’s plenty of crime and everyday selfishness in Cambodia, too, but the same is true of our Western cultures. The difference is that we learned how to avoid the worst elements of our societies, but many expats seem to walk right into the worst elements of their adopted countries and don’t learn from the experience. The world is not black and white. It’s filled with color. The trick is in finding the brightest colors, wherever you happen to live. You don’t need to pretend the darker hues aren’t there, but you don’t need to embrace them, either. Bringing a little sunshine into the lives of others may be the best therapy of all.