Does the sun improve your mental health?

Hooray, the sun is finally out! I can’t count the number of times I have heard this phrase – or a variation of it- in the last few days. Even though the weather in the Netherlands can be erratic, this year it has been a long wait for some good sunny weather. Now that the sun is out, the people I see on the street and the friends I meet generally seem happier. But is it really that simple and is the sun our magic medicine for a better mental health?

First of all, let’s look at the benefits of light –both natural and artificial- in general. Research has shown that being exposed to more light during the daytime and less light during nighttime helps our internal clock to regulate our sleep wake rhythm. Especially expose to light in the morning is beneficial to your health, since it improves your mood, alertness and metabolism.

But is there an exclusive benefit to sunlight? According to numerous studies, the appropriate level of vitamin D is a key factor in helping prevent and alleviate depressive symptoms. Even as little as 10-15 minutes of sun exposure per day can give you these positive effects. Sunlight also causes the release of serotonin, a neurotransmitter directly linked with mood and energy. Additionally, UVA rays generate nitric oxide in your skin, increasing blood flow and therefore energy is better absorbed. A helpful side effect here is that better blood flow causes lower blood pressure, which can be linked to reduced stress.

With the change of seasons and longer days, there is a much better chance that we get our necessary dose of sunshine. These are important findings, because they place a component of mental wellness into our own control. We recognize the importance of taking a break from our day to enjoy a walk outside, which benefits both our physical and mental state.  

Researchers believe that the healing, mood-enhancing capabilities of the sun are limited, but can help in the right circumstances. So even though the sun definitely has a positive effect on our mental health, it doesn’t mean that psychological problems can be solved by catching rays.

Source : https://www.medicaldaily.com/does-sunlight-impact-mental-health-429268, https://www.namiwisconsin.org/news/2018/5/25/the-effects-of-sunshine-on-mental-health

What is a post-traumatic stress disorder?

Living in an unstable country, with risks of violent attacks or natural disasters, can create a sense of unsafety and can lead to anxiety complaints. When you are personally exposed to a seriously stressful situation you may suffer from post-traumatic stress. This can happen when you are exposed to a life-threatening situation, serious physical injury or a threat to your physical integrity. But a post-traumatic stress disorder (PTSD) can also develop from traumatic experiences outside of war zones, such as physical or sexual abuse, being bullied during childhood or being in a car accident.

Symptoms of PTSD include vivid memories of the event (flashbacks), sleeping problems and nightmares, irritability, problems with concentration and feeling startled easily. Often symptoms of depression (low mood, loss of appetite and social withdrawal) also occur. A diagnosis of PTSD can be set when the symptoms last for 1 month or longer. Most people with PTSD have a series of avoidance behaviors to help them cope with these symptoms (for example, avoiding certain situations that resemble the traumatic event, or avoidance of thinking about the event). Avoidance can also occur through substance abuse, such as drinking or smoking weed to not think of the event and to feel calmer.

Even though most people experience some of these symptoms directly after a traumatic event, not everyone who goes through trauma actually gets PTSD. It is thought that a combination of a traumatic event, inherited mental health risks, your temperament and the way your brain regulates hormones and reacts to stress determines if you actually get PTSD. Also, there are some factors that increase the risk of getting PTSD:

·         Intensity and duration of the trauma

·         Having gone through previous trauma (for example childhood abuse)

·         Having other mental health problems or substance abuse

·         Lacking a good support system

Getting timely support may prevent normal stress reactions from getting worse and developing into PTSD. This may mean turning to family and friends who will listen and offer comfort. They also may help prevent you from turning to unhealthy coping methods, such as misuse of alcohol or drugs. Support could also mean seeking out a mental health professional for a brief course of therapy. Some people may also find it helpful to turn to their faith community.

Do you recognize the symptoms in yourself? Please contact us to see how we can help.

No safe place

While most of us were spending a sunny Easter weekend enjoying long brunches and having an Easter egg hunt, the world was shocked by yet another terrorist attack, this time in Sri Lanka. Having lived in South Asia for a few years, I was shocked to learn that one of the targets was a hotel that I actually stayed at during Easter holidays two years ago. Furthermore: having lived in the region for a while, I immediately could think of five people I know that were actually at the scene when the attack happened. 

The bombing of churches in New Zealand earlier this year, trucks driving into a boulevard in Nice and a Christmas market in Berlin, a shooting in a tram in Utrecht: if you follow the news, it seems that there is no place in the world where you can live safely anymore.  In recent years, it seems like ‘war’ and ‘terrorism’ isn’t something that only happens far away in unstable areas of the world. As a matter of fact, those places that deemed stable and safe seem to be the main targets for attacks nowadays.

You could spend hours every day watching, reading and listening to news related to these events. This level of exposure can significantly influence your worldviews and how you live your life. The aftermath of events like these can make people feel more vulnerable. And as cities go on alert because of the threat of future attacks, fear can color our daily routines and world views.

It is probably not a surprise that a terror attack can have a major impact on people’s mental health. But what sort of effects are common, and how long do they last?

Studies have shown that after a terrorist attack, psychological effects (such as post-traumatic stress disorder) are not only seen in victims and their families, but also in people that are living in a city when it’s attacked. For instance, a survey of Madrid residents one to three months after the attacks on a commuter rail line in 2004 found an increase in post-traumatic stress disorder and depression.

In a 2005 study of London residents conducted a few weeks after the 7/7 attacks, 31% of respondents reported a significant elevation in stress levels and 32% reported an intention to travel less. A follow-up study conducted seven months later found that the elevated stress levels were significantly reduced. But, the study also noted that a residual level of worry remained. Many people reported relatively high levels of perceived threat to self and others, and a more negative world view.

We would expect to see an increase in psychiatric disorders among people who were directly affected, or who lived in the city at the time of the attack. But this can also happen in people who weren’t living in a city when it was attacked. A survey conducted soon after the September 11 attacks found that 17% of the US population living outside of New York City reported symptoms related to post-traumatic stress disorder. Six months later, that had dropped to 5.6%

A 2005 review of psychological research about the effect of September 11 highlighted the uptick in psychiatric symptoms and disorders immediately after the attacks and the relatively quick normalization in the following 6-12 months. However, people living closer to the area attacked, and thus more directly exposed, were more vulnerable to developing post-traumatic stress disorder, than people living further away.

Why do symptoms of post-traumatic stress disorder increase in people who weren’t directly exposed? The explanation might be the intense media coverage of terror attacks. In the aftermath of September 11, a US study of more than 2,000 adults found that more time spent watching television coverage of the attacks was associated with elevated rates of post-traumatic stress disorder. In essence, a media-related contagion effect is created where people live and relive the attacks when they watch or read stories about them. This overexposure may, as argued by some, produce a subjective response of fear and helplessness about the threat of future attacks in a minority of adults.

Fear is a natural response to events like the attacks in Paris or New York. While everyone feels and reacts to fear differently, it can push people to make different decisions about employment, whom to socialize with, using public transportation such as buses and trains, congregating in public and crowded places, and traveling on airplanes.

Do you notice an increase in anxiety or stress after watching the news, or do you want to know more about PTSD? Read our next blog.

Source: https://www.iflscience.com/health-and-medicine/when-fear-weapon-how-terror-attacks-influence-mental-health/

From tourist to global citizen: what kind of expat are you?

People who choose to start up their life in another country come in all shapes and sizes, and relate to their home and adopted countries in different ways. Some of them call their parents every day and connect to friends from home for daily chitchats, and others living abroad only send a message when they need help with taxes or cooking. And we've likely all run across those who have two (or three) world clocks on their phones, or those who couldn't care what time of day it is back home (or anywhere else for that matter).

It has long been recognized that different expats have different needs when it comes to integration in their adopted country and staying in touch with family and friends back home. As an expat you can see for yourself: what kind of expat are you? 

The Master Planner
We all know the type: organized, well prepared, maybe a tad compulsive. Master Planners see the world as their home – and need every detail of it in place. In the same way they plan out every trip, they also plan their life abroad thoroughly. Before moving countries, the Master Planner will have read up on the history of his new country, has a detailed knowledge of social norms and knows the fastest way to the nearest Starbucks in his new hometown.

The Lifer
The Lifer isn't really an expat. Not anymore. She’s gone native, is fully integrated in her new environment and is happy to never go ‘home’ again. Home? This is home! The downside of course is that, with friends and family still far away, there can be a struggle with expectations from family and friends.

The Tourist
The Tourist may be living abroad, but she’s not planning on staying forever. Her current home will always be a foreign country. You can spot The Tourist by the way she is always converting currencies and comparing habits and prices with those from back home.

The Free Spirit
The Free Spirit hasn't really decided why he’s in a new country, or how long he’s staying. It’s all about exploring, wandering and enjoying life - no strings attached. He might be a progressive parent, a happy-go-lucky student, or simply an eternal optimist always in search of new adventures.

The Global Citizen
The Global Citizen is constantly on the go, but not necessarily for business – mostly just because. Global Citizens love eating breakfast in one place and having dinner in another, and dashing from one activity – and country – to the next. They enjoy being on the move, diving in novelty. With contacts all over the world and a life full of fun, they are all about smooth transitions.

Original article: https://www.thelocal.fr/20150212/voca-phone-app-asks-what-sort-of-expat-are-you-tlccu

Tips for raising Third Culture Kids

If you are moving countries with your family, it’s important to think about what your children need for a smooth transition. Whether your child is an easy-adapting Third Culture Kid or has a bit more difficulty with the transition, fact remains that you as parents play a significant role in managing the transition for your child. Here are some tips on how you can help your TCK during the transition phase:

• Read young children stories about emigration or about their new country. Let your adolescent read books or watch documentaries on these subjects. Some book tips for TCK’s to read:
                                - Pixies new home (for young children)
                                - Slurping soup and other confusions (4-12 years old)
                                - Expat teens talk (teenagers)

• Make a treasury box with your child’s favorite things and give it a prominent place in your new home.

• Keep communicating with your child, don’t judge and listen carefully. All children have to go through the process of saying goodbye to their old home and get used to their new environment. Younger children often express themselves indirectly, for example through play or creativity. For adolescents it is important to genuinely listen to your children and refrain from giving clear-cut and practical solutions to their emotional problems.

• Let your children play an active part in making plans for the new country and let them have a sense of autonomy, within boundaries. Discuss with your family what sort of hobbies they’d like to engage in, how they would like to see their room and what sort of family activities you can do.

On a final note: whatever culture your child grows up in or identifies with, being a Third Culture Kid will probably make your child identify most with other Third Culture Kids. Even though having multiple homes can feel enriching, it can also make your child feel lost whenever you return to your ‘home country’. After all: your home is not their home. Unless you’ve been a TCK yourself, it is very difficult to grasp this feeling of non-belonging. Acknowledging your child’s feelings and communicating about them is a very important part of being an expat-parent.

Raising a Third Culture Kid can be very demanding for parents as well. The stress of building a life both for yourself and your kids and getting the help you need can lead to anxiety, feelings of depression and other complaints. Are struggling with parenting a Third Culture Kid and looking for psychological support? Feel free to contact us.

Benefits and challenges of growing up abroad

Growing up in a foreign country (or countries) can have a positive effect on a child’s personal and cognitive development. TCK’s are thought to have specific qualities and skills due to their upbringing, for example increased tolerance for other cultures, high interpersonal sensitivity, good adjustment skills and increased cultural intelligence. On average, Third Culture Kids have a higher education than non-TCK’s, are less likely to get divorced and are linguistically more adept. Most Third Culture Kids learn to live comfortably in their world and can adapt and adjust easily from one situation to the next, growing up to be open-minded and culturally sensitive adults.

Third Culture Kids also face some challenges growing up in their neither/nor world. They can experience confusion with politics, patriotism and values. This is especially the case when moving from collectivist to individualist cultures, or vice versa, as the values within each culture are different from the other. Secondly, there is a need for special attention of young TCK’s in educational settings to make sure they are supported when and if entering a new school. TCK’s can also face difficulties with adjusting to adult life: the mixture of influences from the various cultures can create challenges in developing an identity as well as with a sense of belonging. Feelings of rootlessness and restlessness can make the transition to adulthood a challenging period for TCK’s.

Another area of life that is greatly affected by a TCK-experience is forming relationships. On the one hand, being in an ever-changing social environment with friends coming and going makes TCK’s very sociable and they tend to make friends easily. On the other hand, the cycles of frequent goodbyes can lead Third Culture Kids to develop patterns of self-protection against further pain of separation, which can also affect relationships later in their lives.

In a 1986 survey of 300 Adult Third Culture Kids, 40 percent of the respondents said they struggled with a fear of intimacy because of the fear of loss. Although this means that the majority of TCK’s will be able to form safely attached relationships, here are some signals for a protective response:

Refusing to care.
Some people try to limit vulnerability by not forming friendships and rather staying ‘independent’.

Quick release.
This is a form of ‘leaning away’ when a possible (temporary) separation is expected. When friends are planning to move, this quick release response means that people tend to already let each other go: stop meeting, stop calling and terminating friendships in order to prevent the upcoming pain of separation. Adult TCK’s sometimes notice that they get in arguments with their spouses much more easily on nights before upcoming business trips – an unconscious attempt to protect against loss.

Emotional flattening.
Refusing to feel the pain is also a common response to avoid the pain of separation. The flat feeling – neither joy nor pain-  often feels safer that the pain of missing someone.

Source: Third Culture Kids, Growing Up Among Worlds (Pollock & Van Reken, 1999)

Growing up abroad: Third Culture Kids

“Children adapt so easily, don’t they?” Whenever I overhear a conversation between expats in discussing the challenges of moving abroad, there always seems to be one thing more important than their own wellbeing: the happiness of their children. Smoothening the transition for their children is the first priority for most expat parents. But even though it’s true that children can adapt easily to a new environment, it doesn’t always mean that they do.

Children that are raised in a different country than their home country, or in a culture outside of their parents’ culture, are called Third Culture Kids (TCK’s). Growing up in a foreign country means these children are not being brought up in their own culture, but also don’t fully adapt to the host country’s culture.

Instead, they are being brought up in a neither/nor world: it is neither fully the world of their parent’s culture, nor fully the world of the other culture. In this neither/nor world, TCK’s develop a third culture, which is a blend of the parent’s culture and the culture of the country or countries they grow up in.

You know you’re a Third Culture Kid when...

- “Where are you from?” has more than one reasonable answer.
- You flew before you could walk.
- You speak two languages, but can’t spell in either.
- You feel odd being in the ethnic majority.
- You go into culture shock upon returning to your “home” country.
- You can curse convincingly in five different languages
- You think VISA is a document that’s stamped in your passport, not a plastic card you carry in your wallet.

Did you grow up as a Third Culture Kid, or raising kids abroad? Watch out for our next blogs for more information on challenges of growing up abroad and tips for parents of TCK’s.

Trouble in paradise: expats and addiction

The cliché image of life as an expat might sound appealing to a lot of people, but there is a less positive reality behind it. Although some expats do indeed enjoy an exciting life in a new part of the world with lots of social activities, dinners and parties, there are also expats who can’t control their alcohol or drug intake and, after some time, become dependent on them.

What are possible high-risk situations and circumstances that increase the use of alcohol and drugs?

1. Being an expat itself forms a risk
Although living abroad can be an exciting and fun time, it is often also a period of stress. Leaving your old life, friends and family behind can be a great source of tension. Moving abroad can also lead to changes in your relationship and family dynamics. Alcohol then seems to be a means that gives (temporary) relief to this stress, but in the long term it causes more misery.

2. Work pressure
If you have moved abroad for work, the first period will probably be characterized by a high workload: a new job, new colleagues and high expectations. This work pressure, possibly accompanied by the pressure to build a new social network, can lead to more frequent drinking and the use of alcohol and drugs to release some tension.

3. Law and availability
The Netherlands – and Amsterdam in particular- is known for its liberal drug policy (“gedoogbeleid”). This means that the use of soft drugs is socially acceptable and there is a widespread availability. This lowers the threshold to start and continue the use of soft drugs. In addition, Amsterdam has a blossoming nightlife and festival scene where drugs might be illegal, but definitely present and accessible. 

4. An expat partner’s risk
If you have moved abroad because of your partner's work, you may have had to give up your own job. This loss of work, and with it a part of your identity, can cause feelings of sadness, anger and fear. At the same time, a lack of structure in your days may lead to frustration and boredom. To channel these feelings, some people use alcohol to relieve tension and temporarily feel better.

Are you dissatisfied with your alcohol or drug use or do you want to know more about what you can do about addiction? Contact your General Practitioner if you think professional help is needed.

How can I Handle stress?

As explained before, stress is a normal part of life: your body is preparing for a challenge by increasing heart rate and blood flow so that you are ready to perform. These physical reactions are a healthy reaction to your mental preparation for an exciting event: a job interview, performance test or presentation are all events that cause stress for a lot of people.

But what if these mental and physical stress reactions don’t fade over time? Or if there simply are too many things to be stressed about? Longer periods of stress can have negative consequences on both your physical and mental health.

How can you take care of yourself in times of stress?

·  First, make sure you have a good daily structure and rhythm. Go to bed on time and wake up around the same time every morning. Getting enough sleep will help you handle your problems better.

·  Take good care of yourself by eating healthy and limiting alcohol and caffeine intake. The use of alcohol might feel like a relief of stress at first, but in the long term will have a negative effect on stress. Same goes for caffeine: it might feel like your energy increases in short term, but it also has a negative effect on stress and sleep.

·  Get moving! Exercise is a good way to release stress. Find a way of exercise that works for you, such as running, swimming or yoga. Try to make this activity just for you, so make sure you reserve enough time.

·  Get a good overview of your situation by writing down what troubles you. What are in fact the problems that are causing stress? Which ones can you solve yourself and how? For what problems do you need help (practical help or support from friends and family)?

Sometimes problems aren’t easily solved. That’s why it’s important to manage your stress levels even if the stressors are still present in your life. The answer? Relaxation. By relaxing you are helping your body to temporarily stop its stress reaction. Relaxation helps your body to recover. It’s important to build in moments of relaxation on a daily basis, where you give yourself a break from your problems and daily tasks. One way of finding out what relaxes you is the following:

Keep track of your activities throughout the week and make a list: what activities have a positive or relaxing effect and what activities actually increase stress? And do you remember things you used to do for fun, that you don’t do anymore? Make a list of all the possible ways for you to relax and start implementing them into your schedule. Try to make sure there is a good balance between the stressful activities (work, daily tasks, dealing with problems) and relaxing activities.

Stress

Even though most people don’t like it, stress is a normal part of our existence. If we have to give a presentation at work, before we go on a first date and even before we go on vacation many of us experience stress. In these situations, stress helps us: we become more alert and ready to take on a challenge.

But what happens exactly in our bodies at times of stress? Stress is always provoked by something, for example a situation or a thought. This creates a reaction in the amygdala, which in turn sends signals throughout our brain to start producing different hormones. The release of all these chemical messengers will help increase blood pressure and blood sugar and start preparation for (physical) action. The body prepares for fight-or-flight mode by increasing heartbeat and breathing, tension of muscles and therefor a boost of energy.   

In most cases our tension will fall after we have completed our task (finished a presentation, had a good start to that first date and made our flight). The body calms down and we get released from our fight-or-flight mode. But in some cases we are not able to shake off the stress reaction. Perhaps we experienced too much stress for too long. Maybe we (or others) are asking too much of ourselves. Or we experience a lack of support from family and friends. For whatever reason, we can’t seem to relax anymore.

If your feelings of stress continue for too long, you can develop a wide range of complaints such as a lack of energy, sadness, anxiety, sleeping problems, difficulty concentrating and forgetfulness. Since stress is physical reaction, people who are constantly feeling stressed tend to get more headaches, pain in the neck and shoulders, stomach problems and are more at risk to get sick due to low resistance. Due to stress, people also tend to engage in unhealthy behaviors such as drinking, smoking and overeating.

Do you notice any of these signs of prolonged stress and are you unable to deal with it? It is advised to contact your general practitioner to discuss the possibilities for mental health support.

亲爱的在荷学习生活的华人朋友们

无论您是刚刚开始在荷兰的生活对一切还都非常新鲜和好奇，或者您已经在这里生活了很长时间对这里的生活非常熟悉，但是或多或少您都经历了一些在一个外国城市生活的起起落落。想念不在身边的家人或爱人，怀念家乡的食物，更不用说学习荷兰语，习惯荷兰人直接的表达方式，建立社交圈，和融入荷兰社会了。

但是，除了适应和融入，您也许也正经历着其他的一些困难，比如说学习或者工作上的压力有时让人感觉崩溃，人际和亲密关系压的人喘不过气来，或者说您正饱受情绪问题的困扰。而很多时候，当您需要倾诉和被聆听的时候，身边却缺少一个可以信任的人或者稳固的社交圈去分享。如果您感到情绪低落，焦虑，和孤独，但是却没有来自他人的支持和帮助的时候，您是怎么应付的呢？

Kühler & Trooster国际精神卫生的精神科医生和临床心理学家在这里为您提供专业的支持和帮助。我们为一系列的精神或者心理问题提供诊断和治疗，例如，抑郁症，焦虑症，社交恐惧症，睡眠问题，和人格障碍等。针对来访者不同的个人需求，我们设计个性化的治疗方案：心理治疗或/和药物治疗。我们的临床心理学家提供一系列的心理治疗方法：认知行为疗法 （Cognitive Behavioural Therapy），眼动脱敏与再建（Eye Movement Desensitization and Reprocessing），接纳承诺疗法（Acceptance and Commitment Therapy），和图式治疗 （Schema Therapy）等。我们也提供基于正念训练（Mindfulness）的认识治疗小组。

我们认为在心理咨询中能够用母语沟通是很重要的。因此在Kühler & Trooster，我们有一位来自中国的心理学家，王帆博士，可以用中文为您提供服务。王帆出生和成长在中国，从2009年来阿姆斯特丹留学至今已经在国外生活了快10年。我们相信以她的专业训练和个人经历，她可以更好地理解您的困难和需要，并用中文为您提供支持和帮助。

如果您想更多地了解我们和我们的服务，可以发邮件到info@internationalmentalhealth.nl ， 或者拨打我们的电话085-0660500获取更多的信息。

How to increase your cultural intelligence

Most people will experience stress when moving to another country, but the intensity and duration of this ‘acculturation stress’ differs from one person to the next. Cultural intelligence plays an important role in this process, but other factors also come into play: personality traits, your social environment and the amount of contact you keep with people back home will also influence how you adapt to your new culture. The reason for moving abroad also influences your ability to adjust: people who are moving voluntarily generally adjust easier than people who are forced to move.

In a time of globalization, as we expats all know, it is important to be able to recognize and handle cultural diverse situations. As an expat, you need your cultural skills to adjust to a new country. Also, since companies tend to get more and more culturally diverse, you also need to rely on cultural intelligence in order to keep connected at work. This is why a higher cultural intelligence can lead to better job opportunities and increased success in your career.

Cultural intelligence is one of the components of general intelligence. Even though there isn’t a cultural intelligence measuring scale yet, your CQ (cultural quotient) seems to be just as important as IQ (intellectual quotient) and EQ (emotional quotient) nowadays. Even more so than your intellectual and emotional abilities, your cultural intelligence level is seen as a skill that you can train and grow. Here are some tips to increase your CQ:

Improving CQ-Knowledge
Learn about the culture of your new home country. By reading up about the history and current political situation, watching movies and talking to people from your new host country you’ll get better insights to the cultural aspects of it.

Improving CQ-Strategy
It is important to realize that culture shock is a clash between two cultures: your own culture and a new culture. By realizing your own cultural baggage, you’ll be prepared and better able to handle encounters with a new culture. Try writing down which norms and values are important to you from your own culture. How do they differ from the new culture?

Improving CQ-Action
Practice, practice, practice! The more intercultural encounters you’ll have, the smoother they will go. Small faux-pas in the beginning? Neven mind, be gentle with yourself and allow yourself some time to practice.

Lastly: try to keep a mild attitude towards new cultures. Differences aren’t necessarily good or bad, so see if you can observe these differences without judging. If you can let yourself be amazed instead of annoyed by them, you’ll probably find the adjustment to your new home much easier.

Cultural Intelligence

Thinking of Dutch culture, some typical things stand out: we are direct and straightforward, not afraid to speak our minds. We appear to be greedy, which even lead to the term ‘going Dutch’ - indicating that everyone in a group pays for themselves. We used to be good at soccer. At first, we seem very sociable and easy going, but sooner rather than later most foreigners feel they hit a wall when trying to befriend a Dutchman.

Some of these cultural characteristics are very well-known. This allows foreigners visiting or moving to the Netherlands to prepare. Worldwide there are a number of cultural rules that seem to be part of general knowledge: we know men and women do not touch publically in most Middle Eastern countries, in Japan we wouldn’t talk with a loud voice and in Italy you don’t drink cappuccino after breakfast or you will look like a cultural barbarian.

Within the field of psychology, the capability to relate and work effectively across cultures is called cultural intelligence. The term cultural intelligence was first introduces by Ang and Van Dyne in their research to measure and predict intercultural performance. They also came up with the term cultural quotient (CQ), which indicates the level of cultural intelligence. CQ is made up out of four capabilities:

1.  CQ-Drive is about interest and confidence when it comes to cultural diverse settings, how much joy you get out of engaging in intercultural contact.

2.  CQ-Knowledge is about how much you know about cultural differences and similarities, for example when it comes to economical systems, religious beliefs and language.

3.  CQ-Strategy is about how aware you are when it comes to intercultural experiences, so knowing your own culture, in what way you plan to handle an intercultural encounter and how you check with yourself if you have any assumptions or prejudice.

4.  CQ-Action is about your ability to adapt you verbal and non-verbal behaviour to different cultures.

Interested in increasing your cultural intelligence? Read our next blog!

Winter depression

A very common struggle for expats living in the Netherlands is getting through the dark and cold winter days. Even though the Netherlands has a good standard of living, there are plenty of job opportunities and there is a lot of cultural heritage to explore, our climate seems to be a hardship for many people. But what is winter depression and what can you do about it?

Seasonal affective disorder
The official term for winter depression is seasonal affective disorder (DSM V, 2014). The term seasonal affective disorder (SAD) was first introduced by South African psychiatrist Rosenthal, who  described the phenomenon in a journal in 1984. Symptoms of SAD are a decrease in energy, sadness, low concentration, more need for sleep (but less quality of sleep), increase in appetite (mainly in high caloric food) and weight gain.

It’s the season
Usually the complaints start during autumn or early winter and disappear when spring arrives. Sometimes, symptoms arise during the summer when the weather is bad for a longer period of time. One of the key criteria for SAD (instead of depression) is that it always occurs during a certain time of the year and there is also a period of remission during the summer. In some cases, there is even a manic or hypomanic episode during the summer.

Cause of SAD
It is believed that the cause of seasonal depression is a disturbed biological clock. Through our eyes our body receives sunlight, which leads to chemical processes in the brain. These chemical processes induce the production of hormones such as melatonin, that regulate our biological clock. Everybody produces melatonin the evening in order to sleep, but patients with SAD produce it in large quantities during the day. The high melatonin level also has an effect on our ‘happiness neurotransmitter’ serotonin, which is why people with seasonal affective disorder suffer both from a lack of energy and a depressed mood.

Treatment
There are a number of treatment options, such as exposure to light (both natural light and light therapy), regular exercise, supporting psychological treatment and pharmacotherapy.

Tips to cope with the cycle of change

In our previous blog you could learn about the cycle of change, which describes the emotional rollercoaster of an expat’s journey to adaptation to living abroad. Even though the manifestation of the different phases will differ per person, almost everyone who moves to another country will encounter every one of these stages.

But what to do with this knowledge? First of all: knowing that these changes and feelings will occur when you move to a different country is the first step. But how can you still make the most of your first year(s) and take good care of yourself during this rocky time?

- Think about what makes you happy. What kind of hobbies did you have back home? What is your usual pick-me-up when you feel down? Try to think of five activities that bring you joy and make a plan on how to do them in your new environment. In some cases you need to be creative, because your past hobbies might not be easily accessible in your new environment.  But keep in mind: doing things you love, even in times of sorrow, will lighten up your overall mood.

-  Make sure your days remain structured: get up early and make sure you have a combination of fun, meaningful and useful activities to do during the day. If you are a joining partner and not have to work it might feel like a vacation, but this is not a holiday – it’s your life.

-   Engage in new activities. Now that you are in a new environment, you can also think of skills that you always wanted to learn (such as language) or take on new hobbies (yoga, cooking class, creative course). Sometimes, being in a new place also gives you more time because you don’t have the same obligations to friends and family. Using this time for your own personal development can give you a great sense of accomplishment.

-  Find out how you can meet new people, maybe even looking for people who are in the same boat. Make sure you surround yourself with positive people: complaining might feel good for an hour, but meeting people with a positive energy will be more likely to pick up your spirits as well.

-   Even if you and your partner are not on the same page, make sure you have an open and honest communication about how you are feeling. Even more so because being a working expat and joining spouse can create tension in a relationship, it is very important that you keep each other informed about the stage you’re in and what he/she can do to support you.

If you feel you could use some professional help to cope with adjusting to living abroad, please contact us so that we can help you get proper treatment: info@internationalmentalhealth.nl

Cycle of change

Living abroad has many different charms and challenges. Being confronted with a new culture, new people and possibly new languages can both be exciting and overwhelming. No matter how near or far you have moved away from your previous home, you will most likely notice a difference between your old and your new life.

Some people find it easy to adjust to their new environment, whereas others struggle with adjusting and finding a sense of home. Some expats face problems related to moving, such as homesickness and finding new meaningful daily activities. Other expats are confronted with problems they have had for a long time, such as dealing with depression, anxiety or self-esteem issues.

Even though everyone handles the adjustment to a new country in their own ways, there is a cycle of change that almost all expats go through before really settling in and feeling grounded. According to the U-Curve Theory of Adjustment (Lysgaard, 1955) all expats go through four stages of adjustment:

1. Honeymoon
The first stage is the honeymoon phase, where expats see their new country through rose-tinted glasses. The mindset they adopt is like that of a tourist: everything is new and exciting and people are keen to explore their new environment. 

2. Culture shock
When the newcomers have to deal with real conditions on a daily basis (setting up house, possibly finding a job, building a social network, language problems), the second stage kicks in: culture shock. This stage is characterized by feelings of isolation and frustration and can also trigger physical (stress) symptoms. In some cases, the feelings expats experience are similar to symptoms of depression.

3. Adjustment
The third stage is the adjustment stage, in which the expat is gradually adapting to the new country and is able to act more appropriately. For some people during this stage there is a tendency to ‘compare to complain’: while settling in there is a constant tendency to compare the new environment to the life they had before.

4. Mastery
In the last stage, which is called the stage of mastery, the expat is able to function effectively in the new culture.

The duration of the cycles most expats go through differ greatly from person to person. The average time to adjust to a new culture (and go through all of the stages) is thought to be around nine months. It is very common for the joining spouse to experience more difficulties in adjusting than the working expat, since the working expat is more likely to be engaged in work while the spouse has to deal with more of the daily troubles of running a household.

Want to learn how to cope with this cycle of change? Read our next blog!

Mindfulness

On my way to work, which is a 15-minute bike ride, I’m confronted with a non-stop flow of images, sounds and impressions. Traffic lights, cars, parents on cargo bikes hurrying to drop their kids off to school. Nonetheless, every morning I manage to make it to work without even consciously noticing all those things. Instead, my mind takes me to places that are completely irrelevant at the time: a conversation I had with a friend last week, phone calls that I need to make, a recipe that I want to try soon…

By the time I get to work, my mind has been filled with a number of irrelevant thoughts, worries and images. And on top of that, I had to juggle traffic in order to get to work safely and on time. It’s no wonder that, even though my day has just begun, I feel a level of stress as if I have been working, running and talking simultaneously for 24 hours straight.

Can you relate? You’re not alone. Many people struggle with this phenomenon, where they are engaged in an activity, but their minds wander off to completely different places. A lot of the times, we are not even aware of what we are thinking: our minds just race from one place to the next, one image after another, one worry at a time. This process of not being aware of the present and not being connected to what you do, feel and think can be stopped by a very helpful skill: mindfulness.

Mindfulness means: to be completely aware of your current experience. To be mindful means to be able to focus on the present and open to whatever is there at that moment. By improving your mindfulness skills, you will notice signs of stress earlier and you will be better able to deal with negative thought patterns. There is a higher level of awareness and you can better guard your boundaries. With mindfulness you live more intensely and consciously.

Mindfulness teaches you how to focus on the present and therefore experience less distress from negative thoughts and emotions. It has proven to be effective for people with a wide range of psychological problems and can generally help to improve the quality of life. As Jon Kabat-Zinn, the founder of the mindfulness training, has said:

“You can't stop the waves, but you can learn to surf”

Are you interested in seeing what mindfulness can do for you? Please contact us at info@internationalmentalhealth.nl or 085-0660500 to get more information on our 8-week mindfulness course starting March 5 2019.

New Blog

Kühler & Trooster International Mental Health will start publishing a blog.