The Definitive Mental Health Guide for Travellers

In this guide, I hope to share in-depth advice for those travelling with depression or anxiety, although it contains tips we all should bear in mind on the road. I hope this will help those travelling with mental health issues stay safe and content on their future journeys.

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What inspired me to write a traveller’s mental health guide?

Recently, while solo travelling in Europe, I found myself in an unbearable state of depression. Sightseeing certainly couldn’t budge it – in fact, my lack of ability to experience joy in a new country lead me to feel guilty, ungrateful and like there was something wrong with me for not enjoying it.

When I started researching doctor’s advice about depression, I discovered something kinda interesting. Despite many anecdotal claims about how travel is great for your mental health, many people DO struggle and feel like they’re the odd one out due to other people’s apparently ‘more inspiring’ journeys… When in fact it is a pretty logical result of travelling for anyone with previous mental health issues. I’ve personally decided to be honest about both the ups and downs of solo travel so others suffering know they’re not alone.

The moment which inspired this blog post:

Why I wound up depressed backpacking Europe… and what I did about it

Can travellers implement 5 lifestyle changes which doctors say may improve mental health?

Our lives might look shiny, but pretty much everything doctors recommend for those experiencing depression or anxiety is HARDER to carry out within a traveller’s lifestyle. Not to mention that almost entirely across the board, research shows the increase in depression in Western countries – often called an epidemic – is probably caused by our modern lifestyles. Few living as nomads are immune to that. For example, many of us rely more on social media to keep up relationships with meaningful friendships than face to face time – social media is proven to increase loneliness. We also might struggle with ensuring a healthy lifestyle when faced with unfamiliar cuisines and a constantly shifting sleep schedule.

Hope is far from lost. As well as therapy being more readily accessible than ever and advances in medications, doctors are beginning to work with their patients on lifestyle changes based on thorough scientific research. Lifestyle changes have had as much success in clinical trials as antidepressants or therapy. Some neuroscientists advocate lifestyle changes may be the way forward, with a combination (of lifestyle changes plus therapy or medications) usually suggested.

So… what if you’re feeling anxious or depressed while travelling?

How do you implement a lifestyle change when your routine changes constantly?

This post lists five common lifestyle changes which many studies, with differing terminology, have shown ease the symptoms of depression for many patients. For many of you, you will recognise them from already well-known advice and ‘common sense’.

The steps recommended again and again for improving mental health are:

• Exercise
• Dietary changes
• Community / social connections
• Sleeping well
• Controlling ruminations (negative thoughts)

The truth is whether you work nine-till-five or are on the road, unless you prioritise the changes, they won’t occur. So dozens of books, YouTube videos and articles – as well as one-on-one treatment for patients suffering from depression and anxiety – give easy, practical, actionable advice in the hope of making it easier for everyday people.

But though the research is still interesting for travellers when your lifestyle is far from an ‘everyday life’, the advice becomes far harder to implement.

Of course, I’m no doctor or psychologist so I’m putting a great deal of trust in the research of others in this post. With that in mind…

Before we begin:

This post explores if these lifestyle changes can be implemented while travelling and is not intended as a cure for depression or anxiety.

Of course, the first thing anyone should do who is experiencing depression or another mental health issue is contact your GP or another health professional. In personal experience, this is pretty scary advice to read when you’re thousands away from your native health service!

If you’ve not started travelling yet, speak to your GP before you go for advice on how to deal with potential health issues that may arrive. Ensure you are not travelling for longer than you will have access to any of your usual medications, such as anti-depressants

If you’re already on the road, I have listed contact information for a number of health organisations you may be able to speak to (including a couple of email addresses, if you don’t have a sim card). You may also be able to seek advice from the local healthcare organisations where you are travelling and learn the country’s emergency number. Be sure to tell a friend or family member what you’re going through.

It is also possible to receive counselling over Skype, though this may be difficult to arrange through free healthcare. I highly advise arranging this if you are able to afford the counselling sessions. I would love to hear from you if you have any advice on receiving professional counselling while on the road.

EXERCISE

Travelling with depression is tough and often the last thing you want to do is exercise when you’re feeling anxious. But it is worth trying to find easy ways to exercise when our mental health is hormonal changes that follow are often referred to in medical studies as ‘a natural antidepressant.’

Exercise is an interesting one when it comes to travel. On the one hand, you might find yourself walking way more than usual because you’re sightseeing – it’s just a means to an end! My step count always goes up when I have one day in a sight-packed city.

On the other hand, if you’re used to a specific fitness routine or exercise classes, you’ll probably find it hard to keep it up. More well-rounded fitness is usually considered harder to maintain on a crazy travel schedule.

Walk more

Some of the below advice is harder for budget travellers staying in dorms when your options are more limited, but thankfully this one has the bonus of also saving you cash. When arriving in a new city, can you get to your accommodation on foot rather than taking a bus or taxi? And on a day’s sightseeing, is it possible to walk everywhere?

Most phones have a step counter nowadays. Why not set a target of 5000 steps to start with and then increase it to 8000 or 10000 steps?

Use a free app or follow YouTube tutorial workout videos

If you’re a beginner, apps like Track Yoga are very accessible to people who are new to it. It’s easy to follow along and you can only unlock ‘harder’ classes once you’ve finished the beginner ones. A good way to progress at a nice level and start slow.

I have set my target to 3 10-20 minute sessions a week to begin with… Professionals recommend bitesize targets! Missing targets makes it easy to feel bad about ourselves and not continue. We can then increase them if we are consistently hitting our target.

Youtube classes can be great for yoga alongside more fast-paced workouts.

I also met someone who packed lightweight resistance bands to make it easier to exercise from their hotel room.

Pick up your bag manually (rather than wheeling or carrying on your back)

My rule is to wheel my bag outside and for long distances, but pick it up inside accommodations. At the beginning of my current trip, my noodle arms could barely pick up my bag. After lugging it up multiple flights of stairs I can pick it up without any effort (even if I still can’t carry it for long yet haha).

Take the stairs instead of a lift

Stations, airports and accommodations usually have escalators and lifts to tempt your weary legs. Walking at an incline works out different muscles to the flat roads of certain cities, so it’s worth making this effort.

Go hiking or biking

I love seeing things via a good hike so this is perfect for me, whether it’s a day hike from a city or an awesome mountain path.

Many countries such as Vietnam offer a choice between scooters and bicycles, so consider that the latter as it has the extra advantage of keeping you fit.

Try a new activity, such as muay-tai, kayaking or scuba-diving

Definitely, the most fun way to keep fit on the road! You might be able to combine this with an immersive cultural experience by learning an activity that is unique to the country you’re visiting. If not, activities such as kayaking are a great way to work out your arms (harder to do on the road than exercising your legs).

I’ve always been the least sporty person I know, so it’s probably no coincidence my activity of choice on the road has been scuba-diving. You basically just float about, but it still counts right?

Stay somewhere with a gym or look up a local yoga class

This particularly goes for slow travellers. Looking up the location before you book accommodations means your more likely to make the effort. Travelling already means jetting about all over the place so anything you can do to keep the exercise simple at the end of a long day gives you a better incentive.

There’s no reason you can’t continue your yoga practise on the road, it’s just going to take some extra research. You can read tips on how to practise yoga for beginners here, or look on YouTube for online classes.

A HEALTHY DIET

Anyone who has travelling long-term can know that, even if you had a great healthy diet back home, it is hard to keep up this on the road. This is particularly true of anyone with a dietary requirement. Perhaps it is no huge coincidence my depression and anxiety intensified in the Balkans, where I struggled to find ample animal-free protein over a four-week period!

Look for healthy restaurants

Potentially plan in advance where you’re going to eat. Many of us with a dietary requirement use blogs or apps to find restaurants that serve the food we love and not making do with whatever we come across.

HappyCow is an app that shows restaurants and cafes near your location that have vegan or vegetarian options. Often these lists include restaurants with healthier options in general so might be worth a try.

Eat mindfully / don’t overeat

It’s so tempting to overeat when street vendors are everywhere are selling delicious treats. Especially if you think you might never have a chance to taste the unique flavours again.

The key for local treats is not to deprive yourself but to choose portion sizes widely. Maybe you can share a few options with friends so you get a taste of everything with taking too much. Sticking to meal times or when you’re hungry is also a safe bet.

If given a huge plate of food, eat consciously. Pause between taking each bite and take note of when you start to feel full. Enjoy!

Stay in places with a stovetop or shared kitchen

The easiest way to eat healthily is to cook healthy. This is a tricky option for cheap countries where this works out more pricey than eating out so those travelling quickly from place to place are better off looking for fruit stalls. Bananas are probably the easiest healthy breakfast around.

But otherwise heading to a shop or local market, grabbing some fresh veggies and cooking them up just how you like probably will end up feeling like a relief after eating out all the time.

Stay hydrated

I’m rubbish at hydration so always need to make sure I carry a reusable water bottle (I have a filter one for Asia). If you’re bad at remembering to drink water, try to start with drinking a glass at mealtimes.

Omega-3s

Don’t make big changes to your diet without consulting your doctor first.

Weirdly enough, daily cod liver oil supplements packed with omega-3s has been as successful at decreasing depression in clinical trials as many anti-depressants. Oily fish such as mackerel, herring and salmon are also good places to start.

The good news is if that sounds gross to you (see also: fish in general if you’re veggie like me) there are plenty of ways to pack your meals with omega-3s. Flax seeds and chia seeds are great to add to things like breakfast, walnuts are a great snack and soybeans are a great substitute if you’re travelling in Asia as this includes soya products such as tofu. And try eating meals with plenty of green, leafy vegetables.

In some countries, you can also buy loaves of bread and milks fortified with omega-3s.

Pack snacks

I ALWAYS try to pick up snacks such as seeds, nuts, roasted chickpeas and dried fruit when I spot them in a convenience store. This way when I’m out and about, I am less tempted by unhealthy snacks and street food. As a vegetarian, it is often a lot more nutritious than what I can find in a local restaurant.

Google health food stores in the area if you can’t spot them!

Also, those seeds and nuts are often great for getting omega-3s as a bonus.

COMMUNITY AND CONNECTION

In the global North, the ‘epidemic of loneliness’ and resulting depression is often attributed to the fact many of us are spending more and more time alone. And no, social media is NOT a substitute for face to face time. In fact, studies show it makes regular users feel lonelier. Entertainment is increasingly enjoyed independently – such as Netflix or video games – and many of us are used to living in cities where our closest friend lives at least an hour away.

For non-travellers, weekly group activities – such as meetups, dance lessons and communal vegetable plots – are a key factor in reducing loneliness, no matter our age. I meet a lot of new people while backpacking, but it often feels like a conveyor belt of saying hello rather than meaningful relationships.

So what can we do about it?

Talk to friends and family

Although Skype is simply not the same as face to face time, scheduling regular ‘Skype dates’ is a key way to support our oldest friendships. Other people I know prefer long emails and voice notes when WiFi and time are unreliable.

Stay in Hostels (or use their communal spaces)

As much as I crave my own space, I’ve rarely made a friend while travelling outside of a hostel… until I started using Instagram, at least!

I usually recommend those who are socially anxious like me to utilise the free breakfast (and not hostels with a bar). Breakfast time is super chill, void of extroverted drunk people haha and you’re more likely to find someone to explore with that day.

Use Meet Ups, Facebook Groups – and Free Walking Tours if you’re too nervous

Meet Ups and Facebook Groups are key ways to meet like-minded people on the road and I know people who’ve had success with this.

Personally, this is too scary for me though I really advise others to take the plunge! The other people will be nervous too. Free walking tours are another good option – you don’t really have to talk to anyone and all the attention will be on the guide, so it’s ideal if you’re shy. Making a friend will simply be a bonus. 🙂

More posts on travelling with social anxiety:

Travel Tips for Anxious Travellers and Solo Advice for Introverts

What it’s like to solo travel with social anxiety

Use social media responsibly

Instagram has proved an invaluable way for me to meet people on the road so having an account to interact with other travellers is great. Even when you’re not in the same place, people are usually really open to offering advice and support.

But be mindful of how often you use it to interact with your friends from home. Remind them it’s not ‘real’ and to get in touch by asking ‘how are you?’. It’s frustrating when someone believes they know how your day’s been after you post one nice beach photo (on a day you really spent 12 hours crying in your bunk haha). Real conversations are so important. My best mate and I only communicate over WhatsApp/FaceTime and never Instagram!

I heavily advise putting ‘community’ over ‘growing an account’ if you want to use Instagram to improve your mental health! You don’t want to feel like you have to spend 5 days a week posting on social media just so you’re getting enough likes! This is not going to help you. If you genuinely love writing or photography, growing these skills will be more rewarding than numbers anyway. If you really enjoy working in marketing and can view it as a business enterprise (rather than taking it personally) maybe it is a job for you.

Travel slow

Travel slow you have the opportunity to cement greater friendships. If you move on every couple of days, unless you’re a true social butterfly it will get exhausting. And there’s only so many times you can feel stimulated by the conversation ‘so where are you from?’

Consider workaways, volunteering or working abroad. Working Holiday Visas in places such as New Zealand, Canada or Australia or teaching English in Asia are both popular ways to ‘live’ within another country. And Workaways allow you to stay with a local family ‘for free’ in an exchange for a few hours of work a day, often for a month or two at a time.

FIND A WAY TO KEEP IN TOUCH THAT WORKS FOR YOU… AND YOUR TRAVEL FRIENDS 🙂

When you make friends you really click with, you hope you can meet them again later. Particularly if they’re another long-term traveller or have a flexible lifestyle!

But life is so up and down when you travel, with so many people to keep location tabs on, it can be hard to make that work. Find a way to check-in that is both personal (such as Facebook messages) AND practical (such as Instagram where they may post their location).

This way, even if you’ve not spoken for a while you can still keep up with when you’re in the same continent and may be able to meet up. But when you actually do speak, it’s through a private message.

SLEEP WELL

Those staying at a hotel might have a distinct advantage here to those staying in a dorm room, but any traveller is going to find it hard to stick to a bedtime routine on an ever-changing schedule.

Pack for good sleep

Travellers need more than PJs suitable for any given climate! Depending on what impacts your sleep the most, you may need a sleep mask – I recommend a comfortable material such as silk and one that fits fully over your eyes, not letting light in at the bottom. Other travellers swear by earplugs.

I also need good earphones to listen to relaxing music. You might prefer downloading the Kindle app or audible.

Try to maintain a consistent sleep routine, where possible

Where possible, sticking to a similar bed and wakeup time is very beneficial. Sometimes a sunrise trek is calling or you fancy a late-night (or can’t avoid a late flight!), but having an ‘ideal’ bedtime in mind is worthwhile.

And consider how long it takes you to wind down. Personally, I need at least an hour or two of calm activity before bed (whether that’s watching TV instead of going down a blogging rabbit hole haha). I try to do some gentle stretches, drink camomile tea and turn off social media during my downtime.

A good sleep routine includes waking up at a similar time every day! If you’re not a morning person, find out where you can get good breakfast and coffee (or carry it with you) so you’ve got more of an incentive to start your wakeup routine. I also try to get exposure to sunlight as early in the day as possible… usually just through opening the blinds. 🙂

Download relaxing music or sleep stories

You can easily download Spotify sleep playlists or relaxing podcasts and audiobooks offline. Apps like Calm also have specialised sleep playlists and sleep stories which I have found to be surprisingly effective – at calming anxiety, if not always lulling my insomniac brain to sleep.

Don’t drink too much alcohol or drink caffeine after 3pm

The notion that alcohol helps you sleep is a huge myth! Your quality of sleep is worse overall after drinking, even if it does help you drop off quicker. A glass of wine or beer isn’t too bad but drinking enough to get ‘drunk’ is definitely not going to help.

My personal rule with coffee is to not drink any long after lunchtime so the caffeine has plentiful time to leave my system before bed.

Even if you’re a budget traveller, save extra money for an occasional private room

Maybe this isn’t necessary if you’re not a light sleep, but most of us have been kept up by people taking a random phone call at 3am (whyyyy), people switching the lights on at anti-social times or someone snoring on the top bunk. I travelled through parts of Asia where I was barely with it since I was getting one or two hours sleep or night, even though I wasn’t partaking in any evening events.

I’ve definitely learned my lesson and now lean towards private rooms when booking accommodations (outside of expensive cities). There’s no point saving money for travelling for longer if I’m putting my mind and body through intense sleep deprivation. Travelling with depression and anxiety means I have to learn to put my mental health first!

STOP FOCUSING ON NEGATIVE THOUGHTS

Ruminating (focusing on negative thoughts) and CBT (cognitive behavioural therapy) are go-to terms for anyone many people who’ve tried to manage their anxiety. And it’s frustrating when non-travellers presume these are less relevant in the life of a nomad.

Unfortunately, accessing therapy on the road is going to be difficult (as mentioned earlier). This means practising mental self-care is essential, even if we’re dubious about how effective it will be.

A common misconception about travel and mental health is that we don’t take our anxieties and triggers around the world with us. Whether the thought that sparks a burst of panic is from our past or present – or indeed reflecting on our future – it can be hard to stop yourself from spiralling or even having a panic attack.

And even travellers with no mental health condition are constantly being exposed to new stimuli and challenges around the clock which can become overwhelming. It can be hard to find time to pause and reflect. These tips should be helpful for all travellers.

Use an app such as ‘Calm’ or ‘Headspace’

You may find it useful to use an app such as Headspace or Calm. Their guided meditations are a great way for beginners to practise mindfulness. Even if you’re sure meditation is not for you, even using them to take the focus of negative thoughts could be effective. I’ve personally found Calm brilliant for reducing anxiety and it’s resources are totally accessibly for travellers. Phew.

Headspace is a less cluttered app focussing purely on meditation. Calm is great for people wanting more variety and includes many different meditations, ‘masterclasses’ (which are kinda like mindful podcasts), sleep music and breathing exercises.

Take ‘note’ of when you’re ruminating

If your thoughts are spiralling or you’re repeating the same negative thoughts… Think ‘I am thinking XYZ right now and my thoughts are spiralling’. Even just taking note of repetitive thoughts is a good place to begin, as it snaps your focus back to reality. Half of the battle with ruminating is acknowledging you’re doing it!

Some people may find it useful to literally take note. Some use a journal, others use the note app on their phone when they’re ruminating (and then delete it).

And take note of if you worry about the same things again and again and…

If you realise you tend to ruminate on the same things, see if you can change that. Maybe you’re anxious you’ve not got something done? Set aside MORE time than you need to accomplish it. Ie. 2 days downtime for a 1-day task. This way you’re more likely to succeed even if you procrastinate or didn’t sleep well the night before.

If you’re worried about money while travelling, find a way to effectively check your finances or consider implementing working abroad as part of your long-term travel plan.

Distract yourself

Chat to someone (in person or message a friend), try to take part in an activity such as a free walking tour or put a movie on.

I originally didn’t have Netflix but, since I spend nearly all evenings alone, found that this or the background noise of YouTube is better than me just stewing in my thoughts for hours haha.

Don’t judge yourself too harshly 🙂

When practising meditation or mindfulness, don’t think you’re bad at it when you slip back into the same negative thoughts again and again. Even just noticing the negative thoughts is progress! The stakes are super low with meditation haha.

Tell a friend when you’re feeling depressed or anxious.

Depression and anxiety are hard enough to deal with as it is, let alone when you’re travelling. On my recent trip, I told close friends the truth about the fact I was feeling depressed ‘as it was happening’ for the first time. Of course, it didn’t cure the issue, but having people keeping tabs on you and checking in on your mental health is invaluable.

Practise gratitude

Gratitude is shown again and again to be a REAL mood improver, even for people who are ‘naturally’ negative when tested in long-term studies. The key when practising gratitude is to schedule it into your daily routine (say by mentally listing 10 gratitudes at breakfast or before bed) and to BE SPECIFIC. It’s no use telling yourself you’re grateful for food and flights every day as you’ll stop having an emotional response.

Gratitude should be something specific. And consider how you felt.

Here are five examples of travel gratitudes I’ve had during depressed periods:

• I couldn’t go out today but booked a private room. The duvet was so warm and I felt protected and comforted.
• The train driver asked me to buy another train ticket as I forgot to activate mine. An English-speaker translated me and stuck up for me so I didn’t pay again. I felt relieved and thankful.
• At the moment I felt my worst, a friend happened to send me a link to an article I could read and it took my mind off things for a while
• I feel nourished after finding delicious and healthy vegetarian food today
• My flight was delayed and it gave me extra time to calmly listen to an interesting podcast. I didn’t panic and feel like I’m making progress with my flight phobia.

ADDITIONAL CHANGES

Above are the FIVE lifestyle changes that came up consistently in pretty much all of the mental health research I found. The below are additional changes other studies or health organisations have said improve mental health and may still be practised by a traveller even with depression or anxiety.

I’ve included them briefly in this post in case they are of interest to some of you.

LEARNING A NEW SKILL…

Not only is this a way to distract yourself from rumination and anxiety, but it’s always a potential way to incorporate physical activity and meet new people, even as a solo endeavour this is a good way to focus on something with clear positive progression. Academic minds may like to look at the free university short courses on Coursera, others may prefer to use YouTube videos to help them learn photography. Cooking classes are another popular way to learn something new.

ACTS OF KINDNESS…

The UK’s NHS lists this as a way to improve mental health issues… and I think they mean going a step further than typical British politeness.

Whether it’s helping an old lady cross the road, picking up some yummy treats and ibuprofen for the kid who’s caught a cold from hostel air-con or simply listening to your friend from home who’s in desperate need of advice. Maybe you can leave a handwritten ‘thank you!’ to your hostel’s reception desk or can help someone take a photo at a famous sight. If you’re socially smooth, invite an introverted solo traveller to come on a day trip with you.

Note: If choosing a volunteer programme abroad, be sure to research carefully. With ‘voluntourism’ becoming a big business, not everything is what it seems. Particularly avoid animal ‘sanctuaries’ where you are allowed to physically interact with animals. When donating, be sure to give to a well-known honourable organisation rather than directly to children who in some countries are taken out of school to beg.

DIRECT SUNLIGHT….

In some studies, there’s a sixth necessary factor in improving mental wellbeing: DIRECT SUNLIGHT.

Fortunately, this tip assuredly breaks my ‘harder to maintain while travelling’ rule. Even if you’re travelling a cold country, the chances are you’re going to get outdoors during daylight hours – and it’s the sunlight that has positive effects, rather than warmth. Sunlight can help your sleep too, which is a bonus.

If you’re someone who does struggle in Winter when the days are shorter, it might still be worth bearing in mind seasons when you pick your countries to avoid jumping continents and doing ‘Double Winter’. (No wonder I hit peak depression when I did this haha.)

It’s also worth repeating the now well-known tip that popping your phone on blue light mode before bed – or limited screen time during this period entirely – avoids tricking your brain into thinking it’s morning when you should be winding down to bed.

How do you think travellers can make lifestyle changes for their mental health?

I’ve given some of my own ideas about how we could implement the mental health advice, even while travelling. I definitely think it could be hard to stick to these changes if you’re not being encouraged by a professional, so if you’re travelling with a partner it could be a cool idea to get them involved.

For solo and budget travellers like myself? Start simple.

And let’s be realistic about what we can do. For example, set realistic exercise goals; if it’s too much energy to keep up going to the gym in a foreign country, that is totally okay. But we can make a decision to walk instead of taking the bus and take the stairs. Similarly, nearly all capital cities I’ve been to have health food shops or restaurants which make a change to bad travel food habits.

However, finding a sense of community – long shown to vastly improve mental health – is a trickier case to crack. I’d love to hear your thoughts on this.

Once again, please take this blog post with a pinch of salt.

There are no rules or guarantees when it comes to your mental health… Particularly when you’re listening to a blogger and not a medical professional! 🙂 Where possible, they should always be your first point of reference.

List of mental health contacts:

Lifeline for USA and Canada – providing counselling and support

800-273-8255 https://suicidepreventionlifeline.org/

Mental health hotlines for Australian citizens:

https://www.healthdirect.gov.au/mental-health-helplines

Complete list of mental health phone numbers provided by the NHS (UK).

https://www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/

This is a list of all mental centres available to reach by email (UK).

https://www.centreformentalhealth.org.uk/crisis-contacts

International Crisis Hotlines for advice and support (worldwide).

http://www.suicide.org/international-suicide-hotlines.html

Contact the country’s emergency number in case of an emergency.

Photos by Rob Mulally Instagram: @robmulally

What are your experiences with travelling with depression or anxiety? Is there any further mental health advice you think would be useful to travellers?

 

 

 

 

 

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A post shared by ✈️ Solo travel hag (@cassiethehag) on Nov 3, 2019 at 8:32am PST