Your friends, your sport club, your favorite restaurant, your family, your home. As we move to a new country, we leave behind many of the core elements that shape our identity. And the shift is rarely painless. In 1995, I moved from Italy to Denmark: I was 26 years old, had both professional and academic accomplishments on my back, and my plan was to move my life in the new country. With hindsight, my plan had a major flaw from the start: We cannot move our life anywhere – We must re-shape it as we relocate. When we hear about “Integration” in the media, the focus is mostly on the acceptance of the host country´s laws, on learning the language, or on adding a few new holidays to our calendar while we get adjusted to new food tastes. However, the process of integration also implies shifts in our cultural and personal identity: These changes can determine deep senses of loss, alienation and isolation. This is also how I felt in those early times in Denmark. My communication skills failed me (Danish is not the easiest language to learn!), my professional experience found unknown and slippery grounds, and my academic achievements had to measure themselves against different pre-requisites – New in a foreign country, I remember above all the feeling of being socially invisible.

The social compass

Since early childhood, we acquire the habit of self-evaluation by internalizing the concepts of good/bad, competent/incompetent and approval/disapproval based on the way people around us assess our thoughts and actions. Therefore, whether we see ourselves as competent, shy, friendly or reliable, our self-evaluations depend on two main factors: How we compare ourselves to others and how others see us. In this sense, “finding ourselves” and “knowing ourselves” are two achievements that strongly depend on our socio-cultural environment. Relocating to a new country, immerging ourselves in a different culture, while losing the reference points that – like a compass – indicated our position within our social group, can make it difficult for us to find meaning. Marcia (2002)[2], elaborating on the work of the psychologist and psychoanalyst Erik Erikson[3], proposes that identity crises in adulthood reflect the experience of losing our role in society, and of questioning our identity and our own values.

Accordingly, a number of research studies have revealed that persistent problems in cultural adaptation are associated with increased rates of mental health problems among immigrants.

Some of the most common signs of finding ourselves in existential and identity crises are:

Loss of sense and meaning of one’s life and of life in general
Sense of emptiness accompanied by physical and mental fatigue
Lack of motivation and interests
Indifference or extreme difficulty in coping with unforeseen situations
Diffuse sense of apathy
Lack of sense of belonging
Substance abuse (e.g., alcohol, drugs)
Anxiety
Helplessness
Depression

The overall outcome of our self-evaluations determines our self-esteem. Therefore, the sense of deculturation that might get hold on us as we move to a new country can bring along a feeling of failure, as we measure ourselves against new social norms, new traditions and new professional challenges. The discrepancy between our expectations and our achievements can leave us vulnerable to psychological and emotional distress, especially in form of stress, anxiety and depression. Accordingly, research shows that the risk of depression is particularly high among those of us who migrate to a new country[4].

Breaking through and Starting anew

It is estimated that the impact of identity and existential crises will continue to increase as technological tools, urbanization and globalization keep changing our lifestyles and challenge our priorities. Along with this development, data show us that the number of individuals who are offered medical treatment against depression and anxiety – e.g., SSRIs such as Prozac, Zoloft, Paxil, Lexapro, Celexa, or SNRIs such as Cymbalta – increases by at least 20% every year. It is understandably tempting (not to mention, cheaper and faster) to seek pharmacological relief to cope with the psychological and emotional consequences of losing own balance in life. However, the side effects of these remedies often have a significantly negative impact on the individual, such as emotional flattening, insomnia and weight gain. More so, up to 45% of people who have undertaken medical treatment against depression, experience a relapse at the end of the treatment and, even more worrisome, about 56% of people who attempt to come off antidepressants experience withdrawal effects.

Finally, by offering a quick remedy against the symptoms of our crises, medical treatment deprives us of one of the greatest components of psychological well-being: Our sense of agency and the awareness of our own strength in reestablishing our psychological and emotional balance. These important achievements are at the core of psychological therapy, where identity and existential crises are not muted, rather recognized and fully addressed. Together with the therapist, the individual looks at the past, reviews own strengths and weaknesses and, in the light of the current situation, shapes new fulfilling paths of life.

We cannot restore our sense of agency and self-esteem by swallowing a pill, but we can do so by striving to find our inner self, nurturing our true values, reviving our self-esteem and gaining back the control over our life. It might take longer to walk this path but, once we find ourselves at the end of it, our grip on our life will be stronger.

Claudia Carrara, Ph.D., M.Sc. Psychologist

[1] James, R.K. (2007) Crisis Intervention Strategies (6th ed.). USA, CA: Thomson Brooks/Cole.

[2] James E. Marcia (2002) Identity and Psychosocial Development in Adulthood, Identity, 2:1, 7-28

[3] Erikson EH. (1968) Identity, youth and crisis. New York, NY: W. W. Norton & Company, Inc.

[4] Frank K, Hou F. (2019) Source-country individualism, cultural shock, and depression among immigrants. Int J Public Health. May;64(4):479-486.